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27-29 March 2019 Glasgow SEC Centre, Scotland Conference Proceedings People Make Change

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27-29 March 2019 Glasgow SEC Centre, Scotland Conference Proceedings People Make Change 27-29 March 2019 Glasgow SEC Centre, Scotland Conference Proceedings People Make Change internationalforum.bmj.com @QualityForum #Quality2019 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 Glasgow on 27-29 March 2019. 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, the Netherlands, Denmark, Saudi Arabia, Australia, Brazil 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. 18/03/2019 International Forum Glasgow 2019 Conference Proceedings FINAL - Google Docs A management tool to improve paent safety culture in primary care, Aarhus Municipality Denmark Poster Topic: Building Capability and Leadership Ane Blom, Maya Damgaard Larsen, Nikoline Ry. er City of Aarhus Denmark Background Aarhus Municipality works connuously with quality improvement in the elderly care e.g by developing a management tool to improve paen t safety culture (PSC). PSC is considered fundamental for the delivery of safe care and can be described as an aggregaon of individuals’ behavior, habits, norms, values and basic assumpons related to paen t care. Literature shows that leadership frames the quality of the culture under which the staff pracces safety. However, culture is a complex phenomenon. As a manager, a tool to idenf y PSC can be useful to get insight into the culture. Despite that primary care is the most rapidly growing segment of the healthcare sector, studies of PSC are mostly conducted in hospital sengs resulng in a significant knowledge gap in primary care. However, this study shows how a Safety Atude Quesonnair e (SAQ), developed for hospital sengs, can be tested and adjusted to primary care and used for idenf ying quality improvement acvies. Methods The primary target group was managers and frontline staff in elder care. The intervenon was a twostep process of 1) quant av e SAQ‐DK quesonnair e and 2) a qualitav e follow‐up concept. SAQ‐DK quesonnair e: 10 validated quesons from the Danish translaon of SAQ were selected (SAQ‐DK). For each queson explanatory texts were wrien, and pilot tested to ensure full understanding in an elder care seng. The quesonnair e was distributed by e‐mail to frontline staff and their managers in 7 nursing home units and 2 home care teams. Follow‐up concept: is a three‐step structured process with high level of staff involvement. This gives managers and staff a plaorm enabling dialogue about their culture and enabling how to priorize improvement acvies. The result is a driver diagram. Outcome Average response rate of the SAQ‐DK was 87.11% Follow‐up concept showed that 7 out of 9 units parcipated in a facilitated workshop and the improvement acvies were structured in local driver diagrams. One manager from a nursing home expressed that ‘…the actual measurement gives me an insight into where we can benefit from development and improvement’. Qualitav e assessment showed that the managers have taken lead and chosen dedicated staff members to implement the improvement acvies according to the model of improvement. The units follow their improvement acvies with local result and process indicators. A manager expresses that: ‘improvement acvies and culture may be a fluffy size but with the SAQ we express what we can work with in the daily improvement work. It has improved both the workflows and the working environment, and at the same me it has meant that the elderly gets a beer care’. Conclusion Our results showed that using SAQ‐DK in elder care can help iniate systemac quality improvement acvies and contribute to enhance PSC. However, building a PSC needs a clear leadership focus. Leaders need to enable the staff to take ownership and allow quality improvement acvies in their day‐to‐day pracce. https://docs.google.com/document/d/1UUxHAhuclV9_3OFZmEeevyBCnji8MP8J4fzqn5Vi4uk/edit 1/444 18/03/2019 International Forum Glasgow 2019 Conference Proceedings FINAL - Google Docs Percepon of nursing work environment differenaȁted according to educaonal level Poster Topic: Building Capability and Leadership Annemarie (JBM) de Vos, Ellen Olsthoorn Amphia Hospital, Nursing Council, Breda, The Netherlands Brigi e (JM) de Brouwer Accuralis Zorgopmalisa e, Geldrop, The Netherlands Background The increasing intensity of paen t care requires that