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Aims, Goals and Measures of the Scottish Patient Safety Paediatric Programme & integration with SPSP. Why develop a Scottish Patient Safety Paediatric Programme?. Successes of the Scottish Patient Safety Programme (SPSP). Not little adults.

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aims goals and measures of the scottish patient safety paediatric programme integration with spsp

Aims, Goals and Measures of the Scottish Patient Safety Paediatric Programme & integration with SPSP

why develop a scottish patient safety paediatric programme
Why develop a Scottish Patient Safety Paediatric Programme?
  • Successes of the Scottish Patient Safety Programme (SPSP).
  • Not little adults.
  • Programme designed to recognise the unique configuration of Scotland’s paediatric services.
  • 1st country-wide improvement programme for paediatric patient safety.
  • Extension of SPSP.
scottish patient safety paediatric programme driver diagram
Scottish Patient Safety Paediatric Programme Driver Diagram

Identify appropriate paediatric aims

Improve outcomes in paediatric healthcare in hospitals across Scotland by June 2013

Governance structure

Improvement capacity within paediatric community

Align with SPSP

Engage wider stakeholder groups

spspp programme principles
SPSPP – programme principles:
  • Adopted SPSP workstreams.
  • Inpatient paediatric care (all ages).
  • Aims:
    • paediatric evidence-base;
    • ‘best in class’;
    • linked to measurable outcomes.
  • Dynamic improvement programme.
  • Relevant to paediatric hospital care delivered in Scotland.
what defines paediatric harm
What defines paediatric harm?
  • NPSA “Review of patient safety for children and young people”
    • difficulty recognising severity of illness;
    • high rate of medication administration errors – particularly dosing errors;
    • lack of integrated approach to children’s risk management that incorporates health, education and social care;
    • improve communication and listening skills by healthcare professionals, with more effective inter-professional communication;
    • lack of recognition and appropriate management of mental health issues in young people – appropriate environments etc.
aim scottish patient safety paediatric programme
Aim - Scottish Patient Safety Paediatric Programme

30% reduction in adverse events by June 2013:

Reliable systems that can measure the application of

best practice and continually improve outcomes:

learning from paediatric mortality review;

improve recognition of the deteriorating child;

reduce healthcare associated infections;

improve paediatric critical care outcomes;

reduce adverse surgical incidents;

improve medicines management processes & reduced harm from medicines;

promote learning from paediatric mortality
Promote learning from paediatric mortality
  • SPSP Aim: 15% reduction in hospital mortality.
  • HSMR developed for SPSP:
    • not designed for paediatrics.
  • Develop local mechanisms to identify avoidable factors within the paediatric programme:
    • SPSP mortality review tools.
  • SPSPP to link to the child & young person review of serious morbidity and mortality.
improve recognition of the deteriorating child
Improve recognition of the deteriorating child

Aim: All children transferred to a higher level of care should have a completed PEWS score by June 2013.

Percent compliance with early warning score assessment

spsp reliable application of central line insertion bundle
SPSP – reliable application of central line insertion bundle

Central Line Bundle Compliance

spsp linking process compliance to outcome
SPSP – linking process compliance to outcome

Central Line Bloodstream Infection Rate

decreasing picu catheter associated bloodstream infections nachri s quality transformation efforts
Decreasing PICU Catheter-Associated Bloodstream Infections: NACHRI’s Quality Transformation Efforts

“ In contrast with adult ICU care, maximizing insertion-bundle compliance alone cannot help PICUs to eliminate CA-BSIs. Instead, the main drivers for additional reductions in pediatric CA-BSI rates seem to be issues surrounding daily maintenance care for central lines.”

Margolis et al, (2010) Decreasing PICU Catheter-Associated Bloodstream Infections: NACHRI's Quality Transformation Efforts Pediatrics (125) 206-213

(NACHRI - National Association of Children's Hospitals and Related Institutions)

slide16

Leadership to support Scottish Patient Safety Paediatric Programme

  • SPSPP integrated component of NHS board’s patient safety programme by June 2011.
  • Walkrounds, by NHS Board senior team.
  • Actionable items - for paediatric wards.
spsp peri operative ssi bundle compliance
SPSP Peri-Operative - SSI bundle compliance

Percent on-time prophylactic antibiotic administration

Trend in data

spsp peri operative outcomes using data for improvement
SPSP Peri-Operative outcomes – using data for improvement

Percent surgical patients developing surgical site infection

12-2007: Wd Nurses start 30 day f/up – not ICN

4-2007: Start testing SSI bundle – Wd 16

6-2007: Implement SSI bundle – Orthopaedics

scottish patient safety paediatric programme
Scottish Patient Safety Paediatric Programme
  • Appropriate, timely and reliable evidence-based care - linking process to outcome.
  • Focus on delivering child & family centred-care.
  • Promotes effective and collaborative multi-disciplinary team working.
  • Leadership, infrastructure & culture that supports safety & quality.
  • Paediatric workforce - capacity & capability.
scottish patient safety paediatric programme23
Scottish Patient Safety Paediatric Programme

“getting it right every time for every child in Scotland”