The Quality Agenda . Fiona McQueen Executive Nurse Director. What is world class healthcare? Where are we now? Where do we want to be 2 years 5 years 20 years Call to action for the journey. Cabinet Secretary. NHSScotland Healthcare Quality Strategy
Executive Nurse Director
Where are we now?
Where do we want to be
Call to action for the journey
NHSScotland Healthcare Quality Strategy
At its heart is a simple but very ambitious aim:
“To make the NHS in Scotland a world leader in the quality of health care services that it delivers.”
“That aim is not just good for patients, it is also
right for staff.”
Scottish Parliament, Debate 13 May 2010
•Caring and Compassionate health services
•Collaborating with patients and everyone working for and with NHSScotland
•providing a Clean and safe care environment
•improved access and Continuity of care
•Confidence and trust in healthcare services
•delivering Clinical excellence
Person-Centred - Mutually beneficial partnerships between patients, their families, and those delivering healthcare services which respect individual needs and values, and which demonstrate compassion, continuity, clear communication, and shared decision making.
Quality occurs more frequently when the three ambitions are delivered together
the best start in
life and is able
to live a longer
healthier life at
home or in the
safe for every
time and every
staff who feel
The Care Experience of patients and their families is improved
All services are co-produced
There are no needless deaths
There is no needless harm
Staff experience and well being is improved
Take 10 minutes to discuss at your tables
Is this what world class healthcare looks like? Tell us what is missing
Your culture is an outcome of the way employees behave. So how are we encouraging our employees to behave?Lived values = positive behavioursRelentless modelling of positive behaviours delivers positive attitudes.
Select your top five behaviours from the cards at your table.
As a board what is your role in the delivery of ‘lived’ values to improve culture ?
Does this Wordle capture our ambitions?
How should we promote these behaviours?What should be the consequence for those who don’t adhere to them?
•Better quality costs more money
•If you want to ― get “Safe Care” it will cost MUCH more money
(all patients) -2007/08
“When something goes wrong it is how the organisationacts that redefines and reshapes the culture.”
Jeanette Clough, President & Chief Executive Officer
Mount Auburn Hospital, Boston, MA, USA
Plan-Do-Study–Act (PDSA) cycles to develop improvements in clinical practice
Engaging all staff to ensure ownership of new ways of workingImprovement methodology
Plan, do, study, act
Back to Basics programme spread across Crosshouse. - completed in all in-patient areas. All wards monitoring and measuring MEWS, Safety Brief and SBAR plus all other GW measures
Improvement programme spreading at Ayr – 6 wards complete and monitoring and measuring compliance with all BTB /General Ward measures.
Spread to continue through to March 2013
Percent of patients who have peri-operative briefing.
Excellent compliance across all theatres in surgical pause and briefing prior to surgery
As a Board Member, do you know the names of the people who have been harmed or killed in your hospitals
and healthcare systems because
of unsafe, unreliable systems ?
As a Board Member, do you know how many clinicians have been damaged as a result of unreliable or unsafe systems and processes of care?
What assurance does the Board need that we are providing world class health services and that we are learning from events. Discuss at your table and agree the top 2 things that would provide you with assurance
- 20% reduction in Mortality
- 95% patients receive harm free care
- Improved person centred care
Journal of Research Nursing 2010; 15: 139-148
Take 10 minutes at your table to discuss … How the organisation can build the capacity and capability necessary to drive quality improvement at pace and scale
A key operating assumption of building capacity is that different groups of people will have different levels of need for Improvement knowledge and skill.
Our approach will be to make sure that each group receives the knowledge and skill sets they need when they need them and in the appropriate amounts
Continuum of Improvement Knowledge and Skills
What next? Take five minutes at your table to discuss as a Board Member what you will personally do to drive or promote the Quality Agenda