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Abstract
Aim The aim of this abstract is to describe the process of engaging and supporting those working in the paediatric service across an entire health system in a Quality Improvement (QI) programme and to describe its outcomes to date.
Methods Using the Institute for Healthcare Improvement “breakthrough collaborative” methodology, the Northern Ireland Health and Social Care Safety Forum engaged with all paediatric units to agree areas for quality improvement and to develop these into a regional driver diagram. The areas for improvement agreed upon were:
Communication – focusing on handovers, structured communications tools e.g. IPASS and SBAR, the use of safety briefings and the quality of ward rounds. The collaborative has also worked with parent representatives to develop a parent safety poster for use in all paediatric units in Northern Ireland.
Reduction in medication errors – including prescribing and administration errors
Early detection and rescue of the sick child – the collaborative have agreed a set of regional age bracketed early warning score charts and an agreed escalation protocol.
Management and Leadership – Optimising the flow of children in the acute setting
The initial three learning sessions were held over a 12 month period with action periods between. Each Trust sent a core multidisciplinary clinical team to the learning sessions and reported progress in an “all teach, all learn” environment. The Model for Improvement was used to test and implement changes.
Results Figure 1 Regional Driver Diagram and participating units
Regional driver diagram and participating units
Figure 2 – Examples of Improvement work undertaken as part of the collaborative
Example of improvement work and early detection deterioration
Early detection of deterioration
Figure 3 – parent safety poster
Parent safety poster
Conclusion The value of a regional paediatric quality improvement collaborative is that it brings clinicians, managers and parents together with a set of core aims. The collaborative gets results by engaging frontline teams in identifying the key challenges faced, generating the potential solutions and then by using the methodology, testing these in real time to see what works and importantly what doesn’t work before scaling up change.