CHA Patient Safety & Quality
Special Interest Group
Paediatric Safety & Quality Curriculum
Pre-meeting Questionnaire for Member Hospitals
July 2014
Aims:
This questionnaire has been developed by the Quality & Safety Special Interest Group of CHA. It aims to assist
members to identify and share ideas and resources related to establishing and maintaining a culture of continuous
quality & safety improvement.
The survey aims to elicit information on both educational products/resources and on the broader strategic goals in
place for equipping our workforce with knowledge, attitudes, skills and behaviours, and how we are set up for
achieving these goals.
Information and resources shared in response to this survey will be made available to all members via CHA’s secure
member website. They will also be analysed and discussed at the planned face to face meeting in Canberra on
Thursday 14 August.
From analysis of existing strategies, resources and tools, the SIG hopes to create a bi- national (Australian & New
Zealand) curriculum framework for safety & quality in children’s healthcare.
Please send any resources, documents or ideas you would like to share to CHA’s CEO, Barb Vernon via email:
ceo@wcha.asn.au together with your answers to this questionnaire by Friday 25 July 2014.
Children’s Health Queensland Response
1. Safety & Quality Strategies
1.1 Does your organisation have a strategic plan or policy in place around safety and quality of care at your
health service?
Yes
No
1.2 Do you have a strategic plan or policy that covers safety & quality specifically for paediatric care at your
health service?
No, we do not have a strategic plan for quality & safety at my health service
Yes, we have a strategic plan for quality & safety but it relates to all patients at my hospital and does
not mention care of paediatric patients
Yes we have a strategic plan/policy that specifically addresses paediatric care at my hospital (in whole
or in part)
I have attached a copy of my hospital’s strategic safety & quality plan
Children’s Health Queensland Hospital and Health Service - Patient Safety and Quality
Improvement Strategy 2013-2015
1.3 Do you believe your organisation’s strategy is helping to improve the safety and quality of paediatric
care at your health service?
Yes
No
 If yes, which provisions make it an effective strategy in your view?
A clear strategic framework provides a road map that allows our health service to deliver the best
possible health and highest quality of service to our children and families by:
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o
o
o
Outlining our vision and goals for safety, quality and performance
Identifying current gaps and organisation-wide initiatives that will be implemented to
achieve our goals
Identifying measures that will help know we are progressing towards achieving those
goals.
The CHQ strategy has four clear objectives: Safe; Timely, Appropriate and Effective that
ultimately contributes to providing safe, high quality Child and Family Centred Care. It is a strategy
that is simple to read and is easily recognisable through the use of a clearly interconnected
diagram. It is designed in a way that all levels of multidisciplinary staff at CHQ can engage with.
The strategy has been implemented both for organisational-wide and clinical unit service levels. At
each of these levels the implementation strategy has been designed to capture measurable
initiatives that:
o Accurately reflect specific safety and quality challenges
o Answer the question – what is going to be done about them?
o Report on the progress of these initiatives
o Measure demonstrable improvements against the strategy goals.
The Patient Safety and Quality Improvement Strategy and PSQ Governance Framework ‘From
board to bedside’ provide direction and support for our staff to practically contribute to an
organisational culture that embeds safety and quality in day to day practice.

If not, why not? What would need to be different about your strategy to make it more effective?
2. Safety & Quality Infrastructure
2.1 Does your organisation have an in-house clinical redesign school or similar?
Yes
No
Department of Health (DOH)
o Clinical Access and Redesign Unit (CARU)
Children’s Health Queensland (CHQ)
o Clinical Redesign - on a project basis
2.2 What positions do you have whose core responsibilities are in providing safety & quality improvement
support to clinical services? What competencies do you have in place for these positions?
CHQ Patient Safety and Quality Service Team as at July 2014
Position
Name
Role
EDMS
John Wakefield Executive Lead of the Patient Safety and Quality Service.
