NSLHD’s Safety and Quality Newsletter provides information on new and upcoming activities, programs and initiatives within the district that aim to improve the safety of our patients and the quality of our care.
OCTOBER 2022
EDITION 19
Several awareness-raising activities will take place across the district during Medication Safety Week.
IN THIS EDITION:
Medication Safety Week Reports reveal a fall in opioids and antipsychotics dispensing nationally World Thrombosis Day Call for ePosters for International Forum on
Ryde Hospital
Visit the Medication Safety Week stall at Ryde Hospital's main foyer on Wednesday and Thursday (19-20 October) Ryde Hospital Pharmacy department will provide in-services throughout the week Presentations to junior medical officers will take place on Monday (17 October) and Wednesday (19 October) Professor Sarah Hilmer will deliver a presentation at RNSH's Medical Grand Rounds on Tuesday (18 October) Royal North Shore Hospital (RNSH) Visit the promotional stall at HKH during Medication Safety Week Team members from the HKH Pharmacy department will lead several in-services throughout the week. Presentations to junior medical officers will occur on Monday and Tuesday (18 October) Education sessions for junior medical officers will take place on Thursday (20 October) Medication Safety walkarounds and in- services throughout the week Mona Vale Hospital Hornsby Ku-ring-gai Hospital (HKH) Tea-time discussions with clinicians and consumers Macquarie Hospital Visit the Medication Safety Week intranet page to access useful resources or to find out more.
Quality and Safety in Healthcare The Efficiency Quality Dimension Reflective skills workshop What did you think of this issue? Give us your feedback.
This year, NSLHD will celebrate Medication Safety Week on 17- 21 October 2022. During Medication Safety Week, NSLHD will highlight important medication safety moments that keep our patients safe. Staff, patients and consumers are introduced to Mali, a 45yr old fictional patient, whose hospital journey highlights positive medication safety moments during her admission (from emergency department presentation through to discharge). These moments include the clinical practices of medication history taking and reconciliation , safe administration , high-risk medicines and effective communication during care transitions and discharge. Carrying out the medication safety moments observed in Mali’s story can significantly impact a patient’s journey and experience. Patients and consumers will not only feel safe whilst in our care but will appreciate our staff for taking the time to explain their medications to them. The World Health Organisation (WHO) highlighted “Medication Without Harm” as the theme for World Patient Safety Day on 17 September 2022. The key action areas for health organisations to target are high-risk medicines, transitions of care and monitoring polypharmacy.
Medication Safety Standard
Northern Sydney Local Health District
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OCTOBER 2022
EDITION 19
REPORTS REVEAL FALL IN OPIOIDS AND ANTIPSYCHOTICS DISPENSING Dispensing rates fell nationally and in all states and territories. In the five years to 2020–21, there
Two new reports from the Australian Commission on Safety and Quality in Health Care reveal a decline in dispensing of high-risk medicines over five years. The Atlas Time Series Reports from 2016–17 to 2020– 21 released on 21 September 2022 show trend data on opioid medicines dispensing, all ages, and antipsychotic medicines dispensing, 65 years and over. Using data from the Pharmaceutical Benefit Scheme (PBS), the reports examine opioid and antipsychotic medicines dispensing across Australia at national, state and territory, Primary Health Network (PHN) and local levels.
was an 18% reduction nationally in opioid dispensing rates and an 11% reduction in antipsychotic dispensing. However, the reports indicate continuing variation and potential misuse of opioids and antipsychotics in some geographical areas with consistently high dispensing rates The Atlas Time Series Reports can help identify areas that may benefit from further investigation and targeted strategies to improve appropriate prescribing of these high-risk medicines
Access the full reports (ACSQHC)
Medication Safety Standard
What's my role in VTE prevention?
