Scottish Patient Safety Programme – Paediatric Update

Jane Murkin, National Co-ordinator, Scottish Patient Safety ProgrammeJulie Adams, National Facilitator, Paediatrics

National Delivery Plan Implementation Group – 10th March 2010

Our vision – Scotland leading the way in Patient Safety

• Scotland at the forefront - a whole healthcare system approach

• A strategic development priority for NHS Scotland• An explicit and tested approach to improving patient

safety• Build on foundations laid through audit, clinical

effectiveness and clinical governance• Alignment with wider NHS QIS Patient Safety work

Background

• SPSA launched by CMO March 2007 • SPSP first programme of work• Strategic priority for all NHS boards• Improvement programme – process / outcome• Five work streams • Designated Board PM and Exec Lead• LS1 Jan 2008, LS6 May 2010• National Facilitators appointed – Sept 2008• Board trajectories

Inventory national programmes and measurementsMeet with programme leader to understand programme intent, audience, historyHarmonize our metrics

Improve Safety of Hospital Healthcare Services in Scotland

Scottish Government Sets Patient Safety as Strategic Priority

Boards Accept Safety as Key Strategic Priority for

Effective Governance

Robust, evidence based proven clinical changes

IHI/QIS Team Expert at Content, Coaching and

Programme Management

Align SPSP with national improvement programmes

and measures

Primary DriversDemonstrable results to communityClear, shared measurement setVisible on all senior leader agendaPSA represents & demonstrates cohesive, united programmeNational Policy alignment

Secondary Drivers

Ownership of agreed upon set of outcomesReview of outcomes at each meetingQuality and safety comprises 25% of agendaRecovery plans for unmet outcomesInfrastructure supports improvement and measurementInvolve patients in safety

Scottish Patient Safety Programme Driver Diagram

International expert clinical facultyFaculty expert at improvement methods and coachingProgramme design and structure

Acceptance of pragmatic scienceRoyal College Supports PSA Programme

Outcome Aims:

• 15% reduction in mortality• 30% reduction in adverse events• Reduce healthcare associated infections• Reduce adverse surgical incidents• Reduce adverse drug events• Improve critical care outcomes• Improve the organisational and leadership culture on

safety• Data for improvement

Key objectives

Work Area Change Package ElementCritical Care Establish infrastructure

–Daily goal sheets–Daily multi-disciplinary rounds

Infection Prevention–Ventilator bundle–Central line bundle–General infection prevention practices–Glucose control (ITU then to HDU)

General Ward Risk Identification and Response–Rapid response (Outreach) teams–Early warning system

Infection Prevention - MRSA

Reliable care for Congestive heart failure

Communication and Teamwork–Safety briefings–Communication tools (e.g. SBAR)–Prevention pressure ulcers

Leadership Infrastructure to support safety

Walkrounds

Safety a strategic priority

Medicines Management Reconciliation

Anticoagulation , Insulin,

Conduct an FMEA on a high risk medication process

Perioperative DVT Prophylaxis

Continuity of Beta blockers

SSI bundle

Team culture - briefings

Paediatric Programme

• Steering Group established August 2009.• National Facilitator appointed November 2009.• National Event November 2009 – provide access

to expert learning:– Cincinnati Children’s Hospital;– Great Ormond Street Hospital.

Develop paediatric aims, goals and measures

• Ensure aims are ‘best in class’• Paediatric evidence-base• Relevance to improving the safety of paediatric

hospital healthcare in Scotland;• Same workstream infrastructure as SPSP.• Additional paediatric aims – child protection.

Next Steps……

• Confirm aims, goals and measures:– Steering Group meeting 30th April 2010.

• Launch event June 2010:– publicise the programme;– opportunity for specific paediatric training, i.e.

paediatric trigger tool;– capacity building within paediatric community.

• Develop strong patient links. • Establish infrastructure to deliver safe and

reliable paediatric care.