1. The Role of HIQA in Supporting Community Health Nursing
Rachel Flynn,
Director of Health Information and Standards HIQA

2. mission
The Health Information and Quality Authority (HIQA) is an independent statutory authority established to promote safety and quality in the provision of health and social care services for the benefit of the health and welfare of the public.
information requirements for a national patient summary for use in settings such as emergency and out-of-hours care and
information requirements for community based electronic Prescribing.
You have received both standard documents and the statement of assurance in advance of this meeting.
We are seeking approval for those standards prior to submission to the Minister for health.

3. How does hiqa support community health nursing?
Sets national standards and guidance for health and social care services
Undertakes national service-user experience surveys
Defines the health information landscape
information requirements for a national patient summary for use in settings such as emergency and out-of-hours care and
information requirements for community based electronic Prescribing.
You have received both standard documents and the statement of assurance in advance of this meeting.
We are seeking approval for those standards prior to submission to the Minister for health.

4. National Standards Person-centred
Based on evidence and international best practice
A key driver in quality and safety
An impetus to recognise good practice and address poor performance
information requirements for a national patient summary for use in settings such as emergency and out-of-hours care and
information requirements for community based electronic Prescribing.
You have received both standard documents and the statement of assurance in advance of this meeting.
We are seeking approval for those standards prior to submission to the Minister for health.

5. National Standards for the community

6. NATIONAL STANDARDS FOR ADULT SAEGUARDING
HIQA and the Mental Health Commission jointly developed National standards for adult safeguarding to apply to all health, mental health and social care services recognising that people interact and move between a wide range of services
While not all such services are within HIQA’s or the MHC’s regulatory remit the expectation is that all services will work to achieve these standards and promote and protect the rights of adults at risk of harm
We have developed national standards for adult safeguarding to focus attention on the area of adult safeguarding. The aim of these standards is to reduce the risk of harm and promote the rights, health and wellbeing of all adults across the range of health and social care services that they engage with.
The national standards outline a way of working for health and social care services and support the development of a culture where safeguarding is embedded into practice rather than being viewed as a separate activity. The standards support the development of integrated working in and between the range of health and social care services that people interact with, recognising that people may be at increased risk of harm when they are using multiple services or when they are moving from one service to another.

7. Putting standards Into Practice
To raise awareness of what safeguarding is and to engage a wide range of stakeholders we developed a short animation. This animation has reached over 9000 people.
We are developing further resources to support the implementation of the standards and to raise the awareness of both health and social care professionals and people using services of what safeguarding issues might look like in their service

8. GUIDANCE DEVELOPMENT Purpose
to support service providers to understand the various national standards and
to help them to practically implement them for the delivery of safe and effective health and social care services.
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

9. GUIDANCE ON A HUMAN RIGHTS-BASED APPROACH TO CARE AND SUPPORT IN HEALTH AND SOCIAL CARE SETTINGS
Purpose
Raise awareness of human rights and a human rights-based approach among staff delivering health and social care services.
Support service providers and staff in understanding and implementing national standards
Ensure effective delivery of care and support by putting the needs and rights of people using services at the heart of the service.
Promote the use of a human rights-based approach to improve the quality of care, safety and quality of life of people using services
This guidance is currently in development- due to be made available for public consultation in June We would like feedback from as many service providers and frontline staff as possible.
-HIQA’s motivation in developing this guidance is:
- to raise awareness of human rights and a human rights-based approach.
This Guidance will support service providers and staff in their understanding and implementation of national standards . High-level reference is made to a human rights-based approach to care in a number of national standards developed by HIQA with emphasis placed on protecting and promoting people’s rights and respecting their autonomy, privacy, dignity, values, preferences and diversity:
 National Standards for Safer Better Healthcare
 National Standards for Residential Care Settings for Older People in Ireland
 National Standards for Residential Services for Children and Adults with Disabilities
 National Standards for Children’s Residential Centres
 Draft National Standard for Adult Safeguarding.
The Guidance will help to ensure a consistent interpretation of this kind of approach
- The Guidance will also help to ensure the effective delivery of health and social care services which respects the individual’s human rights and puts the needs of people using services at the heart of the service.
- By promoting this kind of approach and ensuring that people’s human rights are respected, protected and fulfilled, service providers will improve the quality of care, safety and quality of life of people who use health and social care services.
The Guidance has primarily been written for staff working in health and social care services but might also be useful for people using services, their families, carers, friends and advocates.

10. National Care Experience Programme
NATIONAL SERVICE-USER EXPERIENCE SURVEYS
National Care Experience Programme
HIQA
HSE
Department of Health
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

11. NATIONAL CARE EXPERIENCE PROGRAMME
Established in 2019
To encourage people to share their experiences of care and to use this information to improve the quality and safety of these services
The parent body for the National Patient Experience Survey and the forthcoming National Maternity Survey
Two further surveys planned by 2021
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

12. NATIONAL PATIENT EXPERIENCE SURVEY
Ireland’s first acute inpatient experience survey carried out in 2017 and repeated in 2018
Move towards patient-centred care, policy and regulation
Using patient feedback to improve quality and safety of care
Third survey currently underway as of today – 1st May 2019

