Empowering Our Patients with Information for Patient Safety Mrs Sandra Miller

1. Empowering Our Patients with Information for Patient Safety Mrs Sandra Miller Director Safety, Quality & Performance Unit Sir Charles Gairdner Hospital, Western Australia SAFETY AND QUALITY IN WESTERN AUSTRALIA

2. Acknowledgements… • The Health Consumers’ Council of Western Australia • WA Council for Safety and Quality in Health Care(WACSQHC) • Office of Safety & Quality in Health Care, WA Department of Health • Sir Charles Gairdner Hospital

3. Why Information for Patients? • Increased health literacy of patients & community • Patient focused care: care focused on patient needs and engaging patients in health decision making • Demand on health care system and need for self-management • Modern expectations in developed world • Improve understanding of the health system

4. Rare events? Why Information for Patients? • Knowledge about systems, error and human factors • Poor health care safety data: 10% adverse events (half deemed preventable?) • Early evidence (from human factors and systems literature) that patients can improve outcomes of their own care • Potential to minimise adverse events

5. What is ‘Patient First’? Rare events? • Patient First is a unique patient safety management program sponsored by the WACSQHC • Developed in partnership with the Office of S&Q, the WA Council for Safety and Quality in Health Care & the Health Consumer’s Council • It has been implemented in WA working closely with the CACs and HCC • Acknowledges the early developmental work of JCAHO and the US Speak Up program

6. Rare events? What is ‘Patient First’? • Unique patient centred program aiming for patients to be active, involved and informed participants in their health care. • Patient centred information tool that helps consumers organise key information to enhance decision making and facilitate dialogue between patients and clinicians. • “Both patients and providers indicate that formulating an agenda of questions is important for patients.” • Chunlan M et al. International Journal of Medical Informatics. 2006

7. Rare events? Patient First Topics • Informed consent; • Making decisions about your health care; • Your rights and responsibilities; • Medication Safety; • Preventing Infection; • Avoiding Falls; • Preventing Pressure Ulcers; • Correct Patient, Correct Site, Correct Procedure; • Improving your emotional wellbeing; • Your health information and privacy; and • Health service information.

8. Rare events? Development process • The development process included the following steps: • Identified local, national and international information currently in use • Consolidated and summarised into a shortened form • Revised by consumers, patients and clinicians for the West Australian context • Identified information gaps • Drafted material to fill the gaps • Consulted again with expert consumers

9. Rare events? Patient First Resources • Booklet • DVD • Leaflets (11) • Poster • Pamphlets • Websites: www.safetyandquality.health.wa.gov.au • www.hcc-wa.asn.au

10. Patient First Program: Phase 1 • Patient First resources were disseminated throughout public hospitals within WA • Area Health Services continue to implement the Patient First Program in all WA public hospitals • KPI within DOH Operational Plan • DoH Patient Satisfaction Survey – 20% patients (remember) receiving Patient First information • Evaluation of Phase 1 of the Patient First Program – identified areas of further need

11. Identified needs from Phase 1 • Development of resources for groups with diverse and special needs • indigenous people, • mental health patients, • children and adolescents, • seniors, CALD and vision impaired • Spreading the word – from consumer to consumer!

12. Phase 2 - Patient Ambassadors! • Health Consumers’ Council led Pilot Program • Undertaken at SCGH – 2007-2008 • “The patient talking to the patient is a powerful tool.”

13. Patient Ambassadors • Uses consumer advocates to disseminate information to the patients and their carers in the hospital outpatient setting. • Commenced at SCGH in the main outpatient clinic area • Rostered basis, working in pairs • Limited to waiting areas • Booklets, leaflets and DVD using a portable DVD player used • Expanded to pre-admission clinic, oncology and respiratory

14. Results so far… • Over 3, 500 patients/families have received information from an Ambassador • Mainly 50-70 year age range • Most popular sections of the information include; rights & responsibilities, informed consent, decision making and privacy. • Many patients commented that if they had received the information previously, “they would have done things differently.” • Some patients referred to the Patient Liaison Service.

15. Patient satisfaction - SCGH * Source: Annual DOH Survey of Public Hospitals in WA

16. SCGH Staff Staff have commented on how valuable the process is for patients and their family/carers. New areas eg. Preadmissions have taken up the process with no hesitations.

17. Ambassador comments… “…patient had a grandchild in the system (health) and saw it as a great tool for all the family…” “…patient took 4 booklets to give to her friends…” “…patient felt that it gave them more confidence to speak with and ask questions of the doctors ...”

18. ACHS Survey Feedback - 2009 “Demonstrated high level of commitment to patient focused care…” “Particularly noteworthy was Patient First and Patient First Ambassadors…” “Very comprehensive education of patients and the community...”

19. Keys to Success… • Executive support from the start. • Memorandum of Understanding. • Managers/Staff who are willing to give it a go. • Active Community Advisory Council. • Orientation to the hospital & outpatient setting. • Structured training program for Ambassadors. • Visual cues/reminders for staff.

20. Future Challenges • Volunteer availability • Considering use of healthcare students • Distribution outside of the acute hospital setting • GP practices and public libraries • Expansion to other hospitals – rural (Albany and Kalgoorlie), Women’s and Newborn’s Health Service and Osborne Park Hospital. • Keeping information current and user-friendly.

21. Challenge for us all Health services need to consider the education of consumers in parallel to building the information systems of the future, so that consumers can: • Understand the information they are given access to; • Understand the way the health system works; and • Can use the information they are given access to, to be better involved in the provision of their health care and the minimisation of any harm

22. Rare events? Further information • Further information can be obtained by contacting • The Health Consumers’ Council of WA • Tel: (08) 9221 3422, or freecall 1800 620 780 (country callers). • E-mail: info@hconc.org.au • Web: www.hcc-wa.asn.au • or: • The Office of Safety and Quality in Health Care • Western Australian Department of Health • 189 Royal Street, East Perth Western Australia 6004 • Tel: (08) 9222 4080 Fax: (08) 9222 4324 • E-mail: safetyandquality@health.wa.gov.au • Web: www.safetyandquality.health.wa.gov.au/patientfirst