Partnering with Patients to Drive Safety and Quality

Transcription

1 Partnering with Patients to Drive Safety and Quality CLINICAL EXCELLENCE COMMISSION Virginia Armour Program Manager, Patient Based Care 2 November 2015 AHHA Patient engagement and the patient experience forum

2 Clinical Excellence Commission The Clinical Excellence Commission promotes and supports best practice clinical care, safety and quality across the NSW health system by: conducting high-level analysis and reviews that identifies risks and opportunities for improvement providing expert support, advice, tools and information working collaboratively with patients, clinicians, managers, health service partners and the broader community. 2

3 Part of the CEC Program:

4 Patient Based Care Model

5 I couldn t have faulted the technical care...

6 Patient Based Care / Patient Centred Care/ Family Centred Care Healthcare that is respectful of, and responsive to, the preferences, needs and values of patients and consumers The sum of all interactions, shaped by an organisation s culture, that influence patient perceptions across the continuum of care - The Beryl Institute

7 I am the patient experience

8 Patient Experience Beryl Institute. Embedded within patient experience is a focus on individualised care Tailoring of services to meet patient needs Engage with them as partners in their care Strongly tied to patients expectations and whether they were positively realized (beyond clinical outcomes or health status) Integrally tied to the principles and practice of patient- and family- centred care

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10 The evidence Improved patient experience is positively associated with: Objectively measured health outcomes Adherence to medications and treatments Health resource usage Improved technical quality of care A reduction in adverse events Doyle C et al BMJ Open Jan 20, 2013

11 Increasing patient satisfaction through patient-centred approaches increases employee satisfaction, and improves employee retention rates Charmel PA, Frampton SB. Building the business case for patient-centred Care. Healthcare Financial Management 2008;March 1-6.

12 Benefits of Patient Based Care Refocusing care delivery around the patient Improves patient care experience. Improves clinical and operational-level outcomes: improved patient adherence fewer medication errors decreased adverse events improved staff satisfaction enhanced staff recruitment decreased length of stay decreased ED return visits And the bottom line.

13 What do patients value in care? Being treated with dignity and respect Having confidence & trust in providers Courtesy & availability of staff Continuity & transitions Coordination of care Pain management & physical comfort Respect for preferences Emotional support Joffe et al. (2003) J Med Ethics Jenkinson et al. (2002) Qual Saf Health Care

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15 The Challenge for health services Survey of over 3500 hospital/health senior executives across Australia. From the survey, 39.2% of the respondents said that Partnering with Consumers is by far the most challenging aspect of the NSQHS standards. Survey respondents: public 75.3%, private 24.7%. Source: Criterion

16 Leaders in patient based care* Organisational characteristics: Strong committed senior leadership Communication of strategic vision Engagement of patient and families Sustained focus on staff satisfaction Regular measurement and feedback reporting Adequate resourcing of care delivery change Staff capacity building Accountability and incentives Culture strongly supportive of change and learning *Luxford et.al Int J Quality in Healthcare Vol 23(5):

17 Sign Up to The Challenge! Dr Karen Luxford

18 Patient Based Care Challenge Dr Karen Luxford and Stephanie Newell, New South Wales mounts patient based care "challenge, BMJ 2015;350 Achieving patient centred care at the organisational level entails moving beyond the traditional focus of quality improvement on clinical measurement and audit to a more integrated approach patient experience clinical outcomes use of resources

19 Engaging patients & carers Patients and carers as active partners In own care Medication management Bedside handover Alerting staff to deterioration In governance Patient involvement throughout organisation (e.g. governance, patient safety, quality improvement, new staff recruitment, systems and building redesign). Models include Patient Advisory Committees through to full integration throughout organisation

20 Patient Directed visitation Decreased septic complications Decreased cardiovascular complications Reducing emotional distress and anxiety Decreased stress hormonal profile Lower mortality rates Fumagalli et al Circulation American Heart Association Lee et al Crit Care Med Vol. 35, No. 2 Kleinpell Crit Care Med Vol. 36, No. 1

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22 Caregivers and patients co-creating a shared agenda for improvement Strategies for scaling up consumer engagement: o Focus Groups with patients, families, staff, etc. o Patient and Family Advisory Councils o Patient engagement on safety, quality and other organizational committees o Patient participation in hiring and evaluation o Patients as faculty o Patients to develop/act in simulations for staff training

23 How are you addressing health literacy barriers?

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25 Patient Stories Using individual patient stories to drive change A very powerful resource that can be used to gain feedback in real time Everyone has a different equally valuable perception of their healthcare experience. Collectively stories can help build a picture of what it is like as a service user and how the service could be improved. Stories are told from the point of view of the narrator and the attention focuses on the individual and not the organisation/condition.

26 Casting the safety net wider

27 TOP 5 a communication tool Engaging with carers to develop up to 5 nonclinical tips and management strategies to aid communication and support personalised care

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29 Thank you Questions For further information: 29