team health presentation to advisory commmittee 9 february 2012

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1 Team Health What we’ve learned so far… Where we want to go… Team Health Advisory Committee Meeting 9 February 2012

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Page 1: Team health presentation to advisory commmittee 9 february 2012

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Team Health

What we’ve learned so far…Where we want to go…

Team Health Advisory Committee Meeting9 February 2012

Page 2: Team health presentation to advisory commmittee 9 february 2012

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What are we trying to do?

To improve teamwork, communication and collaboration for safer patient-centred care, and better staff experiences

Why are we trying to do this?

• Increased staff motivation, well-being and retention• Decrease in staff turnover• Increased patient and carer satisfaction• Increased patient safety • Increase in appropriate use of specialist clinical resources• Reductions in patient mortality and critical incidents• Increase in access to and coordination of health services

Page 3: Team health presentation to advisory commmittee 9 february 2012

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What do we mean by Team Work?

Interprofessional Education (IPE)

Occasions when two or more professions learn from, with and about each other to improve collaboration and the quality of care

Interprofessional Collaborative Practice (ICP)

a patient-centred process of communication and decision-making that enables the separate and shared knowledge and skills of care providers to synergistically influence client/patient care (Way et al, 2000)

Page 4: Team health presentation to advisory commmittee 9 february 2012

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Bureau of Health Information. (May 2010) Insights into Care: Patients Perspectives on NSW Public Hospitals

This first report from the Bureau of Health Information shows clearly that patients are calling out for improvements and that improvement in staff teamwork, between doctors and nurses, is the action most likely to change a fair or poor patient care experience to an excellent one.

The patient perspective…

Patients who felt their quality of care was excellent were likely to have experienced excellence in staff teamwork.

Page 5: Team health presentation to advisory commmittee 9 february 2012

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The clinicians’ perspective…

At the clinical unit level, 96% of respondents reported that they deliver patient care as part of a team (or teams), and 94% reported that effective teamwork was either the most important or in the top three most important issues affecting the delivery of quality healthcare

Clinical Excellence Commission (CEC) 2011. Safer Systems Better Care – Quality Systems Assessment Statewide Report 2011. Sydney: CEC.

Page 6: Team health presentation to advisory commmittee 9 february 2012

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What works?

Multi-faceted strategies

e-Learning modules across professional groups

On-site coaching, debriefing and facilitation

Curriculum that structures formal and informal interactions and is designed to facilitate enquiry

Clinical placements and particularly rural clinical placements

Champions in both health and education sectors

Interdisciplinary program governance

Links with other programs (Established international movement)

Page 7: Team health presentation to advisory commmittee 9 february 2012

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What we learned from our Consultations

• Need to acknowledge and build on what’s already out there: LHDs, Universities, proprietary programs, research, competency frameworks and existing high performing teams

• Ensure curriculum is clinically-relevant and clinically-based (ie work determines the curriculum or case studies used)

• Move on from pilot and demonstration programs

Page 8: Team health presentation to advisory commmittee 9 february 2012

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Program Model

Right Start: Transition to Work in Health• Students in their last semester of study• 5000 new clinical graduates a year• Building core skills & teamwork

Right Start: Foundational Skills• New clinical graduates over first 2 years (10 000 phased)• Builds on Transition to Work in Health (1), includes the

use of Simulated Learning Environments

Building High Performing Teams• Existing clinical teams• 62 000 clinical staff• Network of facilitators, Settings Approach

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Page 9: Team health presentation to advisory commmittee 9 february 2012

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Next StepsRight Start: Transition to Work in Health• Students in their last semester of study• 5000 new clinical graduates a year• Building core skills & teamwork

• Aims to better prepare new clinical graduates for work• Foundational + teamwork skills• Nine funded Expressions of Interest from tertiary providers in

partnership with Local Health Districts• 300 final year clinical graduates have participated in these

innovative pilots• Evaluation of programs in progress (quant and qual)• Showcase event planned for February 27, 2012• Successful modules will be enhanced & standardised

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Page 10: Team health presentation to advisory commmittee 9 february 2012

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Next Steps

Right Start: Foundational Skills• New clinical graduates over first 2 years (10 000 phased)• Builds on Transition to Work in Health (1), includes the use of

Simulated Learning Environments

• Top ten Foundational Skills Module Topics identified through consultations and a review of literature

• Common procedural, clinical and communication issues that may affect patient-centred care

• Modules under development: Templates for participant and facilitator guides, assessment activities

• Mapping of elements, competencies performance criteria to the Health Training Package (CS&H Industry Skills Council)

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Page 11: Team health presentation to advisory commmittee 9 february 2012

Proposed Foundational Topics for new Clinical Graduates

Foundational Topics for new Clinical Graduates

1 Time Management

2 *Knowing when and how to escalate for the deteriorating patient (Detect)

3 Prioritising patient needs or tasks

4 *Communicating clinical handover (JMO Handover)

5 Communicating in medical records

6 Expressing one’s opinion competently to colleagues

7 Communicating with a challenging patient, family or peer

8 Understanding the roles of other health professionals

9 Breaking bad news

10 Working with different cultures and demographics

* Existing packages

Page 12: Team health presentation to advisory commmittee 9 february 2012

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• Additional topics:– Ward Rounds

– Medication safety

Next StepsRight Start: Foundational Skills• New clinical graduates over first 2 years, (10 000 phased)• Builds on Transition to Work in Health (1), includes the use of

Simulated Learning Environments

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Page 13: Team health presentation to advisory commmittee 9 february 2012

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Next StepsBuilding High Performing Teams•Existing clinical teams•62 000 clinical staff•Network of facilitators, Settings Approach

• Facilitated approaches with teams of staff to explore elements of team function & to generate and build on local improvement initiatives

• Tender for Facilitator Training Packages that include:• Facilitation, Coaching, Program Management, Action

Planning, Overviews of other comparable programs (EOC, Redesign)

• Modules for teams include: Team Functioning, Collaborative Leadership, Role Clarification etc. and topics identified through consultation

• Use of Simulated Learning Environments

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Page 14: Team health presentation to advisory commmittee 9 february 2012

Topics to enhance team-based, patient-centred care

Proposed topics to enhance team-based, patient-centred care

1 Understanding the roles of other health professionals

2 Teamwork communication

3 Team reflective practice and ways to facilitate

4 Team purpose and values

5 Engaging patients and their families to partner in decision-making

6 Professionalism

7 Collaborative decision making

8 Team ethics, including confidentiality

9 Knowing when and how to seek advice from other professionals

10 Ongoing team learning

Page 15: Team health presentation to advisory commmittee 9 february 2012

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Next StepsBuilding High Performing Teams•Existing clinical teams•62 000 clinical staff•Network of facilitators, Settings Approach

First phase implementation:• Target 5 Metro & 4 Rural LHDs, 1 Speciality Network• Communication to CEs, trial sites assessed and identified (June)• Recruitment and Induction of 10 Facilitators (July @ HSM 2)• 3-day induction for Facilitators (Facilitator Training Package) (August)• 2-day training for Facilitators (Modules for Teams) (Late August)

• Trialling of curriculum and approach (Sept – Nov)• Evaluation of curriculum, training package and facilitator network (Dec)

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Page 16: Team health presentation to advisory commmittee 9 february 2012

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Feedback on the Plan

• Clarification, Scope, Detail

• Additional Foundational Skills topics (or sub-topics)

• Identification of Subject Matter Experts (Foundational Skills)