Boards on Board The Role of the Board in Quality and Safety
See the problem, own the problem, fix the problem
Derek Feeley22 February 2012
Scotland’s Triple Aim + (or new readers start here)
• Health (prevention and anticipation)
• Healthcare Quality• Value (i.e. quality/cost)• Integration and collaboration
High Ambition – to be a world leader
The ultimate aim of our Quality Strategy is to deliver the
highest quality healthcare services to people in Scotland and through this to ensure that NHSScotland is recognised by
the people of Scotland as amongst the best in the world. We want to achieve this aim in a way this is recognisable and
meaningful to everybody.
Built on people’s priorities
• caring and compassionate health services• collaborating with patients and everyone
working for and with NHSScotland• providing a clean and safe care environment• improved access and continuity of care• confidence and trust in healthcare services • delivering clinical excellence
The Healthcare Quality Strategy Ambitions
• Person-Centred - Mutually beneficial partnerships between patients, their families, and those delivering healthcare services which respect individual needs and values, and which demonstrate compassion, continuity, clear communication, and shared decision making.
• Clinically Effective - The most appropriate treatments, interventions, support, and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated.
• Safe - There will be no avoidable injury or harm to patients from healthcare they receive, and an appropriate clean and safe environment will be provided for the delivery of healthcare services at all times.
Priorities for progress towards our 3 Quality Ambitions – Safe, Effective and Person Centred
• Everyone gets the best start in life, and is able to live a longer, healthier life
• People are able to live well at home or in the community• Healthcare is safe for every person, every time• Everyone has a positive experience of healthcare• Staff feel supported and engaged• The best use is made of available resources
Strategic Narrative; ‘20:20 Vision’
Everyone is able to live longer healthier lives, at home, or in a homely setting
Vision for Adult Health and Social Care
• Older people are supported to live well at home or in the community for as much time as they can
• They have a positive experience of health and social care when they need it
Integration of Health and Social Care
• Legislation:– nationally agreed outcomes– joint accountability– integrated budgets across primary care, community health and social
care, and some of acute care
• CHP committees will be taken off the statute book and replaced by Health and Social Care Partnerships – joint and equal responsibility of the NHS and Local Authority
• Jointly appointed senior accountable officer will report to the Chief Executives of the NHS and Local Authority
• Annual accountability meetings will enable accountability through Boards to Ministers
Implications for Boards
Quality and Efficiency
Via
bilit
yThe 3 curves?
ModelsAdapted from The Second Curve, Ian Morrison 1996
Time
Optimizing the Current Model
Transforming the Organization
12
Patient
Inflection Point
Under the first curve…
• Financial Position?• HEAT Performance?
What about….
• Medication • Do you know how many medication errors occurred – last month, last quarter, last year?
• Has the number gone up or down
• Do you know where they occurred
Under the 2nd Curve; Acute Emergency Admissions by Practice for >75 population2007/08
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61
£/w
eig
hte
d h
ea
d
Board 1, Hospital 2 – 17.8%
0.5
1.0
1.5
Oct-Dec2006
Apr-Jun
2007
Oct-Dec2007
Apr-Jun
2008
Oct-Dec2008
Apr-Jun
2009
Oct-Dec2009
Apr-Jun
2010
Oct-Dec
2010p*
Apr-Jun
2011p
Sta
ndar
dise
d M
orta
lity
Rat
io
Board 1, Hospital 1 – 5.2%
0.5
1.0
1.5
Oct-Dec2006
Apr-Jun
2007
Oct-Dec2007
Apr-Jun
2008
Oct-Dec2008
Apr-Jun
2009
Oct-Dec2009
Apr-Jun
2010
Oct-Dec
2010p*
Apr-Jun
2011p
Sta
ndar
dise
d M
orta
lity
Rat
io
Public Services Improvement Bundle
Looking ahead to the next 2 days
• Building on firm foundations– Boards on Board – January 2011 and Jim Conway– Developed through SPSP
• Welcome to Jamie Orlikoff• Support from the National Leadership Unit • Recognition of expertise within the audience
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