Posts tagged “WPSD”

Come together: how we kept on huddling in the virtual world – Claire Gordon

Posted on September 24, 2020

Huddles are a key part of most NHS organisations nationwide. But how do you huddle virtually – and successfully – in an organisation of 500 people? Senior Communications Officer Claire Gordon tells us how we’ve done it – despite the photo bombers.

When I was first asked to take over organisation of our staff huddles back in 2016, I was a bit bemused. They didn’t sound like huddles to me. They were quite formal sessions where senior managers presented to staff in a boardroom, questions were posed in advance and responses were scripted. There also seemed to be a huge amount of work involved in organising them. Not that I’m shy of a bit of hard graft, but if there’s a better way, I’ll find it!

I quickly decided it would be best for everyone if the huddles were exactly that; an informal get together, on the office floor, where staff and managers could come together to hear updates from each other, share news and celebrate success.

This worked pretty well for people based in our Edinburgh and Glasgow offices. We often attracted large numbers with good levels of engagement and interaction from staff and, latterly, board members. But it didn’t translate across to the tele huddle, which always felt like a very stilted one way conversation down a phone line. Colleagues based in local health board offices just didn’t get the same opportunity to engage with senior managers as everyone else.

Taking to Teams

Fast forward to 2020, COVID-19 and the rapid move to homeworking and all of sudden it wasn’t possible to huddle. Well, not in the physical sense. We thought about videos and webinars but nothing seemed to fit the bill. Then along came MS Teams and a chance to gain back a little bit of that organisational closeness we’d lost.

The first huddle on Teams was a test of technology and nerves. We’d often talked about how we couldn’t possibly accommodate the whole organisation in one huddle when we we’re all office based because phone lines would crash, video conferencing facilities would stall and the world, as we knew it, would undoubtedly end.

But, with big girl pants on, I invited the entire organisation to join us for a virtual huddle on Teams for the first time back in May. The response to the invite was overwhelming. Almost every employee said yes, they’d be there with bells on (not quite, but I like to pretend everyone is as enthusiastic for huddles as me). A second session was hastily arranged after I realised that Teams could only accommodate a maximum of 250 participants!

Tech issues vs human errors

Ahead of the first session, my Comms chums helped out with a dry run. My Comms colleague Stephen Ferguson doing a grand impression of our Chief Executive and huddle host, Robbie Pearson, and another colleague, Victoria Edmond, testing the chat function, a display of skills which later saw her promoted to official Chat Monitor. It worked with six, so it would work with 250 surely!?

And it did. Surprise and relief washed over me as our first virtual huddle went without a hitch, technically speaking. We had over 200 people on the call with no obvious sound or vision issues to report. And I felt rather emotional when I saw lots of folks commenting on the chat about how nice it was to get together, saying hello to each other for possibly the first time in many weeks and sharing the odd smiley face emoji or two.

It hasn’t all been plain sailing. We’ve had what I like to think of as the Teams equivalent of a ‘photo bomber’ – that rogue person whose camera suddenly switches on while the CEO is mid-flow and then walks away from the screen – cue mad panic and quick @mention in the huddle chat in the hope they’ll come back and notice we’re all staring at their front room.

Apart, together

It might sound a bit over the top, but I feel like our huddles have been redefined during lockdown. They now give us a chance to unite as one organisation, if only for 45 minutes. We don’t get the facial cues, the spontaneity or the visual feedback, but we do have the ability to ask questions and make comments in what feels like a safe space. And it’s reassuring, when we see colleagues reacting to those posts, to know that we’re not alone and that someone else, sitting somewhere else, feels the same way. Okay, that was maybe a little bit over the top.

Since organising the virtual huddles I seem to have gained the reputation of being some kind of expert on Teams – which I’m really not! So, despite the imposter syndrome, here are my top tips for a good virtual huddle:

Set the expectations out in the invite. Be clear on what participants need to do and if you’re asking them to do something a bit techy give some simple steps to follow.
Prepare speaking notes and circulate these to all the speakers in advance. Keep the notes brief, bullet points, to encourage talking rather than reading from the page.
Set the tone of the session from the top. Pop a nice friendly message in the meeting chat while everyone’s waiting to go and open with a warm welcome.
Encourage participants to use the chat function. It makes the session more interactive and engaging. It works best if you have someone monitoring the chat and cherry picking questions and comments to pose to speakers.
If someone’s not following the agreed etiquette then @mention them in the meeting chat and reiterate the rules and do this promptly and consistently.
Start and finish the session on time. We’re all suffering from Teams fatigue so don’t keep anyone longer than you said you would.
Build in time for Q&A, and try to cover as many questions as this allows, with follow up after the meeting if it’s not possible to answer them all.
Be brave. If it all goes horribly wrong then just politely apologise, bring the meeting to a close and promise to try again soon.

