PSW Reducing Missed Care Kathleen Bradley David Heaton

PSW: Reducing Missed Care Kathleen Bradley, David Heaton, Popitha Selvanayagam, Michelle Vanin Closing The Gap Healthcare Intervention/Change Ideas Missed Care is a patient safety concern. Closing the Gap Healthcare (CTG), in alignment with our focus on quality, is committed to eliminating patient safety risk to the fullest extent possible. We recognized an opportunity to reduce Missed Care in the Waterloo Wellington geography PDSA 1: Extend Local Office Hours (7 -5 M-F) • Local office open during peak time for sick time calls to manage coverage rather than after-hours centralized customer support centre 8000 Direction of Improvement 7000 6000 UCL 5000 4000 3000 2000 CL Measures Fish Bone Diagram Achievements During IDEAS program • Implemented PDSA 1 on Dec 3, 2018 • Measured impact on Missed Care on weekdays (M-F) • Developed implementation plan for PDSA 2 • Will launch PDSA 2 late February early March 2019 Driver Diagram yy yy d, M M M d, yy yy yy M M d, yy yy M M M d, yy yy d, yy M M M M M d, yy yy yy M M M M d, yy yy yy M M M d, yy yy M M M M M d, yy yy yy M M M M d, yy yy M M M M M d, yy yy yy M M M d, yy M M M M d, yy yy M M M d, yy yy d, yy M M d, M M M M M yy 0 M Outcome Measures • Frequency of PSW Missed Care visits/month in the WW area • # of missed visits/# of scheduled visits Process Measure • unplanned absenteeism/# PSWs scheduled per time period Balancing Measures • Employee retention • Client and employee satisfaction 1218. 357 1000 yy • Missed Care causes are multifaceted, but led by unplanned absenteeism • Implications beyond patient safety: 1. Financial risk exposure 2. Staff satisfaction/retention 4874. 928 PDSA 1 d, Cause and Effect Analysis • Expansion of local office hours has been implemented across our organization • While PDSA 2 has yet to be implemented, the PSW on-call model has been highly effective in our East Coast office • Successful implementation of this model in Waterloo Wellington will allow for duplication of this model to other branches Scheduled Visits Monday to Friday Between Missed Care yy By February 28, 2019, 99. 95% of all patient care needs will be met (<0. 05% Missed Care) within Waterloo Wellington geography. . Spreading Success Number of visits we were able to complete successfully before we had a missed care visit M Aim Statement PDSA 2: On-call Personal Support Workers • PSWs paid per diem to be available on their regular weekend off in order to cover sick calls Results from PDSA Scheduled Visits Completed The Challenge Missed Care Dates Lessons Learned Organizational Enablers • Culture: organization-wide commitment to client safety and quality • Financial: CTG’s ability to implement incentive models • Goodwill: Schedulers’ dedication in working additional hours to assist in the reduction of missed care • Expertise: HQO IDEAS training and support; Project Management Office support • Value of quality data and data-informed decisions • Value and use of quality tools (e. g. driver diagram, diagnostic tools) • Structured project management approach to roll-out of PDSA initiatives • Stakeholder engagement and collaboration is critical to successful implementation • Issues are more complex than they may at first appear • Be fearless and be patient Sustainability • Continue with enhanced local office hours during peak time for sick calls • Standardize employment contracts to set expectations for on-call • Refine communications process between after-hours customer support centre and local office administration • Develop resource and training material to support sustainability Contact Name: David Heaton Title: Client Services Director Organization: Closing The Gap Healthcare Email: David. Heaton@closingthegap. ca Phone: 647 -462 -1144