EDNS
Shelley Nowlan
Medical Lead Patient Safety
Andrew
Hallahan
Director Patient Safety and Quality
Service
Linda Ewing
Patient Safety Officer
Margaret
Wedge
Brian Amos
Patient Experience Improvement
Officer
Executive Co-Lead of the Patient Safety and Quality
Service.
To drive measurable improvements in patient safety at
CHQ through engaging medical staff in implementing a
best practice approach.
Drive measurable improvements in patient safety and
quality in CHQ HHS in line with the CHQ Patient Safety
and Quality Improvement Strategy and provide strategic
leadership and operational management of the CHQ
PSQS.
Provide expertise and leadership to clinicians to implement
patient safety initiatives and strategies throughout CHQ.
Develop and implement effective, reliable systems that
support staff to provide the best possible health care
experience to children and families in CHQ and address
deficits in this when these arrive.
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Data Analyst
Sara Mayfield
Audit and Assurance Officer
Jennifer Thorn
Curriculum and Training Officer
Amanda Martin
Administration Officer
Amy Major
Develop, coordinate and implement reliable, innovative,
timely analysis and reporting of patient safety and quality
data that informs and drives continuous health service
improvement.
Provide clinical audit, procedure and risk management
expertise and coordination to staff of CHQ, supporting the
function of the Patient Safety and Quality Service to
ensure safe practice and high quality outcomes.
Develop and deliver an effective set of tiered training
pathways from novice to expert that measurably and
continuously improve knowledge and skills in patient safety
and quality across CHQ.
Administrative support to the Patient Safety and Quality
Service.
2.3 Does anyone in your organisation have a designated training position accredited by RACP or similar
nursing or allied health professional organisations, specifically for undertaking training in improvement
science? E.g similar to the Darzi Fellowships in the UK.
Yes
No
If so what positions do you have?
3. Educational Resources
3.1 What do you already do at your place re educating staff in quality & safety?
Children’s Health Queensland (CHQ) Patient Safety and Quality
Educational Resources
F2F or
Paediatric
eLearning
Context?
CHQ Orientation
F2F -part of
Yes
1 day
- Family centred care
program
- PSQ
- Child safety
- Infection control
- Manual handling
Professional Update Program (PUP)
F2F - 1 day
Yes
program
- Intro to PSQ
- Family centred care
- Medication safety
- Falls and pressure injury prevention
- Infection prevention
- Managing environmental risk- cytotoxic
safety
Recognition and Management of the
Deteriorating Paediatric Patient (RMDPP)
- Recognition of the deteriorating patient
(CEWT, communication, clinical handover
and documentation)
- Management of the deteriorating Patient
(Airway/breathing, CPR/defibrillation
safety, circulation)
- Simulated Scenarios
- Mandatory CPR assessments
Human Error And Patient Safety (HEAPS)
F2F
Yes
Program
3 hours
Learning Sets – various PSQ topics
F2F
Yes
1 hour
Paediatric Grand Rounds (weekly) – various
F2F
Yes
topics
+ PPTs on
Developed by internal or
external? By whom?
Internal – People and Culture,
Training and Capability Unit
+ individual areas
Internal - Nurse Educators
+ individual areas
Internal - CHQ PSQS
Internal - CHQ PSQS
Internal -Training and Capability
+ individual areas
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Children’s Health Queensland (CHQ) Patient Safety and Quality
Educational Resources
F2F or
Paediatric
eLearning
Context?
LMS
Recognition and Management of the
F2F
Yes
Deteriorating Paediatric Patient (RMDPP)
+ prerequisite
Workshop
eLearning
program and
- Sophisticated paediatric simulation
quiz
education
- State-wide outreach program includes
(train the trainer model for RMDPP)
- In-reach component education
opportunities
Paediatric Life Support - Core Skills (PLS-C)
eLearning
Yes
Accessible state wide
module +
quiz
Developed by internal or
external? By whom?
