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 and Experiences Dr Nancy El-Farargy NHS Education for Scotland ‘Teach - Back’ Session: 20 May 2014 Page 1 of 19 Quality Education for a Healthier Scotland
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 Quality Education for a Healthier Scotland Page 2 of 19
International Forum on Quality & Safety in Healthcare, Paris 2014 • Joint NHS Scotland Exhibition Stand attracted a wide audience • Scottish Government • Healthcare Improvement Scotland • NHS Education for Scotland Quality Education for a Healthier Scotland Page 3 of 19
‘Team Scotland’ • 08.00 ‘huddle’ every morning! • Sharing learning with NHS Scotland staff and beyond Picture via @ejsreid Quality Education for a Healthier Scotland Page 4 of 19
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 Quality Education for a Healthier Scotland Page 5 of 19
Asking Patients: ‘What Matters to You?’ • Reflections from Keynote 1: Maureen Bisognano, President and CEO, Institute of Healthcare Improvement • What matters to you? • Trusting the young • What are your likes and dislikes? Quality Education for a Healthier Scotland Page 6 of 19
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 Quality Education for a Healthier Scotland Page 7 of 19
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]. Quality Education for a Healthier Scotland Page 8 of 19
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’) of 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]. Quality Education for a Healthier Scotland Page 9 of 19
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). Quality Education for a Healthier Scotland Page 10 of 19
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]. Quality Education for a Healthier Scotland Page 11 of 19
Voices of Staff and Patients Quality Education for a Healthier Scotland Page 12 of 19
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 Quality Education for a Healthier Scotland Page 13 of 19
Strategic Backdrop: “2020 Vision” • 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 of 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. Scottish Government , 2020 Workforce Vision. Available online: http://www.scotland.gov.uk/Topics/Health/NHS- Workforce/Policy/2020-Vision [Accessed 19 May 2014]. Quality Education for a Healthier Scotland Page 14 of 19
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 of 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]. Quality Education for a Healthier Scotland Page 15 of 19
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]. Quality Education for a Healthier Scotland Page 16 of 19
Everyone Matters: Everyone Contributes • Co-producing healthcare between staff, patients and families • One example: • Patient Opinion website • https://www.patientopinion.org.uk/ Quality Education for a Healthier Scotland Page 17 of 19
Delivering Education for Excellence in Service Delivery Quality Education for a Healthier Scotland Page 18 of 19
Thank You 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 and Experiences Dr Nancy El-Farargy Nancy.El-Farargy@nes.scot.nhs.uk NHS Education for Scotland, 20 May 2014 Page 19 of 19 Quality Education for a Healthier Scotland
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