In edition of Communique you will find: CQI Calendar 2015

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1 Moving the furniture one centimeter at a time That was a quote from Dr Adam Brownhill at the recent CQI Jurisdictional workshop held in Alice Springs in June. What does it mean? It related to new staff coming into PHC services and making big changes and moving things around and making everyone feel uncomfortable. Change can be very uncomfortable and if we can find ways to make changes that don t cause friction and stress for the people in our teams we should. CQI is all about change finding better ways to do things to improve the outcomes we achieve but it doesn t have to be stressful or chaotic. Quality improvement should be planned and purposeful and based on evidence of what is working well and where there are gaps or problems that need to be addressed. We are data rich in the NT we have a wealth of information to help us to focus our improvement efforts. Effective CQI involves the whole team in the change process. Sustainable quality improvement is often a step by step process, more evolution than revolution that gives you the opportunity to trial change and test its effectiveness before taking the next step. Moving the furniture one centimeter at a time We hope you enjoy this edition of Communique in Quality. In edition of Communique you will find: CQI Calendar 2015 Page 1 Jurisdictional CQI Workshop summary Page 2-3 SAT Tool Masterclass Page 4 AMSANT Health Promotion Workforce CQI Workshop May 2015 Page 5-6 Congress Regional CQI Collaborative 2015 Page 7-8 Anyinginyi Stories Page 9 Breast Screen Bus Barges In Page ABCD National Research Partnership Page 12 Jurisdictional workshop photo gallery Page 13

2 July 2015 Your input would be appreciated We are in the process of planning for 2015 CQI Collaborative. We would love to hear from you if you have ideas about potential speakers or if you have a topic you would like us to consider through a CQI lens. Please contact Kerry or Louise to discuss. 1

3 Dr Heggie Spoke about A disease called better Wednesday 10 th June saw many CQI like-minded people make their way to Alice Springs to attend the Jurisdictional CQI Workshop. We titled the workshop We are not alone because we wanted to emphasise that CQI is a journey that all PHC services in the NT are making together. Every member of the Health Centre team is more aware of CQI and thinking about, and making the most of, opportunities that will improve systems that support good quality health care. Effective, focused Health Centre teams are using data to address gaps in service and to inform strategic planning that will reduce waste, time and money spent, to improve customer or patient satisfaction and increase improved health outcomes for their community. The first aim of the NT Jurisdictional CQI Workshop was to bring primary health care staff from across the NT together and give them the opportunity to either share generously - showcasing the quality initiatives being undertaken in their health centre, or steal shamelessly to listen and learn and to take back great ideas and potential changes to practice from the stories told. The second aim of this workshop was to bring clinicians up to speed on the development of the National CQI Framework. The day s proceedings were started with a sincere Welcome to Country by Mr Peter Wallace and Mr Mick Campbell. During the day we heard from representatives from both the NTG health centres and ACCHS: - Hugh Heggie spoke of how far the NT has come in using data, working as a team to address issues of concern and implementing systems that will work towards improving health outcomes - Carli Pearson from Congress spoke on the efforts to address sexual health during the Lightning Carnival held in Alice Springs over the Easter long weekend 2