Apply best practice principles. The NSLHD Venous Thromboembolism (VTE) Prophylaxis Guidelines guide clinicians in the systematic identification of patients at risk of VTE and the provision of appropriate VTE prevention. Participate in your department/unit's clinical audit this month using the VTE Prevention Audit tool on QARS (NSLHD_4_VTE Prevention for admitted patients). Monitor the rate of hospital-acquired VTE events in your local area. available on the Quality Improvement Data System (QIDS). Click on the how-to guide to find out how to use QIDS to view VTE HAC data. Inform and partner with patients. The patient information sheet is also available in multiple languages for CALD patients and consumers. Visit the VTE Prevention intranet page for more resources and tips.
The Institute for Healthcare Improvement (IHI) and BMJ will hold the next International Forum on Quality and Safety in Healthcare in Copenhagen on 15-17 May 2023. If you and your team have led a successful improvement project, why not share your achievements and contribute your work and ideas to improving healthcare worldwide? ePoster displays are a valuable opportunity to share your improvement and safety projects with colleagues and experts from across the world and to help others learn from your strategies and experience. World Thrombosis Day (WTD) is recognised globally on 13 October annually to focus attention on the underappreciated condition of thrombosis. Venous thromboembolism (VTE), is a significant preventable hospital-acquired complication. Through education and advocacy, WTD seeks to raise awareness of the causes, risk factors, signs/symptoms and evidence-based prevention and treatment of VTE among the public and health professionals alike. Risk assessment and the appropriate prescribing of prophylaxis have been shown to significantly reduce the incidence of VTE.
Call for ePosters now open INTERNATIONAL FORUM ON QUALITY & SAFETY IN HEALTHCARE Every year the International Forum displays a wide range of improvement and safety projects implemented in local, national or global settings. These are available onsite and online for all attendees to view and learn from. ePosters for the International Forum in Copenhagen are being accepted until 7 December 2022.
Visit https://internationalforum.bmj.com to download the Abstract proposal for ePoster and to find out more.
OCTOBER 2022
EDITION 19
EFFICIENCY DIMENSION
How efficient are your everyday processes and interactions? There are many examples of NSLHD initiatives that have been introduced and demonstrate the delivery of efficient care. Here are just some examples. Can you think of more? Many services have continued to offer telehealth as an option for patients to receive care where possible. This has proven to be a more efficient use of not only staff time but the patients’ time.The focus has been on finding sustainable solutions to the new workflows, training and support of patients and clinicians, and additional digital infrastructure to embed telehealth. Awareness of the six dimensions of quality forms the basis of the Foundational level of the Safety and Quality Essentials Pathway. The Safety & Quality Essentials Pathway builds safety and quality improvement capability for everyone in NSW Health Want to learn more? Visit the NSLHD Safety and Quality Essentials Pathway intranet page to view all the training offerings of the pathway available for all NSLHD staff. Processes are in place to allow for the seamless provision of Electroconvulsive therapy (ECT) to consumers requiring this treatment. Obtaining consent for the procedure includes the potential involvement of the Mental Health Tribunal and this is arranged prior to the planned treatment. This means that treatment can be delivered at a number of services with access to operating theatres/anaesthetic and recovery staff. An ECT coordinator is critical in the processes being implemented for efficient care. Royal North Shore Hospital’s Anaesthetic Greenhouse Gas Reduction project significantly reduced Carbon emissions by using an anaesthetic gas with a lower carbon footprint without any adverse effects on patients and consumers. They have shown cost savings of $167,000 by reducing Carbon Dioxide emissions by 1600 tonnes since the commencement of their project.
Past editions of Foresight have introduced each of the six dimensions of healthcare quality in detail. In this edition, we will explore the “Efficiency” dimension.
Efficiency is when care and services are delivered the right way, the first time in the most efficient way. Efficient healthcare is about valuing our available resources. Delivering sustainable, high-quality healthcare involves avoiding waste. Over time there has been an increasing demand and pressure on healthcare resources. The challenge is to work together to be more efficient and reduce the waste of valuable resources. Can our care or services be delivered in a different way in order to deliver better value healthcare? Should we routinely admit the patient as an in-patient if it is equally effective and appropriate for the care to be delivered in an out-patient setting or by the community health service, for example? Inefficient processes and systems that waste time can impact resources available for patient care. Can our processes be redesigned so as to be done more timely to free up resources? Perhaps some processes can be automated? Efficient use of resources must ensure that patients continue to receive safe and effective care. Changes or improvements must still consider any intended or unintended consequences from the introduction of the more efficient system.
