Looking through the safety and quality lens: how can we sharpen the view? - NADA Conference 2018 - NADA Conference ...
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Looking through the safety and quality lens: how can we sharpen the view? Tonina Harvey and Tanya Merinda, NSW Health Suzie Hudson, NADA Gabriella Holmes, Mission Australia Julaine Allan, Lives Lived Well (formerly Lyndon) NADA Conference 2018
Looking through the safety and quality lens: how
can we sharpen the view?
Welcome
Reflective question
Think about a recent time when there was a clinical incident in your service.
How well equipped was your organisation in identifying and
responding to the clinical incident?
A Not well equipped: no documented B Somewhat equipped: some
or established processes for identifying documented processes for identifying or
or managing clinical incidents managing clinical incidents, but not well
established across the organisation
C Well equipped: well documented D Very well equipped: well
and established processes for identifying established processes for identifying and
managing clinical incidents, and have
and managing clinical incidents
reviewed and made continual
improvements over time
NSW Health Safety and Quality
Framework 2017 / 2018
The Framework is
intended to assist with
the design, purchasing,
performance monitoring
and continuous
improvement of health
services that are needs-
based and deliver safe,
high quality and high
value care for all
consumers
Definition Clinical governance is defined by the Australian Council on Healthcare Standards as "The system, by which the governing body, managers, clinicians and staff share responsibility and accountability for the quality of care, continuously improving, minimising risks and fostering an environment of excellence in care for consumers".
Clinical Governance
CORPORATE
GOVERNANCE
CLINICAL
GOVERNANCE
SERVICE
DELIVERY
Safe
Safe &&High
High Quality
Quality Care
Care
C
Overview of Clinical Governance
VISION
People with drug and alcohol
related harms experience person-centred,
safe, high quality intervention and care.
Safe High Quality Care
Governance,
Leadership, Culture
Risks are Calculated,
Mitigations are in place
Integrated Safety &
Quality Improvement
Systems
Clinical Performance is Systems for CQI
Monitored & Measured
Ensures Efficiency &
Consumers are Effectiveness of service
Partners delivery
INTEGRATION ACROSS THE
SERVICE
What does this mean for services? Clinical leadership responsibility and accountability is well defined and connected to corporate governance systems Systems for stakeholder, clinician engagement and performance management are actively in place Treatment services are informed by the evidence of what is working and are respectful of, and responsive to, the preferences, needs and values of clients and the community Information and data are used to inform service delivery and drive quality improvement Resources are allocated to monitor, build and sustain clinical expertise within the service
Increasing AOD safety and quality
Increasing AOD safety and quality
AOD Safety and Partnerships
AOD Safety and Quality Projects
AOD Safety and Quality Plan
Quality Team
LHDs, NGOs,
e.g. core process of private providers,
(1) Governance (2) AOD care; other Health
Evidence Based governance and agencies (ACI,
Michelle, Tonina,
Practice (3) Data accountability; data CEC)
Ann, Jen, Arun, Amy,
Tanya Analytics integrityNGO AOD Core Performance Indicators
AOD-Core1
NSW Minimum Data Set (MDS) for Drug and Alcohol
1
Treatment Services (DATS)
AOD-Core2
Organisation accreditation and clinical governance
2
AOD-Core3
Client reported experience
3
AOD-Core4
Clinical incident management.
4
AOD-Core5
Client discharge and transfer of care.
5AOD safety and quality projects
NGO Core Performance Indicator Support
Information
Training
and resources
Support
Data systemsPractice focus
Gabriella Holmes
Program Manager, Triple Care FarmPractice focus The Quality Journey
Practice focus
Practice focus
Clinical Practice Guidelines:
Responding to Mental Health Emergencies
Orientation ASIST
Training on Implemented Training Clinical
Responding the suite of Mandatory Incidents
Develop
to Suicidal tools in the Training for Reviewed
individual
Ideation All staff Monthly and
wellness Suicide Audited
plans. (First 3 Assessment (Run on site Every Six
months of Kit every 12 Months.
employment) months)Practice focus
The Suicide Assessment Kit (SAK) is a comprehensive assessment
and policy development package, designed to assist alcohol and other
drug services in the assessment and management of suicide risk. The
SAK was developed by NDARC in partnership with the Network of
Alcohol and Other Drug Agencies (NADA), in response to a need
identified as a result of interviewing staff and managers of residential
rehabilitation services nationally (Ross et al, 2012).
The SAK contains three key resources:
1) the Suicide Risk Screener
2) the Suicide Risk Formulation Template, and
3) the Suicide Policies and Procedures Pro-forma.
https://ndarc.med.unsw.edu.au/suicide-assessment-kit
www.nada.org.auPractice focus
Applied Suicide Intervention Skills Training (ASIST) is
a two-day interactive workshop in suicide first aid.
ASIST teaches participants to recognise when
someone may have thoughts of suicide and work
with them to create a plan that will support their
immediate safety.
www.livingworks.netPractice focus Interdisciplinary Team Meeting A weekly meeting that brings together all staff (counselors, trainers, youth workers) to develop individually tailored support plans for program participants. The structure for the interdisciplinary meeting is formal and includes a case discussion; presenting their history, current presenting issues, a wellness plan the young person has developed and how they were currently engaging in the program. The team develops an individual support plan. The really helpful aspect of this is being able to develop support plans for difficult and complex presenting issues that enabled the team to respond consistently.
Practice focus
Julaine Allan
National Research ManagerAccreditation and funder reviews
Clinical incidents
How do we know what works?
Adding details
Examples
Group discussion Sharing clinical safety and quality practice Table discussion x 10 minutes Respond to questions Note main points Brief feedback to broader group What is one practice in your organisation that supports clinical safety and quality for clients? How does this practice support clinical safety and quality?
Reflective question
What is one thing that would help your
organisation to improve safety and quality
practice?Evaluation question
How well has this session improved your understanding of
clinical safety and quality for drug and alcohol service
delivery?
A – Has not improved my understanding at all
B – Has improved my understanding somewhat
C – Has improved my understanding quite a lotLooking through the safety and quality lens: how can we sharpen the view? Where to from here…..what will NADA and NSW Health do to support organisations? Reflecting on what your organisation already does well and how might you enhance it to improve safety and quality? Do your consumers have a voice? – If so, how, where and how often?
Contacts AOD Safety and Quality - Ministry of Health MOH-AODSafetyQuality@moh.health.nsw.gov.au Suzie Hudson - NADA suzie@nada.org.au Gabriella Holmes – Mission Australia holmesg@missionaustralia.com.au Julaine Allan – Lives Lived Well Julaine.Allan@liveslivedwell.org.au
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