Internal - CHQ Simulation
Training of Resuscitation for
Kids (STORK)
Internal in collaboration with
Department of Health (DOH) –
Clinical Skills Development
Service
Internal in collaboration with
DOH – Clinical Skills
Development Service
DOH – Clinical Skills
Development Service
Internal – NE/PICU &
Emergency nursing and medical
staff
Internal – Nursing, medical &
Allied Health Staff
Paediatric Life Support - Advanced Skills
(PLS-A)
Accessible state wide
Paediatric Advanced Care in Trauma (PACT)
eLearning
module +
quiz
eLearning
Yes
Mock MET Program
F2F in
clinical
environment
F2F –
simulation
pods
Yes
F2F –
monthly 1
hour
F2F – annual
event
Not
specificall
y
No
specificall
y
Yes
DOH – Patient Safety Unit
(PSU)
Yes
Both.
External – NPS – AMS modules,
Australian Society of Infectious
Diseases, Australian
Commission on safety and
Quality in Health Care - Infection
Control Workbook, Vemco
MedEd- Antifungal Stewardship
Modules
Simulation Programs
- Multidisciplinary programs conducted in
PICU & Emergency
- Nursing programs for general clinical
areas
- Allied Health program
Patient Safety Education Session – various
topics
Patient Safety Forum – various topics
- Pre and post forum workshops and
seminars are also available
QH Child Safety Education Module
Antimicrobial Stewardship (AMS) - E-learning
portal
Online
module
(PDF)
eLearning
Yes
Yes
Open Disclosure Consultant Training
Safety and Reliability Improvement Program
PRIME-CI (clinical incidents reporting)
F2F
F2F
F2F
Yes
Yes
Yes
Safe Infant Sleeping SIS
eLearning
Yes
DOH – Patient Safety Unit
(PSU)
DOH – Child Safety
Internal – Paediatric Grand
Rounds
DOH – Patient Safety Unit
External – Cognitive Institute
Internal –
CHQ PSQS
DOH – Clinical Skills
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Children’s Health Queensland (CHQ) Patient Safety and Quality
Educational Resources
F2F or
Paediatric Developed by internal or
eLearning
Context? external? By whom?
Development Service
Paediatric Pharmacy Learning Package
eLearning
Yes
Internal - Pharmacy
(Administration of medicines in children and
Drug Handling)
Recognition and Management of the
eLearning
Yes –
DOH – Patient Safety Unit
Deteriorating Patient (RMDP)
- 10
Lesson
lessons
4.3
CEWT
Rural and Remote and Primary Healthcare
eLearning
Yes
DOH – Patient Safety Unit
emergency Children’s Early Warning Tool
(video
(RRE CEWT and PHC CEWT)
presentation)
Queensland Health Early Warning and
eLearning
Yes –
DOH – Patient Safety Unit
Response Systems (Just in Time Training)
explains
- 1 lesson
ADDS and
CEWT
Clinical Handover at the Bedside
eLearning
No
DOH – Patient Safety Unit
(video
presentation)
Clinical Pathways: A Users Guide
eLearning
No
DOH – Patient Safety Unit
- 5 lessons
Clinician Disclosure Training
eLearning
No
DOH – Patient Safety Unit
- 6 lessons
Open Disclosure Consultant Training
eLearning
No
DOH – Patient Safety Unit
- 6 lessons
Pressure Injury Prevention and Management eLearning
No
DOH – Patient Safety Unit
- 6 lessons
Preventing Falls and Harm from Falls
eLearning
No
DOH – Patient Safety Unit
- 5 lessons
Malnutrition Prevention and Management
eLearning
Yes –
DOH – Patient Safety Unit
- 7 lessons lesson 7
Applying the 3 C’s in Medical Imaging:
eLearning
No
DOH – Patient Safety Unit
Correct Patient, Correct Procedure, Correct
- 1 lesson
Side and Site
Coronial Management
eLearning
No
DOH – Patient Safety Unit
- 6 lessons
Surgical Safety and Preoperative Checklists
eLearning
Yes
DOH – Patient Safety Unit
(Introduction by Professor Russel Strong)
(video
presentation)
Communicating Safely: AIDET and SBAR
eLearning
No
DOH – Patient Safety Unit
4
lessons
(includes one lesson on patient centred care)
Clinician Patient Safety Program – Essential
eLearning
No
DOH – Patient Safety Unit
Learning:
- 6 lessons
- Patient Safety
- Communication
- Patient-Centred care
- Working in Teams
- Clinical Incidents
- Clinical Handover
3.2 Which educational resources re Paediatric Quality and Safety are available to staff at your health
service? (please note if these resources are face to face or e-learning modules)
 Please see table above.
