International Forum on Quality & Safety in Healthcare Strive - - PowerPoint PPT Presentation

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International Forum on Quality & Safety in Healthcare Strive - - PowerPoint PPT Presentation

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The 19 th Annual Institute of Healthcare Improvement and BMJ International Forum on Quality & Safety in Healthcare Strive for Excellence, Seek Value, Spark a Revolution Paris, 08-11 April 2014 What Matters to You? Patient Safety Stories

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The 19th Annual Institute of Healthcare Improvement and BMJ

International Forum on Quality & Safety in Healthcare

Dr Nancy El-Farargy NHS Education for Scotland ‘Teach-Back’ Session: 20 May 2014

Strive for Excellence, Seek Value, Spark a Revolution

Paris, 08-11 April 2014 What Matters to You? Patient Safety Stories and Experiences

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International Forum on Quality & Safety in Healthcare, Paris 2014

  • Privileged to learn from international leaders
  • Over 3000 guests from over 75 countries
  • Share NHS Education for Scotland research
  • What Matters to You? Using Patient Safety Stories to Enhance

Patient Safety and Patient Experiences

  • Making the Most of Patient Safety Stories
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  • Joint NHS Scotland Exhibition Stand attracted a wide audience
  • Scottish Government
  • Healthcare Improvement Scotland
  • NHS Education for Scotland

International Forum on Quality & Safety in Healthcare, Paris 2014

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‘Team Scotland’

  • 08.00 ‘huddle’ every morning!
  • Sharing learning with NHS Scotland staff and beyond

Picture via @ejsreid

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Patient Safety Stories and Experiences

  • Lots of learning, discussions and topics
  • Today focusing on
  • Patient stories
  • Narrative
  • Improving experiences
  • Theme seemed to resonate throughout the Forum
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Asking Patients: ‘What Matters to You?’

  • Reflections from Keynote 1:

Maureen Bisognano, President and CEO, Institute

  • f Healthcare Improvement
  • What matters to you?
  • Trusting the young
  • What are your likes and

dislikes?

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The Scottish Experience

  • Scottish Patient Safety

Programme (SPSP)

  • A national approach to

safety and innovation across the Scottish healthcare system

  • Translating policy to

frontline action

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The Consultant is the Patient

  • Personal family reflections
  • Consultant treated in his own hospital
  • Factors for change in medical culture
  • Person-centred care; listen to patients
  • Balance between ‘patient centred systems v checklist patient

assessments

Buist, M.D. (2010). How I nearly met my maker: A story of clinical futile cycles and survival. The Joint Commission Journal on Quality and Patient Safety, 36(7):334-336. Available online: http://www.utas.edu.au/__data/assets/pdf_file/0008/135674/Buist-2010.pdf [Accessed 19 May 2014]. ‘Doctor in the House’ Documentary (2009). Available online: http://www.abc.net.au/austory/specials/doctorhouse/ [Accessed 19 May 2014].

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Shadowing the Patient Journey

  • Looking at improvements through the eyes of both patients and

staff experiences

  • No industry survives without focusing on the needs (and ‘wants’)
  • f end users
  • Shadowing patients
  • Determine current state and process maps accurately
  • Great for ‘on-boarding’
  • Continuously engage with users in real-time – co-design
  • Break down any perceived and real silos
  • The value is in the experience – how patients progress

through to wellness

DiGioia, A.M. & Greenhouse, P.K. (2011). Patient and family shadowing: Creating urgency for change. Journal of Nursing Administration, 41(1): 23-28. Hawkes, N. (2013). Patients’ actual care pathways often differ markedly from doctors’ perceptions. BMJ, 347:F6728. Available online: http://www.bmj.com/content/347/bmj.f6728 [Accessed 19 May 2014].

