EVALUATION of PATIENT SAFETY WEEK, 3 to 9 NOVEMBER 2014 Contents

EVALUATION OF PATIENT SAFETY WEEK, 3 to 9 NOVEMBER 2014 December 2014 Contents Introduction ............................................................................................................................................ 2 Dr James Bagian workshops .................................................................................................................... 2 Let’s PLAN for better care ....................................................................................................................... 4 Promotions in secondary care ................................................................................................................ 5 Website and social media ....................................................................................................................... 7 Survey...................................................................................................................................................... 7 Conclusion ............................................................................................................................................... 9 Recommendations ................................................................................................................................ 11 Appendix 1: Media release, and media coverage of Dr Bagian’s visit .................................................. 12 Appendix 2: Let’s PLAN for better care ................................................................................................. 17 Appendix 3: Patient Safety Week resources ......................................................................................... 25 Appendix 4: Advertisements ................................................................................................................. 30 Appendix 5: DHBs’ Patient Safety Week activities – media releases, summary of activities, photos .. 32 Introduction Patient Safety Week was an awareness raising week run by the Health Quality & Safety Commission as part of the Open for better care campaign. The purpose of the week, which ran from 3 to 9 November 2014, was to: • create focus, energy, momentum and raise awareness of the importance of patient safety through a concentrated burst of activities over a week • distribute and share the resources available and celebrate and share positive and successful initiatives so more New Zealanders can learn about and become enthusiasts for patient safety • establish and strengthen relationships with organisations and networks interested in promoting consumers as partners in care to increase knowledge and skills • create a community of patient safety week supporters and champions for future years. The three main audiences for Patient Safety Week were: • providers of health and disability services across primary, secondary and tertiary care • the general public who, as patients, people with disabilities and/or family members, access health and disability services • influential organisations and individuals who want to assist the Commission in the delivery of Patient Safety Week, and become partners in the design and implementation of future weeks. The week had three complementary focuses: • Workshops with Dr James P Bagian, human factors specialist – held in Auckland, Wellington and Dunedin. • Launch of Let’s PLAN for better care (primary care) and a training resource for consumer representatives • Promotions in secondary care. Patient Safety Week came just after the release of the Commission’s serious adverse events report, which set the scene about the importance of an ongoing focus on patient safety. Dr James Bagian workshops Leadership for patient safety with Dr James Bagian workshops were run in three centres (Auckland, Wellington, Dunedin) across patient safety week. A reducing perioperative harm- focused workshop was also conducted in Auckland. These four events reached approximately 350 participants, with participants being predominantly clinicians. Of the sessions within each workshop, Dr Bagian’s sessions received the highest approval rating. The ‘Open Hour’ was not as well attended and given a lower score in comparison to the other sessions. While there was some ambivalence about the usefulness of the Open Hour, the Let’s PLAN resource was well received. 2 Overall feedback about the Dr Bagian workshop was positive; some comments from participants are included below. • “I found the guest speaker very easy to listen to and follow and whilst I probably didn’t learn anything that I didn’t already know, putting those ideas into practice is not always easy, so good to have different viewpoints.” • “It was inspirational and I thoroughly enjoyed the opportunity to reinvigorate my passion for patient safety and also to network with colleagues.” • “I thought it was a really great workshop and Dr Bagian is a fantastic presenter with skills to make participants think and contribute – not always apparent in presenters!” • “Dr James Bagian was an amazing presenter. His principles were easily understood and applicable to any environment. I really enjoyed all of his sessions.” • “Dr Bagian is a very polished and experienced presenter. It is obvious that his fast and full presentations are based on a wealth of experience which makes them very authentic. I’m not sure I learned anything new though. My favourite parts were the challenging and provocative elements.” • “Jim speaks very fast and goes through a lot of information – for some this may have moved too fast. The case studies and scenario questions were good learning techniques.” Survey results ‘How helpful did you find the following? Leadership, patient safety and components of 4.32 4.15 a safety system (Dr Bagian) 4.13 4.12 Beyond the RCA: case studies 3.74 3.36 Challenges and best practices: what's 3.6 Dun (7 Nov) 3.42 happening regionally? 3.48 Wgtn (5 Nov) Akl (3 Nov) Teamwork and communication for quality (Dr 4.44 4.2 Bagian) 3.92 3.16 Open Hour 2.57 3 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 3 Some key messages taken away from the Dr Bagian workshops, and reflective of comments across the week, included: • The need for more awareness about the role of human factors in patient safety and the need for stronger leadership with more direct approach to improve identified systems issues. • That patient safety is being taking seriously and people are actively looking at ways to improve. • Our DHB is reporting and investigating serious events in a more advanced way than perhaps we realised. • Reinforced many messages already heard. Liked the message of "don’t hint and hope". • Requirement for systems approaches and visible leadership. • To focus on recording data about near misses and using this data to drive patient safety culture. There was considerable media interest in Dr Bagian’s visit, with coverage from TV One’s Breakfast programme, Sunday Morning with Wallace Chapman on Radio New Zealand National, the Dominion Post, Dunedin TV and the Otago Daily Times. Media were most interested in the connection between patient safety and Dr Bagian’s background in the NASA space programme. See Appendix 1 for more details about the media coverage received. Let’s PLAN for better care Let’s PLAN for better care was launched during Patient Safety Week. Let’s PLAN is a health literacy initiative to help consumers prepare well for their visit to the GP or other primary care health professional. It was developed because consumers felt they would like something to help them communicate better with their doctor and nurse, and know more about the medicines they are on. Let’s PLAN was launched on 5 November, with a media release, and was also featured in the Open Hour at each of the main Dr Bagian workshops. Information about Let’s PLAN was distributed to general practices in the Commission stakeholder database (including attendees of the Practice Managers & Administration Association of New Zealand conference in Rotorua), all PHOs, over 1000 community pharmacies, all Open Hour invitees, DHB CEOs, quality and risk managers and communication managers, and communication managers of all the relevant professional organisations. Uptake of the Let’s PLAN resources to date has been encouraging, with a large number of requests received for copies of the pads and posters. Of the 5000 Let’s PLAN tear-off pads (30 sheets each), 2500 remain. Requests for additional pads have come from a wide range of agencies, including general practices, pharmacies, PHOs, Maori health providers, specialist hospital departments, cancer nurse coordinators, rural health services, aged residential care facilities, a community occupational therapist, a university student health practice, ACC offices, Age Concern, Citizen Advice Bureaux, Diabetes New Zealand, Heart Foundation, Muscular Dystrophy Association, Arthritis New Zealand, Anglican Family Care (social services organisation working with vulnerable children and families), Rural Women New Zealand, English Language Partners (for immigrant and refugee learners), Kingdom Hall Church, Palmerston North (for older congregation members). 4 Media releases promoting Let’s PLAN were prepared. See Appendix 2 for the Let’s PLAN materials, media releases and media clippings. Media coverage included an interview with Chris Walsh, director of Partners in Care, on Nine to Noon with Kathryn Ryan on Radio New Zealand National and an article for Without Limits magazine for people with disabilities. Different media releases were prepared for general, pharmaceutical and nursing media and organisations. The latter

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