4 Cont - Heather Ferguson looked at systems in place to improve Childhood Anaemia - Bernie Eaton and Linda Harrison told us about the Women s Health Expo at Wadeye Health Service - Jason King proudly spoke of the Santa Teresa s 5 Year Journey to Improve Well Being of the Community - Tanya Davies showed how Sunrise Health Service integrate PDSA cycles into their Clinical Governance - A team from Danila Dilba lead by Lesley Woolf spoke of the importance of a multidisciplinary team in their holistic approach to patient care - Yvonne Ginifer and Alan Gourlay shared their experiences and efforts in combatting Quality Under Fire out at Ntaria - Sarah Gallagher representing Utju, spoke of the Healthy Food Keeping Strong program Two concurrent sessions were held after lunch. The audience were given the opportunity to choose from either: - Using CQI Processes for Planning and Improvement introduction and practical use of the following CQI tools brainstorming, SWOT, nominal group technique, the 5 whys and PDSA. This was facilitate by Kerry Copley and Louise Patel (AMSANT) - Developing a checklist to improve the quality and confidence in nkpi data. This session was facilitated by Margie Cotter (AMSANT) and Maryanne Lewis (Sunrise Health Service) A very energetic Tanya Laker from Congress had everyone getting physical in a change of state exercise that prepared us for the last sessions of the day. We remained focused whilst listening to Cate Kildea from Indigenous and Rural Health Division and Karen Gardner, who shared the progress on the National CQI Framework. Overall the day was a success. Stories told, lessons learned, friendships renewed and new connections made. Thank you to those who participated in this workshop and so generously shared the great work that is being done in the PHC sector in the NT. 3

5 On Thursday 11th June a number of the NT CQI Facilitators gathered at Congress Remote Health Services Division to work on the Facilitator's Guide to the One21Seventy Systems Assessment Tool (SAT). What is a Systems Assessment? The SAT is a structured process, based on international and Australian evidence that identifies the strengths and weaknesses of the system - the system being the health centre. Why do we do a Systems Assessment? The SAT determines how the systems that support client care function. And we all know that better functioning systems are more effective in producing the results that they are designed to achieve! With input from all present we clarified components, elements and items of the SAT, discussed how we prepare the HC team for the SAT, and discussed how we, the CQI Facilitators, prepares for the SAT. The outcomes of the day saw a happy CQI team - questions had been answered, ideas had been generated, the team spirit renewed. This was about the NT CQI Facilitator team doing some CQI on itself! 4

6 A recent success for Member Services and AMSANT was the content and level of participation at the Continuous Quality Improvement (CQI) Health Promotions Workshop, held on the 14 th and 15 th May 2015 at Danila Dilba s Healing and Wellbeing Centre in Darwin s Northern Suburb of Malak. As an integration into Aboriginal Primary Health Care s key reforms approved by the Northern Territory (NT) Aboriginal Health Forum; CQI Coordinators Kerry Copley and Louise Patel provided an outline of CQI principles, a framework and elements which provide a practical approach to support both the Aboriginal Community Controlled and the NT Government health services in implementing CQI. The workshop, deliberately tailored to the Health Promotion, AOD and SEWB workforce, was a first for the NT. The idea grew out of a training needs identified by the Tackling Smoking & Healthy Lifestyle workforce in NT ACCHSs. The AMSANT Indigenous Health Project Officers (IHPO) worked with the AMSANT CQI coordinators to design the workshop to meet the identified needs. The Workshop catered to 21 Participants from Danila Dilba Health Service, Sunrise, Miwatj, Wurlli Wurlijang, Malabam, Heart Foundation, and AMSANT. The cohort of participants shared their experiences in their roles of Outreach Workers, Regional Tobacco & Healthy Lifestyle Coordinators, Health Promotion and Chronic Disease stakeholders. The Workshop gave me a great foundation of networks; the action planning (PDSA) and Program Logic methods learnt will prove invaluable I am sure. Workshop attendee. 5

7 Cont The workshop content provided a cycle of improvement in health service delivery to further achieve Aboriginal health outcomes. The CQI Program will support the implementation of the various quality initiatives being undertaken across all health services, bringing these initiatives together, providing a consistent approach to promote clinical quality improvement across the Territory but with flexibility for adaption to local needs. List 3 things that learnt, found most value from this CQI Workshop 1. PDSA Plan, Do, Study and Action (Do and Action are not the same thing) 2. Program Logic (one sheet diagram, sets out logical flow of work, is a good way to pre plan for PDSA cycle) 3. Networking (established new contacts and reconnected with some old contacts) Congratulations to the AMSANT CQI Team, the Indigenous Health Project Officers and all participants from the various Member Services, on a well delivered, relevant and energizing CQI Workshop over the day and a half workshop. Well done to all involved. Contact: Frank Campbell AMSANT Indigenous Health Project Officer (Chronic Disease) Phone: Fax: frank.campbell@amsant.org.au Web: 6

