does the patient benefit from networking?... · •information technology is not only to enhance...

DOES THE PATIENT BENEFIT FROM NETWORKING?

Guðlaug Rakel Guðjónsdóttir Chief Executive at Landspitali, the National University Hospital in Iceland

Definition of networking

• The exchange of information or services

among individuals, groups or institutions

• It describes interactions and

communications or activities between

individuals, groups or institutions.

LNN Copenhagen 14.-16. May

Share the knowledge – enhance the experience

• Most important is how you use and share

the knowledge.

• Share the knowledge for example by

networking

• Share and learn from each other– it

becomes usable.


Knowledge sharing networks

• Networking tools are supportive in nursing

practices and patient well being

• Social networks are significantly useful in

knowledge sharing for nurses and can

improve patient safety


Building the network

• The LNN congress is an exceptional

venue to meet colleagues, exchange

views and socialize, both within each

country but not least between countries.

• Building the network, for the benefit of the

patient !


What about the patient ?

• Does the patient benefit from the Nordic collaboration in your country?

• Are we active in sharing results or experiences ?

• What have we put into practice to improve the patient’s journey through our services?

• Have we learned from each other, both from succsses and pitfalls?


The leader – yourself !

• How do we improve patient safety ?

• Learning from adverse events ?

• How do we inspire others ?


Quality and safety

• Information technology is not only to

enhance nurse to nurse collaboration but

also nurse to patient interaction and will

improve quality and safety of healthcare.

• Information technology is a fundamental

asset for health care providers – decision

support

• Some examples – live it and share it in this

Nordic cooperation ! LNN Copenhagen 14.-16. May

Quality and safety

• CRM – Crew Resource Management

• Emphasis on cognitive and interpersonal

skills

– Communication

– Situational awareness

– Problem solving

– Decision making

– TEAMWORK


Teamwork


Enhance the experience

• Network – some ideas !


Provides valuable information on various operational and safety factors

Systematically viewed and assessed, independently and in safety huddles.

Each featured with trends, displaying days, weeks and months.

REAL TIME OPERATIONAL INDICATORS

REAL TIME INDICATORS MAIN DASHBOARD

MAJOR TRACK

PATIENTS

BEDS AVAILABLE WAITING ROOM TRIAGE DOOR TO DOCTOR

TOTAL PATIENTS

MAJOR + MINOR

LENGTH OF STAY

MAJOR TRACK

TOTAL VISITS

TIME UNTIL ADMISSION LONGEST WAIT FOR

WARD BED

RISK MANAGEMENT

DEFINED PROCEDURES FOR EACH INDICATOR LEVEL

0

10

20

30

40 50

100

90

80

70

60

Green

Monitor

every hour

Red

Treat patients in

triage level1-3 only,

until stabilized

Yellow

Take immediate measures to

facilitate flow

Reallocate staff and resources

EXPERIENCE

Improved:

• Overview of operations

• Transparency

• Communication

• Teamwork / networking

• Quality

• Processes

• Resource utilization

SITUATIONAL AWARENESS MEETINGS / SAFETY HUDDLES

• The longtime goal is to prevent all unforeseen

patient adverse events

• The key component is to spot signs of trouble and

react before it escalates

• Situational awareness is a proven best practice

method to raise risk awareness, detect

abnormalities early and to initiate preventive and /

or mitigating actions.


IMPROVING SITUATIONAL AWARENESS

• To improve situational awareness many

organizations have implemented regular

systematic situational awareness meetings

• Frontline staff come together and assess risk

factors systematically and put forth risk reducing

action plans

• Incorporate regular system wide safety huddles is

a key factor to engage and sustain situational

safety awareness in day to day operations


IMPROVING SITUATIONAL AWARENESS CONT.

• This approach is common in aviation and military

operations and has been adopted by many

hospitals in order to provide safety for their

patients and staff

• Cincinnati´s Children's Hospital (CCHMC) in Ohio

has been the industry leader in this approach.


SITUATIONAL AWARENESS MEETINGS

• Look back

– Safety and quality factors the last 24 hrs.

• Look forward

– See, predict and prepair to ensure safety and quality of care for the next 24 hrs.

• Follow up

– Report on risks or events from the last 24 hrs or over the last few days and provide information on how the situation is being improved


SAFETY CHECK LIST • Acute sick patients, watchers

• Risk involving treatment, behavior or medications

• Communications and information flow – Orders or tests not completed in a safe manner – Communication barriers

• Clinical intuition – Something feels wrong, I have a concern – Patient or his/her family is concerned

• Patient flow –Patients due to be admitted and discharged – Ward unable to accommodate volume needed

• Staff – Staffing issues that possibly impact safety

• Environment – Safety issues due to facilities, equipments or systems



Each ward

huddles with

safety checklists

every morning

Issues the ward is

unable to resolve

on it´s own is

escalated to the

joined huddle at

11:15

Hringbraut

Joined video

huddle

Fossvogur

THE IMPLEMENTING JOURNEY

• Emergency department first to pilot daily huddles

in April 2015

• All inpatient wards followed within the next 2

years

• Ambulant wards started late 2016

• System safety awareness meetings led by chief

executives 28.December 2017


SYSTEM MEETING

• Scripted / standardized daily huddles at 11:15 every

day of the year – Fossvogur and Hringbraut campuses conneceted by video conference

• Safety check list and follow up 10 minutes, max 15

minutes

• Breaks into two main huddles

• Fossvogur

• Hringbraut

– Able to connect via the internet


LEADERS OF THE HUDDLES ASK…

• What immediate actions did you take?

• What is the impact on the rest of the hospital?

• How does this impact our ability to provide safe

care?

• What can we do to reduce the risk to patients,

families and caregivers?

• How can this team help you improve the situation?

• Are we resourced appropriately for this?

• That’s a Safety Critical Issue…


LESSONS LEARNED

• Vast improvement in real-time awareness of issues

– makes problem solving much easier

• Simple as possible

• Standardized checklists or scripts are the key

• Give it time

• Involvement of all staff across clinical and non-

clinical services


THANK YOU FOR LISTENING

Guðlaug Rakel Guðjónsdóttir Chief Executive at Landspitali, the National University Hospital in Iceland

does the patient benefit from networking?... · •information technology is not only to enhance...

Documents