Safer Higher Quality Care for
our Patients
HSCP Research Conference
Friday 28th February 2014
Dr. Philip Crowley, National Director QPS
Media coverage
€320k payout as hospital says
sorry over death from
dehydration
Healthcare System Failures
Where does improvement Happen?
National
Group
Ward
Quality Improvement of Patient care
Where Improvement Happens
Pathways
Leadership
Patient involvement
Clinical Governance
Education & Learning:
- Measurement
- QI Methods
Guidelines
Collaboratives
Conditions
Quality Improvement of Patient care
National
Group
Ward
A culture change – safety first
1. Individual relationship between HSCP and patient
2. Multidisciplinary Team / Ward
3. Hospital / organisation
Patient and H+SCP




Take ownership – accountable for the safety of care
Pivotal role in respecting and defending the dignity
of every stage of life
Pivotal role in advocating for and on behalf of
patients
What are the 3 biggest challenges that prevent me
in delivering care – communicate out and up
MDT and Ward

Leadership role in drawing others into supporting
change
 Engaging
Patients and staff you manage
 Safety Pause
MDT and Ward

Understanding what safety
and quality means for your
ward
Safer Better Healthcare
Standards
 Multidisciplinary team
prompts

MDT and Ward

How well are you delivering Safe Quality Care
 QA+I
tool, clinical audit
Clinical audit guidelines
Hospital / Organisation


Strong culture of Governance for Quality and Safety – be a
champion for quality/question everything
Generate a culture of listening to your staff and patients


Quality and Safety Walkrounds
Transparency


Patients – open disclosure
Measurement – Quality Profile
Checklists


Safe survey national policy and checklist
Ward rounds principles for best practice and checklist
Open disclosure





National Guidelines
National Policy
Guide for health and social care
staff
Patient information leaflet
Staff support ‘assist me’ model
0
Oct
4
2
1
2
1
Post Operative Hip #
1.5
1
0.5
0
Mortality Indicators
2
0
0
4
Time to Hip # surgery
5
1.5
1
0.5
0
0
5
0
4
Medication Management
10
2
6
2
6
3
1
6
3
0
1
0
1
1
5
1
1
1
3
4
Dec
1
0
Oct
Wound Dehiscence
2
Nov
2
5
Sept
1
1.5
1
0.5
0
2
July
Aug
Transfusion Reaction
May
3
0
2
June
5
April
In hospital fracture
March
0
1
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
2
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
Dec
Nov
Oct
Aug
4
Feb
Dec
2
Dec
Oct
1
Nov
0
Sept
2
Nov
Sept
July
0
Oct
Sept
Aug
July
May
June
1
Aug
2
July
1.5
June
April
0
June
May
April
Feb
March
2
Jan
1
0.5
May
Post Operative DVT / PE
March
Jan
3
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
2
0
Feb
4
April
3
1
March
2
Jan
4
Feb
Accidental Puncture or
Laceration
Jan
0 0 0 0 0 0 0 0
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
Dec
1
6
4
2
0
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
Dec
Oct
Nov
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
Foreign Body left in Post
Operatively
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
Dec
Oct
2
Nov
3
Nov
Aug
Sept
4
Sept
2
1
Sept
July
1
Aug
July
6
Aug
May
June
Occurances
0 0 0
July
May
2
June
2
May
April
March
10
June
0
4
April
3
March
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
20
April
0
Feb
2
1
0
March
Quality Improvement
Jan
0
Feb
+
Jan
Staff Experience
10
Feb
Patient Experience
Jan
Quality Profile
Dashboard of Quality Indicators and
Outcome Measures
10
In hospitals falls
3
7
0
Post Operative Sepsis
1
5
0
Iatrogenic Pneumothorax
1
Cardiac Arrest
3
2
1
10
Pressure Ulcers
5
2
1
Employee Likelihood to
Recommend
Employees & Patients:
Likelihood to Recommend
Patient Likelihood to Recommend
Press Ganey Associates
16
How can we support you?
Quality and Patient Safety
Division
Patients and Staff
Engagement
Improvement
Supporting and
Assuring Quality
Areas for focus by QPS
Listen to staff
Foster development
and growth
Listen to and
empower
patients
Embrace
Transparency through
Measurement
(Indicators/Clinical Audit)
Improve the Safety
of Patients
QI skills
and knowledge
Patient central




Patient Forums
National Healthcare Charter
Patient Safety Champions
Measuring experience
 Surveys
 Patient
stories – from ward to board
Listening to Staff

Staff experience – seek and value feedback/ideas
for improvement
Patient Safety Culture Survey/ Walk-rounds
Prioritise staff welfare

‘Walk in my shoes’


Elements of the National QI Programme
Each parallel element
targets a different level
of healthcare
professional, maximising
penetration of QI
capability across the
hospital system
Measurement



ASK FOR THE DATA
Data driven quality improvement
Number of incidents plus trends

Ensuring preventable don’t keep reoccurring
Quality Profile




New quality indicators
Patient experience and Staff experience
Complaints…
Clinical audit
Use data to
generate
light not heat
Berwick’s Challenge






Abandon blame as a tool and trust the good will and good intentions
of staff
Reassert the primacy of working with patients and carers to achieve
healthcare goals
Use quantitative targets with caution – they should never displace the
primary goal of better care
Recognise that transparency is essential and expect and insist on it
Give staff career-long help to learn, master and apply modern
methods for quality improvement
Make sure pride and joy in work, not fear, infuse the service
Thank You
Oh! The places you’ll go.....
And will you succeed?
Yes! You will, indeed!
(98 and ¾ percent
guaranteed.)
Kid, you’ll move
mountains!
Today is your day!
Your mountain is waiting.
So…get on your way!
Dr. Seuss