1. A Look Back AHQPSC - Spread and Sustainability Learning Series

2. What Was Our Focus ?  To build reusable knowledge, skills and tools for creating, sustaining and spreading better practices  Secondary focus on patient safety clinical care bundles (MedRec, surgical checklist, VTE prevention, surgical antibiotic prophylaxis)

3. Why This Approach?  Islands of improvement (stuck)  Improvement evaporation (gains not sustained)  To get beyond notion that QI change is a one shot deal  Expand learning beyond clinical care teams to include senior leaders, middle managers and support staff (regional/systems approach )

4. Interprovincial Advisory Objectives for the Learning Series  60% participation Atlantic Health Regions  80% Regions have implemented, sustained and spread at least one better practice before Nov 2013 (2 years)  90% say that participation has improved their capability to sustain & spread better practices.

5. Spread and Sustainability Learning Series Two Waves 12 Regions / Organizations 16 Regional Spread & Sustainability Teams Medication Reconciliation and Safe Surgery Project Charters Two face to face meetings Virtual Team Calls every second month Virtual Learning Sessions every second month GSKs for Med Rec and Safer Surgery Support for measurement using PS Metrics Surveys – baseline & every 6 months Executive Sponsor Face to Face Learning Exchange. Access to a Safety & Improvement Advisors & Faculty

6. Regional Spread & Sustainability Teams  Horizon Health – Med Rec Admission – Med Rec Transfer  Vitalite – Med Rec – Safe Surgery  Eastern Health – Med Rec – Safe Surgery  Central Health – Med Rec – Safe Surgery  Health PEI - Med Rec  Western Health - Med Rec  Labrador Grenfell Health - Med Rec  GASHA - Med Rec  SWNDHA - Med Rec  AVDHA - Med RecC  CEHHA - Safe Surgery  PCHA - Med Rec

7. Development of Evaluation Framework 1.CPSI Safety Competencies 2.IHI Dimensions of Spread 3.Themes from 2009 SS Focus Groups 4.LEADS framework CCHL 5.Accreditation Canada ROPs 6.CPSI’s - the Middle Mgmt Squeeze Concept (top & Frontline)

8. Survey Dimensions  Culture of Safety  Leadership and Champions  Clinical Involvement  Communications  Monitoring, Measuring and Feedback  Resource Utilization  Patient Safety is not enough

9. Our Environments are Dynamic  Our teams have all faced their own specific challenges during the past two years. – Leadership changes – Shifting provincial and organizational priorities – Changing political priorities – Team member turnover

10. Change is Occurring  Standardization of policies  Clarification of roles  Improvement in intervention measures  Physician champions finding more ways to participate  Teams being acknowledged for their efforts.  Improvements in measurement.