Quality Improvement Division Frontline Ownership of Quality Improvement

Quality Improvement Division Frontline Ownership of Quality Improvement in Decontamination Practice - Our Experience 1

QA and QI CEC: Quality Assurance: focuses on monitoring the system of production for stability (through data), detecting emerging problems and taking steps to address them. Quality Improvement: a variety of methods and tools are used to develop, test, and implement changes, and if needed redesign the relevant process.

Quality Improvement “. . . everyone in healthcare really has two jobs when they come to work to do their work and to improve it. ” Healthcare will not reach its full potential unless quality improvement becomes an intrinsic part of everyone’s job, every day, in all parts of the system. Batalden and Davidoff 2007

Do we need to change? Here is Edward Bear coming down the stairs – “bump, bump on the back of his head”. He thinks there must be another way of coming down the stairs If only he could stop bumping for a moment to think of it ! A. A. Milne “ Winnie the Pooh” (1926)

Why do we need to do things differently ? Ø We keep doing the same things and expect different results? Ø Decontamination services reactionary. Ø Human Factors- engagement? Ø Recognise-Guide the planning and delivery of services away from crisis management and move towards proactive service quality improvement (HSE, 2016).

National Quality Initiatives Traceability • The National Tracking 8 Year Project. • CDU’s, EDU’s and Theatres and Endoscopy Suits -July 2018 • GSI coding • Interface with Clinical Systems • Centralised Server. Data collection opportunities support efficiencies, training, equipment replacement and provide meaningful data to inform planning for the future and QI • All new equipment purchased on tender must have capability to interface

Tracking Loan Sets

UDI- Solutions MDR 217/745 -Devices that are reusable shall bear a UDI carrier on the device itself. The UDI shall be permanent and readable after each decontamination process throughout the intended lifetime of the device.

QI Initiatives-Supporting Services

Quality Improvement at the Frontline ? “. . . everyone in healthcare really has two jobs when they come to work to do their work and to improve it. ” Healthcare will not reach its full potential unless quality improvement becomes an intrinsic part of everyone’s job, every day, in all parts of the system. Batalden and Davidoff 2007

CEC Ø CEC-Quality Improvement Academy was established in January 2016 Ø provide Quality Improvement education and tools for staff in healthcare who want to improve the safety and quality of healthcare.

CEC Key subject areas in the curriculum include: Ø Clinical Practice Improvement Ø Clinical Leadership Ø Medication Safety Ø End of life care Ø Venous Thromboembolism (VTE) prevention Ø Antimicrobial Audit training

Foundation Programme for Quality Improvement in Decontamination Practice Aim: is to provide an evidence based curriculum that supports the development of QI knowledge and skills Ø Ø Ø Unique Programme Working with Decontamination Teams 4 days over 5 months Project based 4 Key Concepts

Concept 1 : Health Service Framework for QI

Concept 2: Method for Improvement (Langley, Moen et al, 2009), AIM Model for Improvement using small tests of change/Plan Do Study Act Cycles Plan the change, do the change study / measure to see if there is an improvement – Act on the results and refine if needed. (Langley, Moen et al, 2009),

Concept 3: Measurement for Improvement A National Tracking System Measurement of nonconformances.

How do win the minds?

Concept 4 Winning Hearts and Minds for QI 95% 5% Data analysis Measuring Variation Illustrating variation • Run Charts • Pareto charts Flow analysis Process mapping Identifying waste Demand & capacity managemet Building the will Stakeholder Management Communication planning Influencing styles 18

Winning Hearts -Who should we work with ? Focus Here 60%

Basic Tools for Stakeholder Engagement

Basic Tools for Stakeholder Engagement

How to Win the Hearts? Ø Education-Sessions Ø Involving Team in QI and co- design of the improvement leads to FLO. Ø Invested – Know where problems are Ø Work with the willing. Ø Staff Engagement Positive staff engagement: Better patient and service user outcomes Improve clinical quality and safety Increased staff productivity ( HSE, 2018)

Outcomes

Outcomes

Decontamination Safety Programme Network Event 2018 Spread Participant Feedback Great to know what it happening We need to work together to achieve the same goals Great Projects well presented and posters really useful Import to engaging frontline staff to improve Should try to have the Event twice a year

Benefits Ø We all share the same problems Ø Where attendees come from different organisations, but who operate the same process -they gain as much learning from each other as they do from the course content itself Ø Using Quality Improvement Science, traditionally focused on clinical care pathways, to improving decontamination practice Ø Complementary role in supporting and driving improvements in safe clinical care.

Finally : _Next Steps

Contact Details caroline. conneely 1@hse. ie Decontamination QID Ireland