Prepared by Jenny TyrrellNurse Manager Nursing Development & Capability

Nursing & Midwifery Directorate

October 2012

Grand Rounds via

Video Conferencing

What are we accomplishing?1. Critically review case presentations in a

interprofessional framework to ↑ awareness & foster development of locally adapted, effective systems of quality & safety controls for better outcomes for patients & staff.

2. ↑ learning by allowing reflection on cases that are relevant, practical & respectful of prior knowledge (Adult learning principles ) - everyone learns differing lessons dependant on their level of experience & discipline.

Grand Rounds Via Video Conferencing

Links 8-9 Rural sites via MHECs or Telehealth Units & teleconferencing

Networking without travel

Relevant real cases to reflect on their care strategies

Multidisciplinary in both discussion & attendance- team work- all health professionals welcome

Steps undertaken to implement

Acceptance of project from HETI

Lead Person assigned

EOI from sites & education to sites

Webpage development for all presentations & forms

Building rapport & Confidence & invite other disciplines to attend

↑ Future scope & sustainability

Grand Rounds Via Video Conferencing

Sites alternate monthly- offering different cases to reflect & learn from

Builds confidence with technology use

Builds capability through critical questioning & reflection on real case presentations

Presentations 2011 & 20122011 2012

The Devil is in the Detail - Sliding Scale Insulin

Dyspnoea in Palliative Care Advanced Care Directives Paediatric Head injury Pressure Area Prevention Early Presentation of Chest

Pain/AMI Gun Shot Wound• Cardiac Pacing of a Patient in a

Rural Setting • Management of Haemoptysis • A Simple Case of Tonsillitis – not

so simple • Management of a Patient with

Asthma with Laryngeal Stridor

• A multiservice approach to holistic wound care

• Head injury management while isolated by floods

• Paratrooper- Trauma presentation

• Little Boy Blue- idiopathic VT arrhythmia

• Tricky Dicky- a collaborative approach to confusion

• Mrs Bear – go back to basics• Is it Dementia or Delirium

Continuous Improvement model

Started January 2011 → constant improvements Eg

– Webpage developed = Access to P.P & forms pre presentation

– Mute Button - pre presentation (link)

– Presentations recorded →Power points with voice (Link)

– Future scope - other groups expanded

Future Scope

3 x Acute hospital groups running each month

community lone practitioners monthly

Community health centre groups

Future Scope

Team responsible - Implementation

Nursing & Midwifery Directorate

Telecommunications team

Site Managers

CNE-CME’s, CNC -CMC,

site teams , acute & community, Dr’s, Ambulance officers & allied health

Performance measures used

Attendance data

Evaluations

↑ capability / confidence -use of Technology

Build rapport & participation = ↑ questioning & reflection → practice change

↑ awareness in other models of care, options for presentations – thinking outside the box

Evaluation

Used to ensure improvements & evidence for accreditation

January – August 2011 = evaluation from CETI & MLHD

Annually - July 2012

Future – survey monkey?

Evaluation July 2012

Reflection on Clinical Practice

Numbers regarding participation

Multidisciplinary team engagement

Comparing 2011 results to 2012

Question 2011 results 2012 results Improvement

Rate VC technically 31% Very good /excellent

77% Very good/ Excellent

↑ 46%

Led to reflection on teams clinical practice 79% Yes 91% Yes ↑ 12%

Led to reflection on own clinical practice 78% yes 92% Yes ↑ 14%

How valuable was Grand Rounds

75% very good/excellent

96% very good/ excellent ↑ 21%

Participant attending 141 participants

200 participants ↑ 59 participants

Questions

?

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