Prepared by Jenny Tyrrell Nurse Manager Nursing Development & Capability Nursing & Midwifery Directorate October 2012 Grand Rounds via Video Conferencing

What are we accomplishing? 1.Critically review case presentations in a interprofessional framework to ↑ awareness & foster development of locally adapted, effective systems of quality & safety controls for better outcomes for patients & staff. 2.↑ learning by allowing reflection on cases that are relevant, practical & respectful of prior knowledge (Adult learning principles ) - everyone learns differing lessons dependant on their level of experience & discipline.

Grand Rounds Via Video Conferencing Links 8-9 Rural sites via MHECs or Telehealth Units & teleconferencing Networking without travel Relevant real cases to reflect on their care strategies Multidisciplinary in both discussion & attendance- team work- all health professionals welcome

Steps undertaken to implement Acceptance of project from HETI Lead Person assigned EOI from sites & education to sites Webpage development for all presentations & forms Building rapport & Confidence & invite other disciplines to attend ↑ Future scope & sustainability

Grand Rounds Via Video Conferencing Sites alternate monthly- offering different cases to reflect & learn from Builds confidence with technology use Builds capability through critical questioning & reflection on real case presentations

Presentations 2011 &  The Devil is in the Detail - Sliding Scale Insulin  Dyspnoea in Palliative Care  Advanced Care Directives  Paediatric Head injury  Pressure Area Prevention  Early Presentation of Chest Pain/AMI  Gun Shot Wound Cardiac Pacing of a Patient in a Rural Setting Management of Haemoptysis A Simple Case of Tonsillitis – not so simple Management of a Patient with Asthma with Laryngeal Stridor A multiservice approach to holistic wound care Head injury management while isolated by floods Paratrooper- Trauma presentation Little Boy Blue- idiopathic VT arrhythmia Tricky Dicky- a collaborative approach to confusion Mrs Bear – go back to basics Is it Dementia or Delirium

Continuous Improvement model Started January 2011 → constant improvements Eg –Webpage developed = Access to P.P & forms pre presentation –Mute Button - pre presentation (link)(link) –Presentations recorded →Power points with voice (Link) (Link) –Future scope - other groups expanded

Future Scope 3 x Acute hospital groups running each month community lone practitioners monthly Community health centre groups

Future Scope

Team responsible - Implementation Nursing & Midwifery Directorate Telecommunications team Site Managers CNE-CME’s, CNC -CMC, site teams, acute & community, Dr’s, Ambulance officers & allied health

Performance measures used Attendance data Evaluations ↑ capability / confidence -use of Technology Build rapport & participation = ↑ questioning & reflection → practice change ↑ awareness in other models of care, options for presentations – thinking outside the box

Evaluation Used to ensure improvements & evidence for accreditation January – August 2011 = evaluation from CETI & MLHD Annually - July 2012 Future – survey monkey?

Evaluation July 2012

Reflection on Clinical Practice

Numbers regarding participation

Multidisciplinary team engagement

Comparing 2011 results to 2012 Question2011 results2012 resultsImprovement Rate VC technically31% Very good /excellent 77% Very good/ Excellent ↑ 46% Led to reflection on teams clinical practice79% Yes91% Yes ↑ 12% Led to reflection on own clinical practice78% yes92% Yes ↑ 14% How valuable was Grand Rounds 75% very good/excellent 96% very good/ excellent ↑ 21% Participant attending141 participants 200 participants ↑ 59 participants

Questions ?

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