The Medication Safety Programme aims to greatly reduce the number of New Zealanders harmed each year by medication errors in our hospitals, general practices, aged care facilities and across the entire health and disability sector.
Healthcare associated infection is one of the most frequent adverse events in health care worldwide. Up to 10 percent of patients admitted to modern hospitals in the developed world acquire one or more infections.
Posted by Dr Chris Walsh (Director, Consumer Engagement) on 3 March 2015
I might be showing my age by mentioning this iconic television programme of the mid-seventies when talking about patient experience survey results. I see the parallels between the two as opportunistic.
‘Opportunity Knocks’ entertained us with performances; someone playing a beer bottle and making instruments out of vegetables. ‘Real’ success was measured by whether or not the performer was awarded a singing contract (hence the career of earlier famous singers like Ray Columbus).
The DHB patient experience survey is also about performance, and opportunity is certainly knocking. While results were largely very positive, the answers to three questions showed lower scores and particular room for improvement:
Did the hospital staff include your family/whanau or someone close to you in discussions about your care?’ (‘yes, always’ 55 percent)
‘Do you feel you received enough information from the hospital on how to manage your condition after your discharge?’ (‘yes, definitely’ 61 percent)
‘Were you involved as much as you wanted to be in decisions about your care and treatment?’ (‘yes, definitely’ 69 percent).
Let’s look at the opportunities.
DHBs’ performance will be measured by their response to the numbers and data they received from the patient experience survey. But the real learning comes from digging into the data and finding out why, for instance, people aren’t always receiving enough information about managing their condition after discharge. Is it the way information is packaged or presented? Why are family/whānau not being included in discussions about their loved one’s care? Is it because staff don’t see this as a priority or don’t feel comfortable, or are worried about confidentiality issues? What information do patients expect or want before they are discharged? Does it match with what staff think they need?
The real measure of success will be how the results from the patient experience survey are used to dig further and discover more to improve the performance in the lower score areas and maintain performance in the high scoring ones.
The opportunity is there, it’s knocking; let’s raise the level of performance, surpass the expectations of the audience and applaud the good work so far.
Posted by Dr Janice Wilson (Chief Executive, Health Quality & Safety Commission) on 19 February 2015
About 30 years ago I spent some years as a consultant psychiatrist working with people who were having treatment for cancer – that is in the oncology unit. These were the days when it was relatively new for psychiatrists to work as part of the health care team in other specialty areas, and not unexpectedly much of my role was in listening to, and talking with, people about what they wanted for themselves and their families in the time they had left.
Over the last few years there has been a resurgence in what is known as advanced care planning, not just for people with a terminal illness, but also for all of us as we face death, when we are old or whenever that may happen. Newer and better medical treatment and interventions, and the ability of our health care system to extend life, have given an extra impetus to this, but the focus is essentially the same: what is important to each of us and the quality of life we want when we are old and frail or when we have a short time left due to ill health.
There is something about death itself that focuses the mind. It causes an emotional reaction in all of us as human beings. Health care workers are not immune from this, and perhaps there is no greater or more important conversation we can have with patients and their families than discussing with them how they wish to live in their remaining days, weeks or years, and the ways in which we are able to assist.
Being confident in having these conversations and knowing how to communicate well is vitally important – both in these situations and more generally, for an effective health service. It is core when thinking about quality and quality improvement. It is also an essential element in health literacy and in creating an environment within which people can be an active partner in their health care and be in control of their own health.
While many clinicians already communicate well, we know from complaints and adverse event investigations that this is not the case across the board.
We are also not always good at communicating with each other – clinician to clinician, team to team, service to service. By and large, high quality health care is a multidisciplinary team event, and we know from other areas such as sport that teams only succeed if there is excellent communication – all know the same information, all on the same page, and that page also includes the patient/family as a team member.
If communication is central to success and quality in health care, how can we do better? In other industries or areas where success, and even viability, depends on superb communication, significant attention (and resource) is given to supporting staff and systems to enable this, testing or evaluating customers and the environment about what is working, and ensuring continuing improvement.
Do we pay enough attention to communication in our training, evaluation and continuous improvement?