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3.3 Of the resources available, which ones are developed outside your organisation and by whom?
 Please see table above.
3.4 Of the resources available, which ones have been developed by staff at your health service?
 Please see table above.
3.5 Which educational resources/courses/modules are mandatory?
 Why is this mandatory?
 For which group of employees is it mandatory?
 What does mandatory mean?
o They must complete it?
o Must pass an assessment?
o Must demonstrate competency? How is this measured?
 What are the consequences for not meeting this mandatory course?
o Nil consequence?
o Failure to complete training term?
o Not allowed to do certain things, e.g. country relieving?
Mandatory
Education
Paediatric
Medication
Administration
Education +
Assessment
Why is this
mandatory?
Organisational
requirement –
mandated by
national
legislation,
standards and
guidelines
For which
employees?
RN, EN
What does
mandatory mean?
Completion of
education program
and online
assessment prerequisite, plus
mandatory
attendance (PUP)
plus bedside
medication
assessment
Safe
Prescribing
Organisational
requirement
Jnr Medical
Officers
Completion of
eLearning program
National Impatient
Medication Chart
Online Modules
All Pharmacy
Staff
Completion of
eLearning program
National Impatient
Medication Chart
Online Modules
Completion of
eLearning program
pre-requisite,
mandatory
attendance and
successful
completion of skills
based assessment
Core Paediatric
Life Support
Education
+Assessment
Organisational
requirement –
mandated by
national
standards and
guidelines
Nursing,
medical &
Allied Health
staff
Consequences
In the event that any
competency is not achieved in
the first assessment one
further reassessment is
undertaken. Subsequent failure
to meet the required standard
will be managed through the
PAD process in consultation
with the Clinical Facilitator,
NUM, Nurse Educator and
Nursing Director. This process
will include negotiation of
additional learning strategies
and timeframes for
achievement
Meet with relevant supervisors
or DDMS - an improving
performance action plan
(IPAP) is initiated until such
time as requirements are
completed
In the event that any
competency is not achieved in
the first assessment one
further reassessment is
undertaken. Subsequent failure
to meet the required standard
will be managed through the
PAD process in consultation
with the Clinical Facilitator,
NUM, Nurse Educator and
Nursing Director. This process
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Mandatory
Education
Why is this
mandatory?
For which
employees?
What does
mandatory mean?
Consequences
will include negotiation of
additional learning strategies
and timeframes for
achievement
Advanced
Paediatric Life
Support
Education
+Assessment
Organisational
requirement
Jnr Medical
Officers,
Residents,
first and
second year
Registrars
and new
medical staff
(with the
exception of
Consultants)
Completion of
eLearning program
pre-requisite,
mandatory
attendance at
practical program
options and
successful
completion of BLS
skills based
assessment
Meet with relevant supervisors
or DDMS - an improving
performance action plan
(IPAP) is initiated until such
time as requirements are
completed
Nursing
Medical
Some allied
health staff
who work in
Critical Care
areas
Advanced PLS
course online,
including the quiz
and a practical
defibrillation
assessment as part
of the standard
PLS competency
assessment.