Claire Gordon is a Senior Communications Officer with Healthcare Improvement Scotland.

More information

Visit the Healthcare Improvement Scotland website for information on our response to COVID-19.

Categories: SPSP

Tagged: World Patient Safety Day 2020, WPSD

Right people, right place, right time = right care for Scotland – Mairi McConnochie

Posted on September 22, 2020

Mairi McConnochie of our Healthcare Staffing Programme reflects on last week’s World Patient Safety Day, the challenges ahead and the successes we need to continue to build on.

The theme for this year’s ‘World Patient Safety Day’ was ‘Safe Staff, Safe Care’. In the wake of the COVID pandemic, this theme conjures up images of PPE-clad healthcare workers doing their best to create a safe environment and provide care to patients and service users under considerably trying conditions. But what if we look to the broader landscape of safe workforces? There is much evidence to demonstrate a strong link between safe workforce levels and patient outcomes. A recent European study by the Registered Nurse Forecasting System (RN4CAST) identified that each additional patient per nurse is associated with 32% higher odds of poor quality care. Another RN4CAST study identified that for every 10% increase in the amount of care left undone, there is a 16% increase in the likelihood of a patient dying following common surgery.

There are challenges with shortages in the health workforce in many parts of the world, with the WHO estimating a global shortfall of 18 million healthcare workers by 2030. The situation in some low income countries, such as Uganda where there are 1.6 doctors per 10,000 of the population, contrasts starkly against the more favourable situations in the UK and other high income countries. However, ensuring safe staffing levels is more than about balancing the demand and supply figures – it’s about making sure that the right people with the right skills are in the right place at the right time.

Scotland: leading the way

In this area, Scotland is leading the way by enshrining safe staffing in law. In 2019 the Health and Care (Staffing) Act was passed which requires health boards to adopt particular workforce and workload planning strategies. Using a range of workload planning tools alongside their professional judgement, hospitals, community services and care homes now have to look very closely at which kind of practitioners they should have where and when, to meet the needs of the patients or service users in their local context and to mitigate or escalate risks. At Healthcare Improvement Scotland, the Healthcare Staffing Programme is helping NHS boards carry out better workload and workforce planning so they can meet the obligations of the Act. We do this through training, staffing tools and methodology development and through offering tailored support and guidance to boards. The end goal is to empower boards to be able to re-design services to help ensure they are providing safe care.

Pandemic brings requirements into sharp focus

Never has this need been more pertinent than over the past few months when services have had to dramatically re-shape to handle COVID patients and everything that an infectious disease outbreak brings. Health Care Staffing Programme team members worked within the Chief Nursing Officer’s Directorate (CNOD) at Scottish Government during the peak of the COVID-19 pandemic on the development of staffing templates for use during COVID and immediately post-COVID in various environments such as Care Homes and Community Nursing settings. Team member Nancy Burns devised the Care Home Safety Huddle template, which went live in August, and now has over 1000 care homes across Scotland registered to use it.

Staff absences and an inconsistent approach to workforce planning have increased the pressure on Care Homes during the pandemic. At the same time, Homes were also expected to report a raft of information for various sources. The template aims to provide an overview of individual care homes for care home managers, Boards and Health and Social Care Partnerships to understand, intervene in and mitigate any areas of risk as they emerge. It also offers a clearer national picture of care homes and any emerging issues that require a national response, and allows easier reporting, freeing up vital care home resources.

Turning the spotlight on safe staffing

Now bringing this experience back with them, the programme team is building on these Scottish Government templates to ensure they are robust and have longevity for service delivery after the immediate post-pandemic phase.

The emergence of COVID 19, combined with this new government legislation, have both turned the spotlight on the importance of safe staffing for safe care. Now more than ever we must pay close attention to how best to use our workforce as we ride out this pandemic and we must use this opportunity and momentum to bed in new ways of working and allow innovation to flourish.

Find out more about the Registered Nurse Forecasting Studies:

https://apps.who.int/gho/data/node.main.HWFGRP_0020?lang=en

https://pubmed.ncbi.nlm.nih.gov/28844649/

Find out more about the WHO’s health workforce statistics:

https://pubmed.ncbi.nlm.nih.gov/28844649/

https://apps.who.int/gho/data/node.main.HWFGRP_0020?lang=en

Mairi McConnochie is Programme Manager with the Healthcare Staffing Programme of Healthcare Improvement Scotland.