13. OVERVIEW NPES RESULTS 2018
Experiences of hospital care were mostly positive
Patients experience high levels of dignity and respect in hospital
The majority of patients also had confidence and trust in staff
An important number of people highlighted issues of communication and information-sharing
Emotional support from staff was not always available
Some hospitals perform better than others
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

14. DISCHARGE STAGE OF CARE
Lowest rated stage of care, & 2018
Many patients felt that they did not get enough information on how to safely care for themselves when they left hospital
Patients who are not sufficiently informed about their condition are at higher risk of complications and being re- admitted
After-effects felt in community health nursing
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

15. IMPROVING THE DISCHARGE PROCESS
HIQA, through the NCEP, is supporting quality improvement initiatives
All participating hospitals implemented improvements to their discharge processes e.g. introduced or revised patient information booklets on discharge
Mercy UH, Cork
UH Limerick
Saolta HG

16. THE NATIONAL MATERNITY SURVEY
Currently in development
A national survey of women’s experiences of their maternity care
Providing women who have recently given birth in Ireland with the opportunity to share their experiences of maternity services
The aim is to learn from the experiences of these women to improve the safety and quality of the care they and their baby receive
Scheduled for early 2020
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

17. DEVELOPING THE NATIONAL MATERNITY SURVEY
Systematic review
Focus Groups
Gap analysis
Assembly of questions
Delphi study
Cognitive testing
Survey pilot
In collaboration with National University of Ireland, Galway (NUIG)
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

18. THE NATIONAL MATERNITY SURVEY QUESTIONNAIRE
Prenatal care
Antenatal care
Care during labour and delivery
Postnatal care in the community
Capturing the whole pathway of care
You and your baby
Care while you were pregnant (antenatal care)
Your labour and the birth of your baby
Care in hospital after the birth (postnatal care)
Feeding your baby
Care at home after the birth
Overall experience
You and your household
Themes:
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

19. NATIONAL MATERNITY SURVEY METHODOLOGY
Model Design
A retrospective survey design
Eligibility Criteria
Women who are 16 or over, resident in Ireland, during the survey period
Exclusion Criteria
Women who have had a stillbirth in the index pregnancy and women who have died or whose baby has died
Mode of contact
Post
Mode of response
Online primarily
Paper option made available in second
reminder letter and on request
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

20. When babies are 3 months old
NATIONAL MATERNITY SURVEY TIMELINES
Sampling
Survey
October 2019
MRH Mullingar
Waterford UH
Wexford GH
Letterkenny UH
Portiuncula UH
St Luke’s GH
Cavan GH
Mayo UH
MRH Portlaoise
UH Kerry
Sligo UH
South Tipperary GH
Home births
NMH
Coombe
Rotunda
CUMH
Limerick UMH
OLOL Drogheda
Galway UH
November 2019
February 2020
Women who gave birth in October 2019
March 2020
Women who gave birth in November 2019
When babies are 3 months old
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

21. COMMUNITY MATERNITY CARE
The National Maternity Strategy, Irelands’ roadmap for a safer,
better maternity service states:
PHNs have a key role in supporting child health, families and new babies, screening for postnatal depression, providing breast feeding support and checking the baby’s development, amongst other services
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

22. NATIONAL STANDARDS FOR SAFER BETTER MATERNITY SERVICES
Standards relevant to community health nursing:
Healthcare professionals in the community support women and their partners to make a confident and effective transition to parenthood and to develop parenting skills.
Women are advised of breastfeeding supports in the community and provided with materials containing contact information for these groups.
The lead healthcare professional for the postnatal period coordinates timely access to the following services for women and or their babies as required:…..
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

23. Contributing to a safer better maternity service in Ireland
HOW CAN THE NMS BENEFIT COMMUNITY HEALTH NURSING?
The National Maternity Survey will support community health nursing to meet its responsibilities as outlined in the National Maternity Strategy and the National Standards for Safer Better Maternity Services.
It will do this by:
Identifying which areas of post-natal community maternity care should be targeted for quality improvement
Identifying which areas of post-natal community care maternity are working well
Contributing to a safer better maternity service in Ireland
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

24. health information
HIQA’s remit extends to providing leadership in defining the health information landscape in Ireland
Driving improvements in the quality of health information
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

25. Person-centred view of health information
Used to deliver and monitor safe and high quality care
High quality and collected as close as possible to the point of care
“collected once and used many times”
Data collection should be ‘fit for purpose’ and cost effective
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

26. Sharing health information
Improving the sharing of information between different healthcare settings
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

27. In Conclusion Thank you
HIQA will continue to support community health nursing in its aim to improve the quality and safety of health and care services in Ireland
Thank you
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet

28. Do you wish to participate in
the Development of the national maternity Survey?
We require participants to engage in a Delphi study
The purpose is to select questions, by consensus, for inclusion in the National Maternity Survey
The Delphi Study will be administered through an online tool
Two rounds of questions
Round 1: 16th – 31st May
Round 2: 10th - 21st June
Requirement to respond online during these periods
We would be very grateful for your participation
Should you wish to participate, please us at:
Delphi study
Handout
For service providers: Supporting People’s Autonomy: Guidance - to support service providers to help those who use health and social services, in particular vulnerable people in their care, make informed decisions and live more independent lives.
For the Service user: A5 guide booklet