Session D1 at International Forum for Quality and Safety in Healthcare, Paris 10 April 2014.
This is a Pecha Kucha style presentation, which is a series of 20 slides, each running for 20 seconds, a total of 6 minutes and 40 seconds.
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New improvers transforming healthcare
1. Welcome to D1
NEW IMPROVERS TRANSFORMING
HEALTHCARE
Eight leaders from around the world will
present their strategies for engaging
clinicians in quality improvement training in a
Pecha Kucha style format
Please tweet #Quality2014 & #d1
“
2. After this session,
participants will be able to:
• Gain a range of perspectives and insight from leaders of
initiatives to engage pre- and post-registration clinical trainees
in quality improvement
• Experience the Pecha Kucha presentation method, which
massively increases the impact of presentations and retention
of ideas by an audience
• Learn as much about strategies to engage trainees in quality
improvement in 90 minutes as might take four hours through
conventional presentations
• Experience an exhilarating variety of ideas and projects from a
worldwide range of viewpoints
3. Join in!
Please tweet your comments, views and
questions with the hashtags #Quality2014 and
#d1
We will review your tweets at the end of the
presentations
4. Clarity and brevity in presentations
are endangered practices
Source of image: onlignment.com
27. Sepsis per 1000 central line days
33.3
32.3
12.2
26.1
35.7 36.2
0.0
42.0
39.5
7.9
12.8
15.4
29.1
14.5
0.0
16.7
9.3 8.8
0.0 0.00.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov
Sepsisper1000centrallinedays
Median = 29.1
Median = 8.8
Better care for sick babies
Improved access for complex
patients
CVC Infection per 1000 Catheter Days
29.1
8.8
0
5
10
15
20
25
30
35
40
45
50
Month
16.4
1.7
40. Balancing Needs of Learners
Mastery of improvement
Accreditation
Integration
Competence
41. Program Curriculum
Year 2- Clinical Improvement
Year 3- Leadership Development
Year 4- Residents as Teachers
Team-Based
Clinical
Improvement
Year 1- Personal Improvement
42. Investment in Improvement
Year Curriculum
Time (x 12)
Independent
Work
Clinic
(x 3)
Total
1 7.5/year 300 72 606
2 7/year 180 120 636
3 6/year 0 168 586
1828 Hours!
72. • Speak Up
• NHS Sleeeeeeep
• Don’t Kill Bill
• Anti-Bullying
CAMPAIGNS & APPS
WORKSHOPS
DEBATES
• Leadership
• Communication
• Human Factors
• Surgeons should full disclose
Their mortality & morbidity data
• Foreign patients attending for
Emergency care should be charged
77. MUST HEALTHCARE INNOVATION BE CONFINED
TO HEALTHCARE PROFESSIONALS?
QUEEN MARY UNIVERSITY OF LONDON WHITGIFT SCHOOL – SOUTH CROYDON
78. The Hobbit
“There is more in you of good than you
know, child of the kindly West. Some
courage and some wisdom, blended in
measure. If more of us valued food and
cheer and song above hoarded gold, it
would be a merrier world.”
79. Margriet
Schneider
Professor of Internal Medicine &
Chair of the Division of Internal
Medicine & Dermatology,
University Medical Center,
Utrecht,
The Netherlands
#Quality2014 #d1
81. Wonder & Improve
an innovative way for training leadership skills
Prof. Dr. Margriet Schneider
Program Director Internal Medicine
Ambassador Quality & Safety Program
Chair of the Division of Internal Medicine and Dermatology,
University Medical Center Utrecht, the Netherlands
93. Examples of change:
• Read back procedure
• A 2-day ATLS training
• Redesign of clinical rounds
• Uniform dress code
• Upspeeding of admittance procedure
94. Implementation in The Netherlands
• observations,
• interviews,
• documentanalysis,
• evaluation forms
95. 0 10 20 30 40 50
Resident related
Effective
Patient-centered
Efficient
Timely
Equitable
Safe
Effects Wonder & Improve
114 improvement topics
Crossing the Quality Chasm: A New Health System for the 21st
Century. Washington DC: The National Academies Press; 2001.
96. Awareness
“though I’m new here, I’m
invited to think out loud -
when a topic arises that I
feel like I could commit to,
I should go for it.”
Residents discovered:
• Their position
• Their responsibility
• Their affinity and skills
97. Ownership & Empowerment
Residents feel:
• Being heard
• Supported
• Better equipped
‘The simple fact that there is
attention from supervisors for my
problems gives me the courage
to keep on going and keep
improving’
99. Wonder & Improve
Your mother
is here …
Tell her I will be in time,
and please give her
some coffee …
100. Acknowledgements to:
UMC Utrecht
Liesbeth van Rensen, PhD
Judith Voogt, medical student
Utrecht School of Governance,
University Utrecht
Prof. Mirko Noordegraaf, PhD
Lieke vd Camp , masterstudent
Thomas Beerhuis, masterstudent
111. It will take
too long
It can’t be
done
Making a difference!
Reasons
not to
change
It’s
impossibleIt’s not our
problem
It’s too
ambitious
It’s too
complicated
112. What Care Makers say
"I've had a fantastic year it's like a
magic wand being waved in our
organisation, it has put the
excitement back in nursing
#patientcare“
Lisa Reith, Care Maker
122. Making Every Moment Count
“Quality in action: Striving for
excellence”
Emma Vaux
Clinical Lead
Hester Wain
Head of
Patient Safety
Anne McDonald
Head of clinical Quality Improvement
The Royal Berkshire Hospital project team
129. Learning experience
“I realise how good QI is ….it is relevant to
day to day practice… …it’s simple …..makes
a big difference to our patients……… It is
worth giving it high priority in our clinical
duties.”
45 trainees completed 27 projects
130. Learning experience
“I was very passionate about the experience…….
it was so good to do such a project and be able to
keep monitoring it.”
131. Gaining of knowledge and skills
“This has been a very
valuable learning experience
into clinical quality
improvement as well as
being brilliant for my CV”
133. Organisational change
“The magic is in seeing a
trainee identify a
problem they
encounter and feel
empowered to make a
change”
Hospital Board
74%
projects
achieved
their aims
138. Key factors for success
‘You hear about
projects and they
sound really huge
but this has
opened my eyes
to how you can do
little things and
make small
changes that
make a big
difference’
•Core hospital business
•Core team
•Communications strategy
139. Key factors for success
‘I identified it in my own appraisal as the
best thing I have done all year.’
Consultant supervisor
•Pool of ideas & supervisors
•Multi-disciplinary team & patient involvement
•Showcase
163. Kim
Oates
MD Dsc,
Director of Undergraduate
Quality & Safety Education,
Clinical Excellence
Commission, Australia
#Quality2014 #d1
164. Identifying and nurturing future leaders in patient safety
March 2014 – Kim Oates
Kim Oates
Paediatrician, medical academic and grandfather
Identifying and nurturing future
leaders in patient safety
165. In Australia, the average age of the
best known quality and safety
leaders is 62
Where are the future leaders?
168. How much Patient Safety is taught in
Australian Medical Schools?
70% of Deans thought there was a lot
42% of medical educators thought there was a lot less
than their Deans thought
78% of medical students thought there was not much at
all
169. The results of infiltration
Four medical Schools
Two nursing schools
One School of Allied Health
170. First year
Why we make errors
Blame and safe cultures
Using leadership skills to
make patients safer
Listening to patients and their families