Safety Huddle EOC communication Potential items of discussion may include; • Incidents • staffing levels (CMS/Dispatch/Operational) • performance (EOC & Operational) • skill mix , sickness absence & RTWs • traffic reports & weather • vehicle availability & shortfalls • staff welfare issues • hospital & on scene delays • equipment availability/reliability (including IT) newly implemented/recently updated procedures
Safety Huddle key characteristics Focused meeting about one or more agreed harm/s Informed by QI tools and visual feedback Senior clinical leadership Agreed actions - set of team/individual actions (aimed at reducing risk of patient harm) Daily (Monday - Friday as minimum) - same time and place Brief (5-15 minutes) Multidisciplinary ALL the frontline team Celebration, celebration, celebration????
Safety Huddle important elements Informed by QI tools and visual feedback Celebration, celebration, celebration???? Ideas for what is possible in EOC? What measurements can we use? How can we display them easily? How do we celebrate our success?
EOC the next steps Spread of safety huddles and human factor work to continue Think about how you can get involved! Displays of measurement, learning and celebration How do you work as a team? How do you learn as a team? Is patient safety central to all you do?
Questions YASC-15-057-10
‘Trust me I am your patient’ Establishing a movement of Lay fellows Graham Prestwich & Marilyn Foster Lay Improvement Fellows/’Patient experts’
Graham Prestwich Lay Member Leeds Area Prescribing Committee • Achieving desired outcomes of care is far more important and far more valuable than just delivering processes of care. • Patients and carers make a critical contribution to achieving the desired and expected outcomes from medicines • Patient led initiative ‘sponsored’ by The Leeds Area Prescribing Committee
@MrGPrestwich • Patients identified the problem ‘unresolved issues’ • Patient focus groups identified what is important • Patients in partnership are part of the solution (innovation) x (n) x (effective communications) = Likelihood of making a real difference
Marilyn • Importance of Self Care & Prevention • Self Care – Patient involvement • Move from Crisis Care to Prevention - breaking the cycle • Difficult but essential to achieve • How I personally contribute.
Questions? Thoughts / feedback to: Claire.marsh@bthft.nhs.uk
Reducing the wait time from request for TTOs Dr Donald Richardson York Hospitals NHSFT
Problem
Improvement in a complex system is complicated!
Pharmacy Audit -2015 ? Doctor prescribes Patient informed of Pharmacy informed of Discharge received in Patients planned TTOs discharge discharge pharmacy discharge time 0 hours 1 2 3 4 5 6hours Discharge validated Discharge completed by pharmacy by pharmacy
Actions • Planning more discharges in advance so that more patients can be discharged before 11am • Communicating discharges to pharmacy more effectively • Reducing the gap between patients being informed about their discharge, pharmacy being informed and the discharge prescription being written – Actions in parallel are much better • Developing a discharge pledge about the completion time for discharge prescriptions received by pharmacy and responsibilities of all staff.
Highlighting the planned discharge date for all patients
Validated by pharmacist • to ensure accuracy of information • allows the pharmacist to review the patient’s drug chart and medical notes • and speak to the patient
Reconcile medications
Access to pharmacist • Ensuring wards are informed each day who their ward pharmacist is • How to contact them when discharge prescriptions are required. • All staff urged to contact pharmacists asap • For urgent discharge prescriptions, the pharmacy discharge team can also be contacted within pharmacy opening hours
Remove reliance on in hours pharmacy • Making pre-packs of commonly prescribed medicines available. – These can be supplied directly from the ward on discharge • Outsourced dispensing partner in York – To validate and dispense discharge prescriptions after the hospital pharmacy has closed
Reviewing and monitoring workflow in the pharmacy dept (inc dispensary) • Patient boards for TTOs – Symbol for TTOs – Colour coding for pharmacy action • Pharmacy discharge teams – Second team geographically based
Highlighting the planned discharge date for all patients
Discharge TTOs process • Planning discharges • Doctors ordering TTOs • Communicating required order to pharmacist • Validating Order • Processing order • Dispensing prescription
All for a purple tick! 7 minutes reduction
Thanks to NATALIE ALIE BR BRYE YERS RS, , ALA LAYA YA KH KHATUN UN GA GARY Y HA HARDCAST DCASTLE LE
Discharge prescriptions • Highlighting the planned discharge date for all patients on the Core Patient Database (CPD) so this can be worked towards by all healthcare professionals. • Producing an accurate list of all the medicines a patient is taking on discharge, including medicines that have been stopped and the reasons for this. This is produced electronically to ensure that the information is clear and is supplied to the GP in a timely way. • Ensuring that discharge prescriptions are validated by a pharmacist at ward level prior to them being dispensed. This is to ensure accuracy of information and allows the pharmacist to review the patient’s drug chart and medical notes and speak to the patient. It also ensures that patient’s own medicines and medicines supplied for them during their admission are checked and used wherever possible. • Ensuring wards are informed each day who their ward pharmacist in and how to contact them when discharge prescriptions are required. For urgent discharge prescriptions, the pharmacy discharge team can also be contacted within pharmacy opening hours. • Making pre-packs of commonly prescribed medicines available. These can be supplied directly from the ward on discharge. • Enabling Healthcare at Home, the outsourcing dispensing partner in York to validate and dispense discharge prescriptions after the hospital pharmacy has closed. This service is available until 8pm for wards in York that have been identified as having high numbers of admissions and discharges. • Reviewing and monitoring workflow in the pharmacy dispensary to ensure efficiency and continual service improvement.
Refreshments and Networking Georgina Denis available at Q stand #ImprovementFellows
Safety Culture Where are we now? Matt Hill, Consultant Anaesthetist & Regional Patient Safety Lead 1 st March 2017
2/19/2019 Where I started……
Why measure safety culture?
Performance = capability x behaviour
2/19/2019 Surveying • Paper & manual entry • Paper and scanning • Web-based • Automatic analysis • Safe and Reliable Healthcare
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