Fostering a Culture of Quality & Safety at Providence Health Care
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Transcript of Fostering a Culture of Quality & Safety at Providence Health Care
Fostering a Culture of Quality & Safety at Providence Health Care
November 16, 2012
Meghan MacLeodQuality Improvement Specialist
Dr Adrienne MelckGeneral Surgeon & NSQIP Surgeon Champion
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Overview
Quality, Safety & Care Experience at PHC
Quality Improvement in the Surgical Program
OR Culture Survey>Teamwork & Communication
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PHC Quality & Safety Structure
Board
Quality & Performance Improvement Cte of the Board
Senior Leadership TeamCouncil for Excellence
Quality, Patient Safety & Clinical Risk Management
Committee
Medical Advisory CteCouncil for Excellence
Infection Control Standards Committee
Program/Service Quality & Safety Ctes (7)
Other Ctes
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Performance metrics
Strategic priorities
SurgicalQuality
Committee
Surgical Program Quality Improvement Structure
Working GroupsMortality Review
Urinary Tract InfectionsColorectal Surgery (ERAS)Surgical Safety Checklist
OR Culture Survey
Unit Leadership TeamsMSJ Periop
MSJ Surgical WardSPH Surgical Wards
SPH Periop
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OR Culture Survey
Sponsored by BC Surgical Quality Action Network (SQAN)
Pascal Metrics (over 500 hospitals across Canada / US)
14 hospitals currently participating in BC
7 domains
•Teamwork climate, safety climate, job satisfaction, stress recognition, working conditions, perceptions of senior management, perceptions of local management
•Each with 4-7 questions
Reports by facility, work area & discipline
•Benchmark reports, summary reports, raw rates, bar graphs, scatter plots, heat maps ….
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Survey Response Rates
Area Response Rate (%)
MSJ Surgical Suite 100
SPH OR 78
SPH Surgical Day Care 100
SPH Post-Anesthetic Care Unit 75
SPH High Acuity Unit 89
7Teamwork Clim
ate
Safety Climate
Job Satisfactio
n
Stress Recognitio
n
Working Conditions
Perceptions of
Senior Mgmt
Perceptions of
Local Mgmt
Ave
rag
e P
erc
ent
Po
siti
ve
Goal Zone
Danger Zone
PHC Overall Results
49
61
4442
292732
42
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Area Results within BC: Teamwork Climate
Aver
age
Perc
ent P
ositi
ve Goal Zone
Danger Zone
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Area Results by Provider: Safety Climate
Safety Climate Overall 62 70 50 29
I would feel safe being treated here as a patient 77 100 80 71
Medical errors are handled appropriately 67 89 70 83
I know the proper channels to direct questions regarding patient safety 85 80 85 71
I receive appropriate feedback about my performance 54 78 55 40
It is difficult to discuss errors (negatively worded) 17 33 20 0
I am encouraged to report patient safety concerns I have 67 78 80 43
The culture makes it easy to learn from the errors of others 69 67 60 43
Area by Provider Type
Proportion of respondents reporting “high” or “very high” agreement
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Nurseswith each other:
69%
Surgeonswith each other:
82%
Anesthesiologistswith each other:
100%
% of OR caregivers reporting “high” or “very high” levels of communication & collaboration with other members of the OR team.
79%
79%
34%
72%
46%
68%
Communication & Collaboration
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Qualitative Comments
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Culture Survey Working Group
Membership
•NSQIP Surgeon Champions
•Anesthesia Lead
•Program Director
•Nursing Operations Leaders
•OR Nursing Supervisor
•Business Analyst
•Quality Improvement Specialist
First Steps
Understand data
Questions!> (eg, Local vs. senior mgmt)
Share right away>Mass email with tidbits of data & plan going forward
Present high level data PHC QPSCRM Cte Surgical Business Cte All Party Rounds Dept meeting
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Sharing & Acting on Results
Engage in dialogue with each area/department & care provider (Surgeon, Nurse, Anesthesiologist, Porter, etc)
Clarify meaning of responses
(eg, Perceptions of Senior Management)
Uncover important issues
Determine Staff priorities for change
Safety Climate Overall 62 70 50 29
I would feel safe being treated here as a patient
77 100 80 71
Medical errors are handled appropriately
67 89 70 83
I know the proper channels to direct questions regarding
85 80 85 71
I receive appropriate feedback about my
54 78 55 40
It is difficult to discuss errors (negatively worded)
17 33 20 0
I am encouraged to report patient safety concerns I have
67 78 80 43
The culture makes it easy to learn from the errors of others
69 67 60 43
Area by Provider Type
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Emerging Themes
Performance feedback
Staff recognition
Communication with management
Closing the loop on incident reporting
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Next Steps
Developing trust
This is not “just another survey”
We are taking responses/data to heart & committing to do what is doable
Addressing priority issues
Communication
Feedback
System transparency
Readminister survey
Link with Surgical Safety Checklist and other Working Groups
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Thoughts onTeamwork & Communication,Quality, Safety & Care Experienceat PHC