8 As part of Congress s commitment to Continuous Quality Improvement and in conjunction with AMSANT, the inaugural Central Australian Regional CQI Collaborative was held at Congress in May this year. Services invited were from within Congress remote and urban sites/programs and also invited were three remote non Congress AMS for whom Congress supports with CQI activities. The Remote services that attended included Santa Teresa, Mutitjulu and WAHAC; urban services included Family Partnership Program (FPP), Alukura (Women s health), Chronic Disease Program, Gap Road Clinic and Ingkintja (Men s health). A total of 18 likeminded participants attended the day. The focus of the collaborative was primarily looking at antenatal care and anaemia in children in relation to the NT AHKPI s. Guest speakers included Ms Sue Roth, Alukura Midwife RM/RN who gave a presentation on antenatal care, and Dr Deb Fearon, Paediatrician, Alice Springs Hospital who gave a presentation on anaemia in children. Both presenters and their chosen topics were well received and robust conversations ensued. Furthermore all sites/programs were asked to present a short fifteen minute presentation related to CQI and their NT AHKPIs. Each site gave an overview of what CQI processes they had in place and what effect this had on their service delivery outcomes in relation to their NT AHKPIs. Once again there were robust conversations amongst the group and shared learning in relation to each site s experiences. This was 7

9 Cont.. undertaken in a safe space which was honoured by everyone who participated. It was recognised that in the past data and CQI was sometimes used as a big stick and that there was a perceived culture of blame. One of the important outcomes from the collaborative was to try and break down these past perceptions. Given the openness of the conversations the belief was that this was being actively achieved within the group of participants. The participants used and learnt about two CQI tools, being a PDSA and a SWOT analysis which was aimed at giving them the confidence to use these tools in their workplace. Also during the day, to promote team work and a sense of fun, a variety of activities, including Ti Chi were undertaken. These activities were really well received and participants appeared to find them highly enjoyable. Overall the vibe on the day was very positive and the day deemed a success. Everybody participated enthusiastically, open discussions where had both about the positives and the challenges of CQI and data. There was a real sense of sharing and wanting to learn from each other, and a sense of appreciation for the journey everyone was undertaking. Congress and AMSANT would like to thank everyone who participated so enthusiastically during the inaugural Regional CQI Collaborative. We look forward to the next one! 8

10 The journey to ISO Accreditation has been a long and rewarding road and has ensured that our daily practices are transparent, accurate and tractable and that our structures are even stronger. Margaret Robson was tasked with the job of being our independent Auditor. She was able to talk to staff from all areas of the organisation and quickly put them at ease. Margaret will be returning to visit with Anyinginyi Health Aboriginal Corporation in September 2015 as a follow up and to ensure that all of our policies, procedures and processes are embedded. Dual Accreditation in any organisation is no easy feat but in our efforts to improve we are now looking further afield. Other Accreditation processes are being looked at in an effort to ensure compliance and confidence in a number of other areas within Anyinginyi. Anyinginyi commitment to quality, transparency and accountability continues to drive this never ending journey of continuous quality improvement. Written by Marcel Clark CQI Facilitator The Anyinginyi CQI team produce, publish and circulate a newsletter each month on Work Health and Safety (WHS) issues. Their aim is to make Health Centre staff more aware of safety in their everyday tasks in the workplace. Newsletters have to date covered the following topics Safety at Work, Manual Handling, Workplace Bullying, Personal Protective Equipment, First Aid and Evacuations. Written by Catherine Lombard Assistant CQI Facilitator 9