the nursing capacity and quality have to be increased. Moreover, in order to ar act and retain academically trained nurses, creang a healthy and producv e working environment is essenal. Sufficient and skilled nurses, good relaonship s with doctors, autonomy, team leader support, control over professional pracce, and paen t‐oriented care culture are posively associated with paen t outcomes, such as pressure ulcers, infecon, delirium, malnutrion, paen t sas facon and mortality. The appropriate deployment with regard to all CanMEDS roles and level of educaon do jusce to competencies of both academically (hbo) and vocaonal trained (mbo‐inservice) nurses, without over‐demanding and under‐ulizaon them. New nursing profiles in The Netherlands assign the management role, coordinaon and care improvements to academically trained nurses and the protocol‐based individual paen t care to vocaonal trained nurses. Thus far, it is not known what the percepon is of the nursing staff in the Amphia Hospital on the characteriscs of the work environment, such as autonomy, control over professional pracce, and relaons with doctors. In addion, insight into the differences and similaries between the various educaonal levels is lacking. The aim of this research is to obtain insight into the percepon of hbo, inservice and mbo trained nurses regarding the work environment. The results will provide input for the implementaon of the new nursing profiles in the Amphia Hospital in 2019. Methods The Dutch Essenals of Magnesm II was used to measure the work environment of nurses and to idenf y the strong aspects and the improvement opons. This instrument measures eight characteriscs of an ar acv e and producv e work environment, which nurses consider important to deliver good quality care: (1) Working with skilled colleagues, (2) Good relaons with doctors, (3) Autonomy, (4) Team leader support, (5) Control over professional pracce, (6) Educaon opportunies, (7) Sufficient staff and (8) Paen t‐oriented care culture. In addion, the percepon on the quality of paen t care, the overall job sas facon, and the professional job sas facon were measured. Outcome Almost two third of all nursing professionals (ntotal=1349) in Amphia (61,8%; n=834) completed the quesonnair e. The major part was inservice trained (40%), followed by mbo (28%), and hbo (28%). Hbo‐nurses are most posive in comparison to mbo‐ and inservice nurses regarding seven of eight characteriscs (Table 1). Yet, inservice nurses score higher than higher hbo‐nurses on the characterisc 'Sufficient staff'. Mbo‐nurses score lowest on six of the eight characteriscs. Conclusion All nurses, regardless of educaonal level, indicate that they are sas fied with their work. Hbo‐ and inservice nurses, however, have a more posive percepon on the work environment than mbo‐nurses. This is due to the fact that mbo‐nurses have a significantly more negav e picture than the hbo‐ and inservice nurses on 'Team leader support', 'Control over professional pracce', 'Sufficient staff', and the result variables 'Quality of paen t care' and 'Professional job sas facon'. In addion, hbo‐nurses are significantly more posive about the professional competence of colleagues than mbo‐ and in‐service nurses. These results imply that the improvement potenal for hbo‐, inservice and mbo‐nurses lies in different areas. In order to ensure the correct applicaon of all CanMEDS roles, implementaon trajectories in the context of funcon differena on should take into account the differena ted percepon on the working environment, depending on the level of educaon. https://docs.google.com/document/d/1UUxHAhuclV9_3OFZmEeevyBCnji8MP8J4fzqn5Vi4uk/edit 2/444 18/03/2019 International Forum Glasgow 2019 Conference Proceedings FINAL - Google Docs Opmising Strength and Resilience in Healthcare Staff Poster Topic: Building Capability and Leadership Anne‐Marie Doyle, Anna Bootle, Elizabeth Haxby The Royal Brompton and Harefield NHS Foundaon Trust, London, England Myra Hunter King’s College, London, England Background There is growing recognion of staff work‐related stress and links between leadership, staff health & well‐being, quality & safety, and organisaonal culture. The latest naonal staff survey (2018) showed 39.8% of staff were unwell as a result of work‐related stress, the highest rate in 5 years. The aim of the research was to evaluate the efficacy & acceptability of a new group programme for staff entled
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