Safety Improvement in Primary Care 2

“Look at three areas of major clinical risk to patients as they move across the health system.”

Areas of Focus Medication Reconciliation Managing results Shared care and communication at out patients

Health Foundation are looking for … Knowledge Where the harm is occurring ? What risks have been identified ? What interventions have been tried ? What difference did it make? How we have gone about it …….

Case studies which describe the journey - the process, outcomes and learning of our work in each work stream

Progress Literature Engagement Process Mapping What could be improved Ideas for improvement Measurement

Laura Ryan 22 Sept 2011 Aim SIPC2 NHS Borders 95% of blood tests are reconciled and acted upon in a timely and accurate manner within participating practices by July 2012

Laura Ryan 22 Sept 2011 VSM and Process mapping

Laura Ryan 22 Sept 2011

Progress report High level ACTIONOWNERPROGRESSRAG status 1.All decision makers to appear on label printing option High Level/ Gordon/ Labs On going A 2.The requestor/ person responsible for following up the results of the test should go on the form. High level/ LauraOn going A 3Clarify responsibility of who can test/ follow up tests with particular reference to midwives and specialist nurses LauraOn going A

Themes Efficient accurate 2 way communication Reliable systems: To handle incoming information To implement changes/management changes/fu Inform patients of the processes and their roles within them What I do /not do in my part of the system impacts on someone else

Going Back to your Practice/Teams

CHANGE IS… Growth Opportunity Innovation ûThreat ûDisorientation ûUpheaval

Innovation Adoption Curve.

WHAT HINDERS CHANGE?  “Unnecessary” changes  No opportunity to reflect on proposed changes  People coerced or manoeuvred into change  Lack of direction  Lack of resources  Lack of information

WHAT HELPS CHANGE?  Communication – hearts and minds Suggest - Practice Team Meeting Create will –Video –Be honest –Be realistic, include the negative –Rumour management –Allow time to think

WHAT HELPS CHANGE?  Planning – involve the team  Clear leadership  Get buy in from your colleagues see benefits  Frustration/ Doing a good job  What’s on the horizon – programme/ contract  Share work

TOP TIPS! vRepeated message vHave good reason for making change vInvolve people vA respected leader vOutside help – US! vEstablish symbols of change vData – notice boards - discuss vAcknowledge and reward

Discuss in your teams What will you do to engage with your team? What? By When?