Implementation (WP5): Presentation of Main Outcomes Lena Mehrmann, - PowerPoint PPT Presentation

Patient Safety Initiatives Implementation (WP5): Presentation of Main Outcomes Lena Mehrmann, Tugce Aksoy, Christian Thomeczek German Agency for Quality in Medicine (AQuMed / ÄZQ) PaSQ 5 th Coordination Meeting – March 12 th , 2015 – Brussels

Work Package 5 (WP5) – Patient Safety Initiatives Implementation Content Implementation of selected Safe Clinical Practices (SCPs) in  Healthcare Organisations (HCOs) in European countries Compilation of one tool box per SCP  Monitoring and assessment of implementation process  Results Report on implementation experiences  Tested tool boxes – were they helpful?  L. Mehrmann, M.Sc. PaSQ Coordination Meeting 2 Brussels 2015

Presentation of main outcomes Agenda 1. Safe Clinical Practices for WP5 implementation 2. Overview of participating PaSQ Member States 3. Support tools for the implementation process 4. Monitoring and assessment 5. Results (implementation progress, tool boxes) 6. Conclusion and final remarks L. Mehrmann, M.Sc. PaSQ Coordination Meeting 3 Brussels 2015

Safe Clinical Practices for WP5 implementation Clinical practices to enhance patient safety which are implemented OR  for which a baseline measurement has  which have been evaluated using an been established before implementation, intervention and a control group,  for which a measurement has been  for which an improvement in patient safety established after implementation, has been demonstrated when comparing  which have shown an improvement in these two groups. patient safety as per the before and after measurement. Demonstrated effectiveness in clinical trials L. Mehrmann, M.Sc. PaSQ Coordination Meeting 4 Brussels 2015

Safe Clinical Practices Demonstrated effectiveness in for WP5 implementation clinical trials  WHO Surgical Safety Patient Transferability involvement Checklist (SSC)  Medication Reconciliation Criteria (MedRec)  Multimodal intervention to increase hand hygiene compliance (HH)  Paediatric Early Warning Scores (PEWS) Existing Feasibility of implementation implementation tools within PaSQ L. Mehrmann, M.Sc. PaSQ Coordination Meeting 5 Brussels 2015

Participation in WP5 implementation 18 PaSQ Member States L. Mehrmann, M.Sc. PaSQ Coordination Meeting 6 Brussels 2015

Participation in WP5 implementation Medication Reconciliation 106 HCOs WHO Surgical Safety 86 HCOs Checklist 220 HCOs* Hand Hygiene Compliance 81 HCOs Paediatric Early 35 HCOs Warning Scores * Several HCOs applied more than one SCP L. Mehrmann, M.Sc. PaSQ Coordination Meeting 7 Brussels 2015

Support tools for the implementation process Implementation tool box for each SCP L. Mehrmann, M.Sc. PaSQ Coordination Meeting 8 Brussels 2015 http://www.pasq.eu/Wiki/SCP/WorkPackage5ToolBoxes.aspx

Support tools for the implementation process Webinars were organised for each SCP MedRec WHO SSC PEWS Hand Hygiene  Aim: Foster the exchange of knowledge and experience  Main target audience: The coordinators in the HCOs or other people from the HCOs taking part in the WP5 implementation process L. Mehrmann, M.Sc. PaSQ Coordination Meeting 9 Brussels 2015 Source picture: http://www.nextgenerationseo.de/wp-content/uploads/2012/02/webinar.gif

Monitoring and assessment  Baseline questioning (BQ): September 2013  Endline questioning (EQ): September 2014  Self-assessment tools for the monitoring process L. Mehrmann, M.Sc. PaSQ Coordination Meeting 10 Brussels 2015

Results Medication Reconciliation:  HCOs that took 95 out of 106 HCOs (90%) part in the whole WP5 implementation WHO Surgical Safety  and assessment process Checklist: 62 out of 86 HCOs (72%) Hand Hygiene:  48 out of 81 HCOs (59%) PEWS:  Results 15 out of 35 HCOs (43%) L. Mehrmann, M.Sc. PaSQ Coordination Meeting 11 Brussels 2015

Results HCOs that took What was the implementation progress part in the whole WP5 made within the main WP5 implementation implementation phase (Sept. 2013 - Sept. 2014)? and assessment process Have the SCPs been implemented as proposed in the tool boxes; means that the information and tools proposed have been used? Results L. Mehrmann, M.Sc. PaSQ Coordination Meeting 12 Brussels 2015

Results implementation progress (SSC) WP5 implementation was used to deepen the implementation WHO SSC use in the HCOs (N BQ =63, N EQ =62) Number of baseline answers: 63 (100%) Number of endline answers: 62 (100%) 100% (62) 100% 79% (50) 50% 21% (13) L. Mehrmann, M.Sc. PaSQ Coordination Meeting 0% (0) 13 Brussels 2015 0% In use Not yet in use