Categories: SPSP

Tagged: World Patient Safety Day 2020, WPSD

The pursuit of quality: a healthcare journey – Robbie Pearson

Posted on September 16, 2020

To mark World Patient Safety Day, our Chief Executive, Robbie Pearson, reflects on Scotland’s patient safety journey and looks ahead to a more holistic approach to safety in the future.

With the celebrations to mark 72 years of the NHS, I was reflecting that it is now 10 years since the Scottish Government published the Healthcare Quality Strategy. While we don’t mark anniversaries of documents as we do major events like the birth of the NHS, this publication was a critical step in NHS Scotland’s improvement journey. The Strategy is centred on three linked ambitions of safe, effective and person-centred care, and, with that simple and clear ethos, it has withstood the test of time.

Safety – as one of those ambitions – is also only one dimension of quality, but I am very conscious that it is at the heart of the work of Healthcare Improvement Scotland.

One major element of Healthcare Improvement Scotland’s work is the Scottish Patient Safety Programme (SPSP) which was formally launched in 2008. In the very early days of SPSP, a small handful of committed individuals had a determined fight on their hands to plant its roots and to nurture its growth, in the face of other competing improvement initiatives, sceptics and some vocal opponents. In building on small early wins, SPSP has grown to be a success which reflects the dogged determination and enthusiasm of the many who have worked hard to implement improvements in frontline care, in order to reduce harm and mortality.

The results have been impressive:

Hospital Standard Mortality Ratio (HMSR)reduction 14%
Cardiac arrest rate reduction 29%
Pressure ulcer reduction 26%
Neonatal mortality reduction 15%
Paediatric Ventilator Associated Pneumonia (VAP) reduction 86%
Stillbirth reduction 24%

There isn’t one answer to safety though, nor is SPSP the only aspect of Healthcare Improvement Scotland’s contribution to achieving the ambition of a safer NHS.

Whether it be in tackling variation in the use of medicines, the monitoring and tools to support safe staffing, learning from adverse events, the development of guidance for the diagnosis and treatment of major priorities such as cancer and heart disease or in the external assurance of hospital care, we are focused, as an organisation, on supporting the wider implementation of good practice and reducing avoidable harms.

In so much as the Healthcare Quality Strategy emphasised the different dimensions to quality, we need to recognise that there are also different ways to support the creation of a safer system of care.

We already know that evidence-based clinical interventions in wards delivered consistently improve safety, but so does the right leadership, working environment and organisational culture. Indeed, I would argue the provision of safe care, also fundamentally depends on a safe and supported health and social care workforce. This echoes the priority set out in the World Health Organisation’s ambition to ensure we prioritise the safety and well-being of all those staff working in the health and social care system.

It has been a long journey since the early days of SPSP. We have though, over that time, gained a better understanding of the many dimensions that contribute to safer care. Healthcare Improvement Scotland is taking that into account in redesigning our approach to safety for the next ten years – which holds and builds on the gains of SPSP – but brings together in a more cohesive and connected way our approach to improving safety.

‘Safety’ cannot be seen as only relevant for specific moments of care, whether it be the safe use of equipment, avoiding a fall, pre-operative checklists and so on. The reality is that this aspect is highly relevant but also insufficient. We must keep a focus on safety at the point of care for our clinical and care staff as well as our aspirations for safer systems.

In future, we will see a more holistic approach to safety. We will rapidly review the evidence for safety in key priority areas and ensure that there is both the national support and external assurance in making care safer from the frontline to the very top of the organisation.

Today of course is WHO World Patient Safety Day. As mentioned earlier, this year’s theme attempts to raise awareness of the personal safety risks health care workers face around the world. Such risks have been highlighted this year by COVID-19 but sadly these risks are a more common reality for some in the most deprived parts of the world.

Scotland’s healthcare workers are part of a system that by global standards is generally very safe. However this level of safety has been achieved by constant vigilance and hard work. Our collective efforts to keep health care workers safe are themselves a vital component of patient safety. Today provides an opportunity to focus on Scotland’s success as well as better understand and learn from the global issues in continuing to make all aspects of care safer in future.

Beyond today, our improvement journey must continue, supported by the same commitment, determination and enthusiasm with which it began.

Looking back we can see the positive impacts resulting from the Healthcare Quality Strategy that was set out a decade ago. Looking forward, even with the deep challenges we continue to face in managing COVID-19, we must hold on to these ambitions and ensure they remain at the heart of what do in the coming weeks, months and years.

Robbie Pearson is Chief Executive of Healthcare Improvement Scotland

More information

Categories: SPSP

Tagged: World Patient Safety Day 2020, WPSD