Connecting and sharing across Wessex to improve patient safety CSIP Conference 14th June 2017
Supporting Primary Care: A Safe Practice Framework for General Practice Dr. Usha Couderc, Clinical Lead for Primary Care Dr. Helen Prince
Our vision To develop a safe practice framework which will support staff in the delivery of a safe standard of care in General Practice. To raise staff awareness of patient safety. To support staff to identify areas for improvement and where they are doing well.
Why? 360 million consultations/year in General Practice Raising workload, increasing patient demand, reduced workforce 10% of GPs in the South East felt workload was manageable and allowed them to provide quality and safe care for their patients (BMA, 2016) Reference: Patient Safety under threat from pressures in General Practice, BMA December 2016
How? The initial safe practice framework idea originated from local GPs and was supported by Julia Barton [SEH CCG]. The idea was discussed in the Wessex Primary Care Forum and then developed by the [WPSC]. The framework was supported by a test specification and a measurement strategy to review the content and understand the ease of use and impact. The framework was tested by 2 local GP practices. The framework was then reviewed following feedback and amended. It is now being further refined in Wessex and in the West of England Primary Care Collaborative
The Initial Framework A voluntary tool which aims to assess the maturity and robustness of the patient safety systems. Designed to be a portal to patient safety in the practice a continual way to improve A PICK and MIX methodology. Self-assessment tool (Green/Amber/Red). When completed the framework identifies process & systems that are working well and those which may need improvement. Further resources about patient safety are available via links to support staff development and understanding of patient safety.
The Safe Practice Framework: Testing it at a practice level
Plan What? Where? When? Who? How? To test using the framework in real-life practice. Tadley Medical Partnership At the next practice CQC meeting. Myself and the practice CQC leads: 2x senior GP partners 1x lead nurse Practice manager. Use the Framework as a basis for discussing the safety aspect of CQC. Gather feedback from participants. Measure time taken to complete the Framework. Write my own reflections about using the Framework. Feedback to team at Wessex AHSN.
Do
Study Time taken to complete Colleague feedback My own reflections 1 hour 25 minutes Well received and felt to be useful. Liked the structure as new CQC domains are quite woolly. Felt length of time was ok. Gave a framework for guiding discussion about safety. Allowed identification of both gaps and areas doing well. Felt that it was too long to do in one sitting. Helped to develop understanding about patient safety. Needs to be done as a MDT. Fitted into CQC meeting nicely. Opportunity for developing an action plan.
Act Data from the test has been fed back to the Wessex AHSN team and has contributed to the subsequent development of the Framework. In the practice we have: Completed a Safety Culture Survey. Increased frequency of SEA meetings from every 4 months to every 2 months. Renamed SEA meetings to Safety & Learning meetings to allow for wider safety discussion. Increased MDT participation at our Safety & Learning meetings. Made plans to hold an educational event on patient safety for ALL staff members.
My practice Concerns about duplication dispelled. Offered a planned approach to the quality work in the practice. The process of completing the framework as a team; generated healthy discussion raised awareness about patient safety started conversations provided an opportunity to celebrate what was working well offered a shared understanding of what was still required encouraged the team to take ownership
As a PSC what did we learn? Feedback itself is crucial to ensure the framework is useful for you. The feedback we received; Most useful when completed as a team. Each team member had ownership of the good practice that was identified and wanted to take responsibility for what needed to change. Local Medical Council [LMC] Chief Executive saw value in the framework. Rewritten to reflect Key Lines of Enquiry and as a 2 stage approach. Not an assurance tool.
Moving Forward West of England is using the framework for their collaborative. Wessex keen to extend the testing phase. We are assessing; Ease of using the framework Content Impact of using the framework We will be seeking brief feedback on these 3 areas to influence and improve the design of the framework. Roll out to Clinical Commissioning Groups across Wessex Share nationally
Summary Safe Practice Framework-Supporting general practice to deliver safe care Protects patients and staff. Not an assurance tool Evidence for CQC inspection/appraisal and revalidation. Learning, learning, learning...
Part of continual improvement is sharing the learning and seeking more views We are keen to hear any questions you have about the framework and our project We are keen to hear how you think we could improve further