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What Matters to You? Poster Presentation

  • I presented our NHS Education for

Scotland research on patient safety stories

  • Listening, reflecting, learning and

changing practices through data and emotive narrative

  • Looking at improvements through

the eyes of both patients and staff experiences

  • Where:
  • Board meetings
  • Safety briefs
  • Handover

What matters to you? Using patient safety stories to enhance patient safety and patient experiences. (El-Farargy, et al., 2014, International Forum on Quality and Safety in Healthcare. Paris, 08-11 April 2014).

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Making the Most of Patient Safety Stories

  • Stakeholders told us:
  • How stories are gathered
  • Where they are

disseminated

  • Preferred formats
  • Outcomes and lessons

learned

  • Onward improvements
  • Caveats
  • New to the area
  • Ethical issues
  • Evidence base v

anecdotes

Making the most of patient safety stories: Enhancing patient safety and patient experiences. NHS Education for

  • Scotland. Available online: http://www.nes.scot.nhs.uk/media/2514414/enhancing-the-patient-experience-via-

storytelling20140121.pdf [Accessed 19 May 2014].

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Voices of Staff and Patients

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Engaging Hearts and Minds

  • Why do stories matter?
  • Turning data into an experience
  • Resonating with experiences
  • Establishing connections
  • Emotive narrative
  • Creating significance
  • Catalysing improvement and change
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  • Our vision is that by 2020 everyone is able to live longer

healthier lives at home, or in a homely setting.

  • We will have a healthcare system where we have integrated

health and social care, a focus on prevention, anticipation and supported self management.

  • When hospital treatment is required, and cannot be provided

in a community setting, day case treatment will be the norm.

  • Whatever the setting, care will be provided to the highest

standards of quality and safety, with the person at the centre

  • f all decisions.
  • There will be a focus on ensuring that people get back into

their home or community environment as soon as appropriate, with minimal risk of re-admission.

Strategic Backdrop: “2020 Vision”

Scottish Government , 2020 Workforce Vision. Available online: http://www.scotland.gov.uk/Topics/Health/NHS- Workforce/Policy/2020-Vision [Accessed 19 May 2014].

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What is Quality Improvement?

  • The systematic, data-guided activities designed to bring about

immediate, positive changes in the delivery of health care in particular settings.

  • While quality improvement uses a wide variety of methods, they

all involve deliberate actions to improve care, guided by data reflecting the effects.

  • Depending on the activity, quality improvement can look like a

type of practical problem solving, an evidence-based management style, or the application of a theory-driven science

  • f how to bring about system change.
  • (p. S5)
  • Addition: ongoing journey of improvement (in any setting)

Baily, M.A. et al (2006). The ethics of using QI methods to improve health care quality and safety. A Hastings Center Special Report. Available online: http://www.thehastingscenter.org/uploadedFiles/Publications/Special_Reports/using_qi_methods_to_improve_health _care_quality_safety.pdf [Accessed 19 May 2014].

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Reflections from the BMJ

  • “What matters to you?”
  • Listening to patients and responding to concerns
  • Co-producing health with patients
  • “Prevention is better than cure” – out-with formal healthcare

systems

  • Treat every patient as a family member

Richards, T. (2014). “All I ask is that you listen”. British Medical Journal Group Blogs. Available online: http://blogs.bmj.com/bmj/2014/04/14/tessa-richards-all-i-ask-is-that-you-listen/ [Accessed 19 May 2014].

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Everyone Matters: Everyone Contributes

  • Co-producing healthcare between staff, patients and families
  • One example:
  • Patient Opinion website
  • https://www.patientopinion.org.uk/
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Delivering Education for Excellence in Service Delivery

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Thank You

The 19th Annual Institute of Healthcare Improvement and BMJ

International Forum on Quality & Safety in Healthcare

Dr Nancy El-Farargy Nancy.El-Farargy@nes.scot.nhs.uk NHS Education for Scotland, 20 May 2014

Strive for Excellence, Seek Value, Spark a Revolution

Paris, 08-11 April 2014 What Matters to You? Patient Safety Stories and Experiences