In the event that any
competency is not achieved in
the first assessment one
further reassessment is
undertaken. Subsequent failure
to meet the required standard
will be managed through the
PAD process in consultation
with the Clinical Facilitator,
NUM, Nurse Educator and
Nursing Director. This process
will include negotiation of
additional learning strategies
and timeframes for
achievement
PICU
Registrars
Infection
Prevention and
Control & Hand
Hygiene
Organisational
requirement mandated by
national
standards
Cytotoxic Safety Organisational
requirement mandated by
national
legislation,
standards and
guidelines
Jnr Medical
Officers
Attendance RCH
Medical Orientation
or online (Hand
Hygiene Australia)
For all staff at
risk of
exposure to
cytotoxic
substances
i.e. drugs and
related waste
Mandatory
attendance (PUP)
Meet with relevant supervisors
or DDMS - an improving
performance action plan
(IPAP) is initiated until such
time as requirements are
completed
Meet with relevant supervisors
or DDMS - an improving
performance action plan
(IPAP) is initiated until such
time as requirements are
completed
Subsequent failure to meet the
required standard will be
managed through the PAD
process in consultation with the
Clinical Facilitator, NUM, Nurse
Educator and Nursing Director.
This process will include
negotiation of additional
learning strategies and
timeframes for achievement
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Mandatory
Education
Blood
Management
Why is this
mandatory?
Organisational
requirement –
mandated by
national
standards and
guidelines
Child safety
Legislative
self-assessment compliance
of capability
For which
employees?
RN, EN
What does
mandatory mean?
Completion of
eLearning program
mandatory (once
only)
- Patient Blood
Management
Jnr Medical
Officers
Completion of
eLearning
programs
 Clinical
transfusion
practice
 Collecting
blood
specimens
 Critical
bleeding
Mandatory
attendance
(orientation) and
completion of
eLearning module
Complete
capability selfassessment tool
Meet with the relevant
supervisors or DDMS - an
improving performance action
plan (IPAP) is initiated until
such time as requirements are
completed
Mandatory
completion of
eLearning module
Complete
capability selfassessment tool
Must be completed and signed
off by supervisor/line manger
RN, EN, AIN
Jnr Medical
Officers
Manual
Handling (CHQ
introduction to
the prevention
and
management of
musculoskeletal
disorders/rehabi
litation)
Fatigue Risk
management
Legislative
compliance
All CHQ Staff
MO, RN, EN,
AIN
Organisational
requirement mandated by
national
All Medical
Staff
Mandatory
attendance
(orientation) and
completion of
eLearning module
Mandatory
completion of
eLearning program
plus online
Consequences
Subsequent failure to meet the
required standard will be
managed through the PAD
process in consultation with the
Clinical Facilitator, NUM, Nurse
Educator and Nursing Director.
This process will include
negotiation of additional
learning strategies and
timeframes for achievement
Failure to meet the required
standard will be managed
through the PAD process in
consultation with the Clinical
Facilitator, NUM, Nurse
Educator and Nursing Director.
This process will include
negotiation of additional
learning strategies and
timeframes for achievement
Meet with relevant supervisors
or DDMS - an improving
performance action plan
(IPAP) is initiated until such
time as requirements are
completed
Failure to meet the required
standard will be managed by
appropriate line manager
Meet with the relevant
supervisors or DDMS - an
improving performance action
plan (IPAP) is initiated until
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Mandatory
Education
Why is this
mandatory?
standard
For which
employees?
What does
mandatory mean?
assessment
Consequences
such time as requirements are
completed
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3.6 Of the resources available, which ones are you most proud of? i.e. which ones do you believe are the
most effective in helping to enhance the safety and quality of paediatric care at your health service?


Paediatric Pharmacy eLearning Package - (Administration of medicines in children and Drug
Handling) – very effective from a medical education perspective
Mock MET program and simulation programs.
3.7 Is there an educational tool or resource that you would like to showcase at the meeting in Canberra on
14 August?
Yes
No
What is it: PSQS Educational Framework
Simulation – check with Louise Dodson?
3.8 What are the gaps in educational resources related to paediatric safety and quality available to staff at
your health service?