Contact: NSLHD-SQEP@health.nsw.gov.au
Join this free experiential workshop designed to strengthen your skills in reflective practice. Learning a structured reflective process is considered one of the most important skills a health professional can develop. Access tools and tips sheets that guide the application of reflective skills in different contexts e.g., as an individual; with peers; or within your supervision. Increase your knowledge and skills to deal constructively with the challenging aspects of your work and better appreciate the contribution you make. Workshop overview
This workshop will:
deepen people’s knowledge of what quality reflective practice looks like and why it is important for worker wellbeing strengthen people’s reflective practice skills
provide people with an opportunity to practice applying reflective practice skills share a range of tools and tips sheets to support ongoing application on the job
Click on one of buttons below to register
Tuesday, 18 Oct 2022 9:00am -1:00pm
Thursday, 20 Oct 2022 9:00am -1:00pm
Tuesday, 25 Oct 2022 9:00am -1:00pm
Wednesday, 26 Oct 2022 9:00am -1:00pm
Wednesday, 9 Nov 2022 9:00am -1:00pm
Monday, 14 Nov 2022 9:00am -1:00pm
OCTOBER 2022
EDITION 19
NSLHD CLINICAL AUDIT SCHEDULE
The NSLHD Clinical Audit Schedule has been developed for all sites and services within NSLHD to support the monitoring and evaluation of clinical care processes and to provide support for clinical quality improvement activities across NSLHD. Download the complete 2022-23 NSLHD Clinical Audit Schedule. Note: The Schedule is divided into three categories (NSLHD acute, sub-acute, MHDA and PACH). Visit the clinical audit intranet page for more information.
Clinical audits required to be completed this month and next month are listed below.
October 2022 QARS Audits (entry links)
NSLHD_01_Documentation Audit_September - November 2022 (RNSH | HKH | Ryde | MV | Virtual Hospital) NSW MRN 01.16 Maternity Continuum Documentation NSLHD_1_Maternity_Safe Sleeping for Babies (RNSH | HKH)
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NSLHD_3_Infection Prevention Control Program compliance NSLHD_03_Transmission Based Precautions NSLHD_04_Prescription Pad: Quality of Prescribing NSLHD_04_ Prescription Pad: Storage and handling NSLHD_4_Accountable Drug (S4D S8) Register v2.2 NSLHD_4_VTE Prevention for admitted patients NSLHD_5_Nutrition Audit NSLHD_05_Communication and Care Cues - Cognitive Impairment
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NSLHD Blood & blood product transfusion documentation
NLSHD_08_Monthly inspection for resuscitation trolley/ Resuscitaire equipment checklists (RNSH | HKH | Ryde | MV | MHDA | PACH)
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POLICIES, PROCEDURES AND GUIDELINES New, updated and recently published district-wide PPGs.
Clinical Governance Standard
Click on the links below to download documents from the Prompt document system. Refer to the NSLHD weekly bulletin in your inbox to access the most up-to-date list of PPGs
Lithium Therapy Management Guideline MHDA Sudden Unexpected Death in Infancy (SUDI) Management Medicated Dressing Policy - NSLHD
LESSONS LEARNED FROM SERIOUS ADVERSE EVENT REVIEWS
Clinical Governance Standard
Did you know that the Clinical Excellence Commission shares findings from serious incidents that have occurred across NSW to aid in reducing preventable risk of a similar event occurring to another patient? Recent publications include: Lessons and learnings from Mental Health and Alcohol and Other Drugs Serious Incident Reviews - September 2022 (CEC) More publications are available from the lessons learned intranet page. The scenarios depicted in the publications have been drawn from a variety of cases across NSW in order to maintain the confidentiality of consumers and staff. It is acknowledged that the issues identified in these cases represents a small portion of care.
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