Speaker: Margaret O Neill National Dietetic Advisor HSE Health and Well Being Division
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1 Speaker: Margaret O Neill National Dietetic Advisor HSE Health and Well Being Division Olivia Sinclair Project Manager HSE Quality Improvement Directorate
2 The way forward: Improving nutritional care in the HSE Margaret O Neill, National dietetic lead, Health & Wellbeing division Olivia Sinclair, Quality Improvement Division Improving Health and Wellbeing in Ireland
3 The way forward-nutrition in the HSE HSE Integrated care programmes Hospital Groups CHO s Quality Improvement Division Health Business service unit Health & Wellbeing Healthy Ireland Obesity Chronic disease HP&I, Public Health Environmental health Acute Hospitals Nutritional care Food provision Policies Screening Care pathways Primary Care Nutritional care Screening Integrated care pathways Social Care Nutritional care Residential services HIQA standards Mental Health Development of Adult & CAMHS services Improving Health and Wellbeing in Ireland
4 Nutrition- Priorities and Actions 2015 HSE Service Plan 2015 Health & Wellbeing Division Develop a hospital and patient food policy and implementation plan Support hospital groups and community healthcare organisations to develop site specific implementation plans for Healthy Ireland- Saolta Plan Appointment of National Dietetic Lead Quality Improvement Division Lead, in consultation with service users, a quality improvement programme on nutrition and hydration across all settings Appointment of a Project manager- nutrition & hydration lead Improving Health and Wellbeing in Ireland
5 The way forward- Nutrition To establish a governance structure to align nutrition workstreams across all divisions Steering group will be informed by 3 expert working groups Health and wellbeing working group Nutritional care working group Sustainability working group Work closely with the Quality Improvement Division Improving Health and Wellbeing in Ireland
6 Cross divisional nutritional governance group Quality Improvement Division Health and wellbeing group HI implementation plan Calorie posting & Vending policies Staff health and wellbeing Obesity prevention Chronic disease Public health nutrition Nutritional care Nutrition & hydration- Policies & care pathways Malnutrition screening Nutrition support Food provision Multid teams Stakeholders- IRSPEN, INDI etc Sustainability National sustainability unit Procurement ( ONS, Food provision etc) Food waste Improving Health and Wellbeing in Ireland
7 Nutritional Care Group Work with QI nutrition and hydration programme Work with all stakeholders in developing hospital food and nutrition policy and implementation plan Work with key partners IRSPEN, INDI Support implementation of HIQA standards with all key stakeholders Development of care pathways in primary care Review models of best practice protected mealtimes, catering audits, menu plans/therapeutic diets Improving Health and Wellbeing in Ireland
8 Healthy Ireland Improving Health and Wellbeing in Ireland
9 Improving Health and Wellbeing in Ireland
10 Quality Improvement Programme: Improving Nutritional Care Olivia Sinclair; Programme Lead March 10th
11 Background IrSPEN meeting with Quality Improvement Division; Commitment by the HSE in the National Service Plan 2015: Lead (in consultation with the services) a programme focussed on the improvement of hydration and nutrition for service users Initial focus on acute hospitals; Partnering up & working together. 11
12 Context Hospital Guidelines Aims Raise awareness of the problem; Prioritise nutritional care; Guidance for optimising nutritional status; Promote MDT& outlines responsibilities front line & executive; Promotesperson-centred care; Requirements for hospital food.
13 Context contd... National campaign; Education for everyone!; Screening a MUST do; Result of screening linked to care plan; Regular review.
14 From the top... Minister for Health:...acute hospitals to embrace these highly comprehensive guidelines and put them into practice, in a step-by-step process over the next two years. National Hospitals Office Network:...imperative for these guidelines to be implemented at a local level... regular review. Patient feedback should be an integral part of this review.
15 A snapshot hospitals, 1299 patients. Practice varied between hospitals: ocommittee established in 31% centres; opolicy in 27%; o 19% knew rates of screening; orates below 50% in majority of centres; o65% of screening results linked to a care plan; ocommunication to next care setting/team not always provided.
16 Examples of local initiatives...
17 and large scale programmes
18 Quality improvement Combination of a change (improvement) & a method (an approach & toolkit), while paying attention to the context to achieve better outcomes; Sustainable change is more likely to result from an approach that involves patients and staff in developing, designing and implementing changes; Quality improvement made simple; The Health Foundation, 2013.
19 An example:
20 February March April May June July August
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22
23 The way forward right now is Planning 2. Getting team together 3. Starting small and testing Together
24 Thank you
25
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