Conference Proceedings
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2-4 May 2018 RAI Exhibition and Convention Centre, Amsterdam Conference Proceedings Reclaiming the Quality in Healthcare @QualityForum #Quality2018 We have always believed that everyone should get involved in improving healthcare, and our mission at the International Forum on Quality and Safety in Healthcare has always been just to do that - make healthcare improvement simple, support effective innovation and provide practical ideas that can be implemented in the workplace. The Conference Proceedings contains work submitted to us via our Call for Posters for this year’s International Forum taking place in Amsterdam, on 2-4 May 2018. The work volunteered by abstract authors for inclusion in this booklet is a reflection and a celebration of what the global quality improvement community has achieved over the past few years. You will find many projects from teams in countries such as the UK, Netherlands, Taiwan, United States, Denmark, Singapore, Canada, and many more. Thank you to all those who have shared their work and have made it available in this digital format. We hope you enjoy this selection of abstracts and will join the International Forum improvement community to share your experiences, challenges, improvement successes and failures at our future events. Find out more about future International Forums at internationalforum.bmj.com. We would like to thank our colleagues for their time spent reviewing over 900 poster abstracts submitted to the International Forum. Abstract reviewers We would like to thank our colleagues for their time spent reviewing poster and improvement science research abstract submissions. Helen Bevan | Helen Crisp | Erica De Loos | Pedro Delgado | Aidan Fowler | Göran Henriks | Ian Leistikow | Jason Leitch | Beth Lilja | Cristin Lind | Margee Louisias | Simon Mackenzie | Ashley McKimm | Sean Molloy | Fiona Moss | Margaret Murphy | Jo Inge Myhre | Kiku Pukk Härenstam | Martin Rejiler | Christian Subbe | Johan Thor | Arnold van Halteren | Nico van Weert | Carla Veldkamp | Kim Vereijken | Christian von Plessen | Joanne Watson | Sharon Williams B11 Building capability through networks: the UCLPartners Improvement Fellows Programme Sophie Bulmer UCLPartners, United Kingdom Kate Hall UCLPartners, United Kingdom Background The UCLPartners Improvement Fellows Programme is an initiative aimed at creating a peer support network, going beyond traditional institutional boundaries, connecting and supporting people with shared interests in quality improvement and safety. Research suggests that networks contribute to healthcare improvement by providing a forum for experimentation and creating knowledge, exchanging information and spreading good practice. However, not all networks are equally effective and it can be difficult to measure their impact. In 2015, UCLPartners developed and launched our Improvement Fellows Programme aiming to further expand on existing opportunities for peer learning and support across the region and to tackle the barriers to improving the quality of health and care and outcomes for patients through creating connections. Methods Following strong interest in the founding cohort of the Q Initiative, UCLPartners developed an opportunity for improvers to connect and to harness the enthusiasm across the region in having a peer support network. The resulting programme enables participants to be part of an enduring network of like-minded people, who can turn to each other for inspiration, support and expertise beyond their current local and professional networks. Open to individuals from all backgrounds with some experience of improvement, but more importantly a demonstrable passion and enthusiasm improvement and the benefits it can bring to patients and staff. Features include: • Learning sessions on topics such as person-centred care, human factors, appreciative inquiry and the science of improvement • Access to learning resources for fellows and their teams • Action Learning Sets, supporting fellows to find practical ways of addressing the challenges they face • Formal and informal networking opportunities. Outcome The programme’s reputation is growing. We received 50 applications for the first cohort in 2015 and selected 22 participants. The following year, applications grew to 148 and we selected 38 participants. We recruited the third cohort of 28 participants in December 2017. We evaluate each session, with fellows asked to rate content as well as opportunities for networking. Feedback is consistently positive, with an average of 92% rating each session ‘excellent’ or ‘good’ in terms of overall value. Our open, competitive application process has widened the UCLPartners audience and network, thus increasing our overall impact. Fellows report increased skills and knowledge and use the network to share learning and implement improvements in their organisations. We are seeing the impact of the network through increased, ongoing cross- organisational work. For example, one fellow in Essex is developing a local improvement hub, connecting with other fellows and the wider network. Conclusion • A structured development programme for a large, diverse, multi-professional group maximises opportunities for sharing learning across boundaries and an enduring network • Informal networking is important and, as well as more structured discussion, should have dedicated time, as this supports the lasting impact of the network • Selecting individuals on their passion and motivation for improvement has more lasting value for a growing network than selecting on experience and expertise alone • Applicants with strong organisational support get more out of the programme and share more with their organisation. • Those who engage fully in the programme and network will reap the benefits of the network and associated opportunities more than those who are less engaged. • Organisations need to support individuals who are passionate about improvement and quality and release them for continuous learning opportunities and enabling sharing locally. I42 Development of web-based care innovation for patients with heart disease. Lessons learnt from a participatory design study Birgitte Nørgaard University of Southern Denmark, Denmark Marianne Sandvei University of Southern Denmark, Denmark Helle Johannessen University of Southern Denmark, Denmark Susanne S. Pedersen University of Southern Denmark, Denmark Background The use of telemedicine technologies in health care has increased substantially, together with a growing interest in participatory design methods when developing telemedicine approaches. Ideally, participatory design should be initiated as early in the design phase as possible and in a setup, that involves representatives of all major end user groups. User involvement will increase the likelihood of creating technological solutions that meet the needs and preferences of end users in their specific social and organizational contexts. In turn, this is likely to enhance efficacy and to ensure that the product makes a difference to patients and the health care system, while also increasing the likelihood of successful implementation in clinical practice. Objective: We present lessons learned from a case study involving patients with heart disease and health care professionals in the development of a personalized Web-based health care intervention. Methods Our study was carried out as part of the ACQUIRE project (AdvanCe the QUalIty of life and caRE), aiming to contribute to the development and design of a web-based care innovation for patients with heart disease. The care innovation was based on a modular platform made available to end users as a web application. The care innovation was expected to increase patient empowerment by encouraging them to become co-managers of their own disease. Design: We used a participatory design approach. We collected qualitative data using multiple methods in 3 workshops and analyzed the data using thematic analysis. Participants were 7 patients and 2 nurses, 1 physician, 2 systems architects, 3 moderators, and 3 observers. Following each workshop, observational notes and transcriptions of discussions were analysed by means of thematic analysis. The transcripts and observational notes were coded and core themes were then identified, mapping end users’ experiences and attitudes. Outcome Users gave valuable feedback on ease of use of the platform, platform design, terminology, and insights into patients’ monitoring needs, information and communication technologies skills, and preferences for self-management tools. Patients and health professionals contributed different perspectives, with the patients using an experience-based approach and the health professionals using an attitude-based approach. A key finding is that given the heterogeneity of patients with heart disease, it is important that both the interface and the content can be targeted to the individual patient. The most distinct difference between patients and health professionals was their different ways of approaching the participatory process; patients actively engaged themselves in the process and contributed with experience-based input, whereas health professionals were more likely to observe and help patients and thus contribute with input of authoritarian and health professional character. Conclusion The definition of a participatory design is broad and slightly ambiguous; though, a participatory design should ideally be initiated in the early phases of the design process; our process is more likely to be a