 Partnering with consumers (parental engagement in clinical care)
 Multidisciplinary discussion and learning - While we have made attempts at this in our RMDPP
and Learning Sets, and many sessions / workshops are open to all disciplines there are still
large gaps – rostering / timing is a significant issue for this to occur.
4
Building and Sustaining a Safety & Quality Culture
4.6 What does your health service currently do to foster/support a safety & quality culture at all levels of
your organisation?
o CHQ currently fosters a safety and quality culture at all levels by:
 Endorsing ‘Quality & Safety’ as one of CHQs five primary organisational strategic pillars
 Defining a clear PSQ strategic framework and supporting guidelines
 The Patient Safety & Quality Committee and establishment of relevant key SubCommittees provide PSQ governance and key strategic links
 Implementing a reporting and feedback cycle aligned to the framework, that encourages
and supports a continuous cycle of improvement
 Embedding key PSQ education and training within orientation processes for all staff
regardless of level, clinical or professional stream
 Reinforcing key PSQ best practice by providing on going access to educational
resources, and in particular, embedding key PSQ education within ongoing professional
development for multidisciplinary teams
 Communicating key PSQ messages through a variety of communication mediums.
o
The Patient Safety and Reliability Improvement Program – a CHQ partnership with the Cognitive
Institute.
 The move to Lady Cilento Children’s Hospital (LCCH) in November this year, provides a
unique opportunity to collectively build a culture which delivers highly reliable and safe
care centred on families and children. CHQ has entered into a partnership with the
Cognitive Institute to support leadership and staff in achieving this goal.
 The program will initially target CHQ service leads recognising how deeply influential
they are in establishing a safety culture and quality of service. The next stage will involve
recruiting, training and utilising safety ambassadors. The final stage will be the
implementation of the ‘always checking’ programme for all CHQ staff.
4.7 What tools or resources do you currently use to engage the interest of all staff in continuous
improvement re paediatric safety & quality?
CHQ is committed to continuous quality improvement which is supported by the Continuous Quality
Improvement Procedure. CHQ currently uses the following tools and resources to engage staff in
the continuous cycle of improvement:
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











Divisional reporting requirements against the Patient Safety and Quality Improvement Strategy –
quarterly reporting including key departmental actions, performance outcome measures/KPI and
90 day status
Audit and accreditation tools
Feedback on accreditation and audits (for example: Queensland Bedside Audit (QBA)
Statewide PSQ tool kits (e.g. Productive ward)
Development of clinical pathways
PSQ specific checklists (e.g. surgical safety, cytotoxic safety)
PRIME incident reporting tool and relevant feedback – often case based team discussion on
lessons learned in a safe no blame environment
Executive safety rounding
Safety rounding within specific services
Reporting to Learning Bulletins (PSU)
CHQ ebullition (weekly) – Safety and Quality communication
Nursing Leadership Development Program – all participants to complete a quality project.
Participants are extremely engaged in this process.
4.8 Of the existing strategies and tools, which ones if any do you believe are most effective, and why?
 Clinical Pathways project – clinicians engaged in this process as they see mutual benefit for
patients, families and themselves. The actual process of developing these is extremely
beneficial.
5
Outcomes from the 14 August Meeting
5.6 What do you want the outcomes to be from the planned meeting on 14 August? What outcomes would
make you happy that this was a good use of a day?
 To gain a very clear understanding of the current state of paediatric safety and quality
resources
– What is out there and available?

Identify the common gaps in paediatric safety and quality resources and discuss future
strategies to address these.

Define what a national safety and quality curriculum for children’s healthcare should/may
look like.

Discuss and develop a comprehensive moving forward plan from here ….
5.2 Is there a strategy or tool related to building or maintaining a Q&S culture that you would like to
showcase at the meeting in Canberra on 14 August?
Yes
 Please indicate the topic or name of the topic/resource you would like to present on and the name of
the person who would like to present.
o
Cognitive Institute – Safety and Reliability Improvement Program – Andrew Hallahan
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