11 One hundred and eighty eight women across the Groote Eylandt Archipelago and neighbouring mainland community of Numbulwar recently participated in breast screening on Groote Eylandt. Two things make this significant. One is that breast cancer is the most common cancer for Aboriginal women and late diagnosis can result in reduced survival rates, so it is noteworthy that of the one hundred and eighty eight women who underwent a mammogram, seventy one percent were indigenous! The other is that being a remote island setting, such services are not available locally and are not easily accessible, with visiting services requiring significant logistical preparation. It has been two years since BreastScreen NT s inaugural visit to Groote Eylandt, with the breast screen bus making its maiden voyage via barge across the Gulf of Carpentaria for only their second visit. Their visit was made possible by the co-ordinated efforts of the NT Top End Health Service s East Arnhem South team. So, with a marked twenty five percent increase in participation from indigenous women from the previous visit in 2013, what was done differently to see such a fantastic improvement in attendance rates by the indigenous women of Umbakumba, Angurugu, Milyakburra and Numbulwar? With exceptionally low literacy and numeracy rates across the Groote Archipelago and mainland Numbulwar, EAS Primary Health Care staff developed a visual based educational resource. This tool assisted Aboriginal Health Practitioners and the Project Co-ordinator to undertake over one hundred and ten home visits to educate women on what breast screening is all about, and why it is so important. 10

12 Cont. Following informed consents, appointments were made, charters were booked, drivers were prepped, reminders were sent and all important catering was on hand to keep people fed while they waited to be seen on the day. Health staff enjoyed chatting to the ladies over the course of the two week period, undertaking a simple survey to determine what worked well for our clients, giving an insight into future planning for BreastScreen NT s next visit. Well done to the TEHS Primary Health Care s EAS team who worked together with BreastScreen NT to see the project reach its potential and contribute to improved health outcomes. This was a true team effort led by Acting Public Health Manager, Tabetha Cox. Thanks also to the ever professional BreastScreen NT staff who assisted clients to feel at ease. Support from the Groote Eylandt Mining Company and Groote Eylandt Bickerton Island Enterprises enabled the project to become a reality. The BreastScreenNT mobile 4WD bus is a joint Australian and Territory Government initiative. Written by Frances Hartley CQI Facilitator East Arnhem South Words may inspire but only action creates change Simon Sinek 11

13 As a way of thanking the many individuals and organisations that have contributed to the success of the ABCD National Research Partnership over the past five years we have developed some materials that reflect the key achievements and findings of this research partnership an 'info-graphic' that describes engagement and reach of the Partnership, and a brief on the key research findings and messages for action, We have also developed a set of briefs for community health boards and for Aboriginal and Torres Strait Islander Health Workers, which can be accessed at this link. Please let us know if you have any feedback or queries on these materials, as this will help us to improve our work in the future - please contact us at abcd@menzies.edu.au Recently the ABCD National Research Partnership was shortlisted and highly commended by the Lowitja Institute s Tarrn doon nonin health research ethics award assessment panel. This award recognises projects that uphold respectful ethical practice in relation to Aboriginal and Torres Strait Islander health. We were also recently awarded a Centre for Research Excellence in Integrated Quality Improvement, and we look forward to extending collaborations through this new centre to address priority issues in the further development of CQI in Aboriginal and Torres Strait Islander primary healthcare. Ross Bailie Professor of Public Health Scientific Director, Centre for Primary Health Care Systems T: (07) F: (07) ross.bailie@menzies.edu.au Founding organisations of the ABCD National Research Partnership: Aboriginal Health Council of South Australia Aboriginal Medical Services Alliance Northern Territory Combined Universities Centre for Rural Health Curtin University James Cook University Maari Ma Health Aboriginal Corporation Menzies School of Health Research Northern Territory Department of Health Queensland Department of Health Queensland Aboriginal and Islander Health Council South Australia Department of Health University of Queensland Western Australia Department of Health The greatest contribution of a leader is to make other leaders. Simon Sinek 12

14 Photo Gallery from Jurisdictional workshop 13