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Quality Improvement Project – Patient Safety WalkRounds

Quality Improvement Project – Patient Safety WalkRounds. QUALITY IMPROVEMENT AND PATIENT SAFETY. By: Mrs Fan Wong Quality Assurance Manager Union Hospital. http://www.union.org. Session Outline. Background of Union Hospital Development Stages Project Objectives Implementation

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Quality Improvement Project – Patient Safety WalkRounds

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  1. Quality Improvement Project –Patient Safety WalkRounds QUALITY IMPROVEMENT AND PATIENT SAFETY By: Mrs Fan Wong Quality Assurance Manager Union Hospital http://www.union.org

  2. Session Outline • Background of Union Hospital • Development Stages • Project Objectives • Implementation • Findings and Results • Limitation • Way Forward

  3. 1. Background of UH • Opened in July 1995 • 1996: 110 beds • 2013 : 433 beds 3

  4. 1. Background of UH • Comprehensive private hospital with 433 beds Registered with Department of Health in 1994 • Newest private hospital in Hong Kong • Staffing above 1500 Full Time plus 100 Part Time • 2012 Service volume • EMC (ER) attendance: 85,238 • Specialist OPD: 95,664 • Admissions: 36,438 • Operations: 24,798 • Deliveries: 7,393 • Occupancy rate (midnight census): 68.9% • Bed utilization rate: 101.46% 4

  5. 1. Background of UH Value, Mission, Vision Professional, Reliable, Efficient, Friendly, Ethical and Resourceful 5

  6. 1. Background of UH • Management System • 1999 to now : ISO Quality Management System (QMS) 9000 series • 1999 to 2010 : UK Trent Accreditation Scheme (TAS) • Staff : SHS : General and work related OSH Ambassador WalkRounds : IOD • Incident : Risk Management Committee • Client Feedback : Hospital-wide SQS : Departmental SQS • Overall Review : Half yearly Management Review and Risk Prevention (MR&RP) 6

  7. 2. Development Stages The development of Patient Safety Walk Round…

  8. 3. Project Objectives

  9. Support from Senior Management and the Multidisciplinary Team… 4. Implementation Team Leader: Risk Manager / Chairperson of Risk Management Committee Members: Deputy Medical Director Quality Assurance Manager Departmental Clinicians (By invitation) Senior Nursing Officer (In-patient) Senior Nursing Officer (Out-patient) Estate Manager Occupational Safety and Health Team Leader Infection Control Team Leader Clinical Leaders from Allied Health Team

  10. 4. Implementation The Workflow and Logistic…

  11. 5. Findings and Results 1) Number of Items raised in Preview Form: Self Assessment

  12. 5. Findings and Results 2. Distribution of domains with recommendations raised by PSWR Team :

  13. 5. Findings and Results 3. Distribution and nature of Incident reported in the Part I: Preview Form Total: 35 cases 1 1 1 2 2 5 16 7

  14. 5. Findings and Results 4. Distribution of Component in Part II: Preview Form

  15. 5. Findings and Results 5. Risk Registry Summary of PSWR Jul 2012 – Mar 2013 as at 15 May 2013: 15

  16. 5. Findings and Results 6. The Task Type for completed and In-progress status as at 15 May 2013: * 4 pending review

  17. 5. Findings and Results 7. Number of self assessment risk issues and PSWR raised issues : 17

  18. 5. Findings and Results 8. Interview : Question mostly asked or mentioned : As indicated by PSWR members, the following were asked most from the scribe’s report The other 9 were not asked at all. 18

  19. 5. Findings and Results 9. Quantitative Data : • For the Visit • Department : 18 • WalkRounds Team : 180 • Department Staff : 60 • Total Time / hours : 221 Pre & Post WalkRounds among Staff in similar magnitude Commitment from Management is very Strong 19

  20. 5. Findings and Results 10. Qualitative Data : • Facilitate communicate to build open culture • Assist staff to focus on patient safety and staff safety • Willingless of staff and department head to discuss department issues enhanced • Timing control • No cancellation of any planned WalkRounds • Raised issues entered as Risk Registry for close monitoring • Specific environmental issues were included in new building plans 20

  21. 5. Findings and Results 11. System Environment and Facilities Issues : • Examples on Self Assessment • Care and concerns on :Patient : Privacy issue due to limited space Staff : staff toilet, medical grade refrigerator, storage space, security of DD System : Power Failure Drill • Concerns on environment :Paediatric Ward : re-design EDC : re-design 21

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  24. Commented by Hospital Chief Executive 24

  25. 5. Findings and Results • Achievements…

  26. 5. Findings and Results • Achievements…

  27. 6. Limitations 1) 2) 3)

  28. 6. Limitations 4) 5)

  29. 7. Way Forward • Leadership Commitment : Bennis et al remarked that: Major progress requires a multifaceted leadership approach, implemented and revisited over time, and includes activities, such as assessing a culture for safety, responding to data, striving for high reliability, requiring transparency, foster communication and teamwork, setting meaningful goals and sharing outcome

  30. 7. Way Forward 1) 2) 3) 30

  31. Reference • Kirkman-Liff B 2004 The structure, processes, and outcomes of Banner Health’s corporate-wide strategy to improve health care quality. Quality Management in Health Care 13(4):264-78 • Frankel A.S., et al.: Patient Safety Leadership WalkRounds Guide.2004 Institute of Health Improvement • Frankel A., Haraden C.: Shuttling toward a safety culture: Healthcare can learn from probe panel’s findings on the Columbia disaster. Mod Healthc 34:21, Jan. 2004 • Frankel A, et al 2009 The Essential Guide for Patient Safety Officer, Joint Commission resources, Illinois • Building a safer NHS for patients 2001. UK Department of Health website: http://www.doh.gov.uk/buildsafenhs/ch6.htm • Joint Commission Resources 2008 Patient Safety Rounds: A How-To Workbook, USA • Leape L. Can we make health care safe? In: Reducing medical errors and improving patient safety. A report of the National Coalition on Health Care and the Institute for Healthcare Improvement. Available at: http://www.qualityhealthcare.org/ihi/uploads/medical_errorsACT.pdf. Boston: ACT:2000 Feb • Peter C, Aly H 2009 Patient Safety First : Leadership for Safety: Supplement 1 : Patient Safety Walkrounds, UK • Hospital Authority (2012). Hong Kong Hospital Authority Clinical Governance Review Report. Available :http://www.ha.org.hk/haho/ho/pad/clinical_governance_review_en.pdf • Australian Health Care Facilities. The Australian Council on Health Care Standards, Sydney • Connor M., et al.: Creating a fair and just culture: One institution’s path toward organizational change. Jt Comm J Qual Patient Saf 33:617-624, Oct 2007 • Institute of Medicine: To Err Is Human: Building a Safer Health System Washington, DC National Academy Press, 2000 • Joint Commission Resources 2012 Even More Mock Tracers, USA • International Patient Safety Goals, Joint Commission Resources • Agency for Healthcare Research and Quality: 30 Safe Practices for Better Health Care. http://www.ahrq.gov/QUAL/30safe.htm (accessed Jun. 15, 2008). • Hospital Authority. (2012). Hospital Authority Strategic Plan 2012-2017. Available: http://www.ha.org.hk/upload/publication_29/359.pdf 31

  32. Thank You!Patient’s SafetyIt’s in our hands 33

  33. Q & A • Contact : fanwong@union.org

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