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Patient Safety &  Quality improvement

Patient Safety &  Quality improvement. Presentation drawn together by Dr Fiona Hignett – Paediatric Registrar, Wessex. With thanks to: Kate Pryde (consultant paediatrician, Southampton Children’s Hospital) Matt Smith (consultant anaesthetist Derriford Hospital, Plymouth).

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Patient Safety &  Quality improvement

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  1. Patient Safety & Quality improvement Presentation drawn together by Dr Fiona Hignett– Paediatric Registrar, Wessex. With thanks to: Kate Pryde (consultant paediatrician, Southampton Children’s Hospital) Matt Smith (consultant anaesthetist Derriford Hospital, Plymouth)

  2. Curriculum overview –Patient Safety & Safe Prescribing

  3. Underpinning knowledge

  4. Curriculum overview –Quality Improvement

  5. Underpinning knowledge

  6. Patient Safety • “Patient safety is the avoidance of unintended or unexpected harm to people during the provision of health care” (The WHO & NHS Improvement) Quality Improvement • "The combined and unceasing efforts of everyone  to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning)“ (Batalden and Davidoff, 2007)

  7. What is Quality Care? QUALITY SAFE EFFECTIVE PATIENT CENTERED TIMELY EFFICIENT EQUITABLE TEAM VALUES, EDUCATION TRAINING & LEARNING, ENVIRONMENT (Crossing the Quality Chasm IOM, 2001)

  8. Safety & Improvement Through the Ages…

  9. We’re still learning…

  10. A Promise to Learn, A Commitment to Act

  11. So how do we know if we’re providing a ‘quality’ service? Patient Outcomes Patient/parent feedback Staff survey CQC Report Complaints Audit Favourable Events ‘LfE’ Adverse Events Targets

  12. Turning Safety & Quality on It’s Head… • Safety I vs Safety II • Eric Hollnagel, EUROCONTROL, 2015

  13.  Culture & Joy 

  14. When Something Goes Well… #LfE

  15. When Something Goes Less Well…

  16. Types of Improvement REACTIVE PROACTIVE

  17. QI builds bridges between… Scientific Approaches, theory & knowledge Delivery of real life medical care Above all it is about making the changes that improve practice (for patients and staff)

  18. IHI Model for Improvement http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

  19. Making Improvements(1) Understand & Investigate the Situation

  20. Tools to help Process Mapping Affinity/Fishbone Diagram Driver Diagram

  21. Making Improvements(2) Engage hearts & Minds

  22. Making Improvements(3) Data Drives Improvement

  23. Pareto Chart & Run Charts

  24. Making Improvements(4) Making a Change

  25. A SMART Change • Specific • Measurable • Achievable • Realistic • Timely

  26. Making Improvements

  27. Striving For Success..

  28. Resources & Reading • Mid-Staffordshire Francis Inquiry Report: • https://www.gov.uk/government/collections/mid-staffordshire-nhs-foundation-trust-news-and-publications • Berwick Report: A Promise to learn, A commitment to act: • https://youtu.be/xb-PjOgxHeo • https://www.gov.uk/government/publications/berwick-review-into-patient-safety • From Safety-I to Safety-II: A White Paper: • https://www.england.nhs.uk/signuptosafety/wp-content/uploads/sites/16/2015/10/safety-1-safety-2-whte-papr.pdf • RCPCH Compass E-Learning: https://rcpch.learningpool.com • Quality Improvement • Paediatric Prescribing Principles • RCPCH QI resources: • https://www.rcpch.ac.uk/work-we-do/quality-improvement-patient-safety • Paediatric ePrescribing (SCRIPT) • www.safeprescriber.org

  29. Resources & Reading • Staff engagement toolkit: • https://www.nhsemployers.org/~/media/Employers/Documents/SiteCollectionDocuments/staff-engagement-toolkit.pdf • IHI Joy in work: • https://qi.elft.nhs.uk/wp-content/uploads/2017/07/IHI-Framework-for-Improving-Joy-In-Work.pdf • Learning from Excellence: • https://learningfromexcellence.com/resources-and-evidence/ • Duties of a Doctor • https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice/duties-of-a-doctor • Serious Incident Framework: • https://improvement.nhs.uk/resources/serious-incident-framework/ • IHI Model for improvement: • http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx • The Health Foundation: • https://www.health.org.uk/ • NHS Improvement: • https://improvement.nhs.uk/

  30. Useful Conferences/Meetings • http://www.ihi.org/education/Conferences/Pages/default.aspx • Next meeting March 27–29th, 2019Glasgow, ScotlandBMJ and IHI, with strategic partners, will bring together more than ​3,000 health care leaders and practitioners from 70+ countries • And if travelling not possible they also have virtual training modules: http://www.ihi.org/education/WebTraining/Pages/default.aspx • https://www.risky-business.com/london.php] • Yearly conference with Paediatrics Day • June 5th-7th, London, England • https://www.fmlm.ac.uk/ • Regular meetings with opportunities for trainees to showcase their quality improvement work • https://www.rcpch.ac.uk/news-events/rcpch-conference/programme-at-a-glance • Quality Improvement Committee Specialist Interest Group Sessions to attend • May 13th-15th May, Birmingham, England

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