OVERVIEW OF THE PASCAL SAFETY CULTURE SURVEY MATERNITY

Transcription

1 Nonpunitive response to errors Perceptions of Local Management Perceptions of Senior Management Exhaustion and Resilience Working Conditions Job satisfaction Teamwork Safety Climate Overall perceptions of patient safety OVERVIEW OF THE PASCAL SAFETY CULTURE SURVEY MATERNITY 20th January 2017 What is the Pascal Survey? In Summer 2016, staff in Maternity were invited to complete a 43-question survey on the safety culture and climate in all areas of the service. This survey would provide staff views on what works well in Maternity, as well as giving us insight into what needs to be improved. The survey is sponsored by the East Midlands Academic Health Science Network, and 7 of the 8 Trusts within the East Midlands region completed it. (Northampton, Kettering, Leicester, Derby, Nottingham, Sherwood Forest and Chesterfield Lincoln did not complete for Maternity). The survey forms part of a four year improvement plan to improve the safety culture within the hospital focusing on Maternity and A&E. The improvement project is fully supported by the Quality Improvement (QI) team at NGH. How did NGH do regionally? Regionally, looking at the responses from all the surveys, we can see that NGH sits roughly in the middle of the 7 Trusts that took part. Healthcare Average* 66% 72% 67% 67% 52% 58% 44% 65% 44% NGH 60% 75% 70% 75% 52% 52% 33% 66% 43% Trust 2 46% 58% 62% 51% 28% 39% 15% 43% 30% Trust 3 58% 71% 64% 63% 58% 38% 28% 53% 25% Trust 4 62% 85% 67% 64% 57% 46% 26% 57% 38% Trust 5 61% 76% 76% 63% 52% 55% 38% 66% 31% Trust 6 67% 86% 79% 64% 64% 46% 25% 50% 50% Trust 7 42% 59% 50% 47% 34% 37% 11% 43% 24% *The average % for healthcare for each domain This has been determined by looking at the % values for each domain. See the domain names at the top of the table at the left hand side. Each domain is an overall % for a group of question. We can see just by looking at the values on the left hand side that only 33% of people had a favourable view of senior managers, 43% said there was not a blame culture (non punitive response to errors) and 52% said they were not exhausted from their job.

2 Overview of the responses NGH Maternity had a relatively high response rate from staff one of the highest in the region. 175 of the 322 eligible staff completed it. This is good, as it means we can make justified conclusions from the survey responses. The response rate by sub-area is shown on the left-hand side. (Broken down by Sturtridge MOW, Robert Watson, PDP, Neonatology, MSWs, MDU and ANC Triage, Medics, Community, BBC HB and Admin staff in BMH). We can see here that a smaller percentage of MSWs and staff in Robert Watson responded to the survey however there were enough responses for us to still get meaningful data. The good stuff from the survey There were many good points from the survey! 94% of NGH Maternity staff said they like their job. Much higher than the average for the NHS, which is at 88%. 91% of staff said they felt it was easy to ask questions if they did not understand something Again, this is higher than the average for the NHS, which is at 86% 84% of staff feel they have the support they need from their colleagues in order to care for patients This is higher than the average again which is at 80% 88% of Maternity staff said they would feel safe being treated here as a patient NHS average 85% Staff overwhelmingly felt that medical errors are handled appropriately in Maternity (86%) Staff felt encouraged to report patient safety concerns (86%) 94% 91% 84% 88% 86% 86%

3 The not-so-good stuff from the survey Some key areas of concern that were consistently brought up in every work area and sub-area were: Perception of Senior Management Staff raised issues in the qualitative comments section of the survey about the visibility of senior management. A follow-up survey with staff in most work areas identified senior management as the Head of Midwifery, Deputy Head of Midwifery and the Matrons. Less than 50% of staff in Maternity felt Senior Management supports their daily efforts. The average in the NHS is 68% considerably higher Non-punitive Response to Errors Issues surrounding a blame-culture were also identified in the comments section. Only 35% of staff said they do not worry about mistakes they make being kept in their staff file. 49% said they don t feel like their mistakes are held against them. 48% said when a Datix is completed, they feel the event is being reported, the other 52% said they felt it was the person being written up. Exhaustion As most people would probably expect, staff have said they feel exhausted from their job. 44% of staff said they did not feel emotionally drained from work. 33% said they do not feel used up at the end of the day. Communication 50% 35% 48% 49% 44% 33% Although communication itself was not a domain of the survey, a consistent theme occurred in the comments section of the survey that there can be a lack of communication between staff and their managers particularly senior managers. Staff felt that there was a barrier between senior management and operational staff, preventing the service from being completely open and transparent. Staff also felt that learning from case reviews/patient care errors was not completely transparent again, this comes down to a lack of communication between all staff.

4 So... what now? The QI team have met with senior managers in Maternity (HOM, dhom and the Matrons) to discuss where we believe the focus on improvement should be. Between us, we have decided to focus on the areas that produced the lowest scores in the Pascal Survey: Staff support & recognition To improve the support provided to staff in Maternity, and to recognise staff for the work they do, every day. Addressing the blame culture To ensure there is an open and transparent culture within Maternity. We want to make sure zero staff within maternity feel there is a blame culture or that mistakes they make are held against them. Senior Management To improve the relationship between senior managers and operational staff. (Improving visibility on the shop floor, offering shadowing programmes for operational staff, sharing a summary of reviews carried out in the service) Communication To improve communication within the service. There are at least two designated leads for the above four improvement areas these are all led by midwives and sisters, and not by the senior managers in Maternity. Whilst the leads for the above have already been assigned, we still welcome contribution from others within Maternity who would like to share their ideas for improvement for the above four areas. We are still in the early phases of the production of a plan for Maternity and welcome feedback from all staff on other ways you think we can improve the safety culture in Maternity. Similarly, if there is something you think could be improved in maternity that does not fall into the above four categories, please let us know! This could be an idea that would improve patient quality of care, or patient/relatives experience or even staff morale. quality.improvement@ngh.nhs.uk We will send out an update in 6-8 weeks, updating you with a high-level action plan for the above four areas. Any other questions? us!

5 Overview of the data, by work area (part 1)

6 Overview of the data, by work area (part 2)