Results implementation progress (SSC) Process steps derived from WP5 tool box  “fully implemented” was the best selected answer option in BQ and EQ  BQ: 56% - 70%  EQ: 79% - 94% L. Mehrmann, M.Sc. PaSQ Coordination Meeting 14 Brussels 2015

Results implementation progress (HH) WP5 implementation was used to deepen the implementation Hand Hygiene practice use in the HCOs (N BQ =60, N EQ =48) Number of baseline anwers: 60 (100%) Number of endline anwers: 48 (100%) 98% (47) 100% 82% (49) 50% 18% (11) L. Mehrmann, M.Sc. PaSQ Coordination Meeting 2% (1) 15 Brussels 2015 0% In use Not yet in use

Results implementation progress (HH) + Components of the practice from WP5 tool box  “partly implemented” / “fully implemented” were the most selected answer options in BQ and EQ  BQ: 47% - 92%  EQ: 50% - 94% L. Mehrmann, M.Sc. PaSQ Coordination Meeting 16 Brussels 2015 …

Results implementation progress (MedRec) WP5 implementation was used to start with the implementation Medication Reconciliation use in the HCOs (N BQ =96, N EQ =95) Number of baseline anwers: 96 (100%) Number of endline anwers: 95 (100%) 100% 78% (74) 70% (67) 50% 30% (29) 22% (21) L. Mehrmann, M.Sc. PaSQ Coordination Meeting 17 Brussels 2015 0% In use Not yet in use

Results implementation progress (MedRec) Process steps derived from WP5 tool box  BQ: “not at all implemented” (63% - 72%)  EQ: “fully implemented”, at least for a pilot test (52% - 60%) L. Mehrmann, M.Sc. PaSQ Coordination Meeting 18 Brussels 2015

Results implementation progress (PEWS) WP5 implementation was used to start with the implementation PEWS use in the HCOs (N BQ =15, N EQ =15) Number of baseline anwers: 15 (100%) Number of endline anwers: 15 (100%) 100% 93% (14) 67% (10) 50% 33% (5) 7% (1) L. Mehrmann, M.Sc. PaSQ Coordination Meeting 19 Brussels 2015 0% In use Not yet in use

Results implementation progress (PEWS) Process steps derived from WP5 tool box  BQ: “not at all implemented” (87%)  EQ: “fully implemented”, at least for a pilot test (40% - 47%) L. Mehrmann, M.Sc. PaSQ Coordination Meeting 20 Brussels 2015

Results implementation progress At a glance 100% 98% +16% +21% 82% 79% 78% 67% In use (BQ) In use (EQ) +48% 30% +60% L. Mehrmann, M.Sc. 7% PaSQ Coordination Meeting 21 Brussels 2015 WHO SSC Hand Hygiene MedRec PEWS

Results HCOs that took What was the implementation progress part in the whole WP5 made within the main WP5 implementation implementation phase (Sept. 2013 - Sept. 2014)? and assessment process Have the SCPs been implemented as proposed in the tool boxes; means that the information and tools proposed have been used? Results L. Mehrmann, M.Sc. PaSQ Coordination Meeting 22 Brussels 2015

Results tool boxes The WP5 tool boxes were used by between 68% (SSC) and 94% (Hand Hygiene) of the HCO coordinators Use of WP5 tool boxes Endline answers 94% 87% 78% 68% L. Mehrmann, M.Sc. PaSQ Coordination Meeting 23 Brussels 2015 Hand Hygiene (N=48) PEWS (N=15) Medication Reconciliation WHO Surgical Safety (N=94) Checklist (N=62)

Results tool boxes The key tools were used by between 48% (MedRec) and 87% (PEWS) of the HCO coordinators. Use of key tools Endline answers 87% 81% Key tools: 72%  Identified by literature/web search 48%  Offered by major international institutions PEWS (N=15) WHO Surgical Hand Hygiene Medication L. Mehrmann, M.Sc. PaSQ Coordination Meeting Safety Checklist (N=48) Reconciliation 24 Brussels 2015 (N=62) (N=94)

Results tool boxes The specific tools were used by between 57% (MedRec) and 79% (Hand Hygiene) of the HCO coordinators. Use of specific tools Endline answers Specific tools: 79% 74% Identified by a questioning of PaSQ National Contact 57% Points and EU Stakeholders L. Mehrmann, M.Sc. Hand Hygiene (N=48) WHO Surgical Safety Medication Reconciliation PaSQ Coordination Meeting 25 Checklist (N=62) (N=94) Brussels 2015

Results tool boxes The most used information from the WP5 tool boxes varied according to the SCP  Hand Hygiene (N=48) 87% L. Mehrmann, M.Sc. PaSQ Coordination Meeting 26 Brussels 2015

Results tool boxes The most used information from the WP5 tool boxes varied according to the SCP  Paediatric Early Warning Scores (N=15) 47% each L. Mehrmann, M.Sc. PaSQ Coordination Meeting 27 Brussels 2015

Results tool boxes The most used information from the WP5 tool boxes varied according to the SCP  Medication Reconciliation (N=94) 46% L. Mehrmann, M.Sc. PaSQ Coordination Meeting 28 Brussels 2015