APRIL 2023
EDITION 24
EMBEDDING VIRTUAL CARE IN SAFETY AND QUALITY FRAMEWORKS In December 2022, the CEC released Embedding Virtual Care in Safety and Quality Frameworks to support and enable health services to ensure patient safety and clinical quality is maintained when delivering health care via a virtual modality. This resource has been designed to assist in planning, implementing and reviewing virtual care health services. The Management of Central Venous Access Device (CVAD) Procedure ADULT- NSLHD has recently been updated following district-wide consultation with subject matter experts, including, the Acute and Critical Care Network, the Infection Prevention and Control and the Vascular Access Team at Royal North Shore Hospital. The procedure addresses post-insertion management, troubleshooting and removal of CVAD for adult inpatients. The procedure is the most viewed document in NSLHD, with approximately 250 downloads per month. It has been updated to ensure all patients with a CVAD receive safe and high-quality care. The update has been guided by recommendations made by the Agency for Clinical Innovation (ACI) and the Cancer Institute NSW, and is to be used in conjunction with Intravascular Access Devices (IVAD) - Infection Prevention & Control Policy Directive PD2019_040. Preventing and Controlling Healthcare-Associated Infection Standard MANAGEMENT OF CENTRAL VENOUS ACCESS DEVICES (CVAD) IN NSLHD
Key considerations include:
Delivering services via virtual care does not require specific additional clinical governance frameworks to be developed. Rather, the overarching clinical governance framework should encompass and be responsive to virtual care services. This may require some updates to the framework, such as including any virtual care specific committees or metrics, or ensuring patient safety and clinical quality committees have oversight of virtual care safety and quality information. Virtual care incidents are identified, escalated and managed as all incidents are under NSW Health Incident Management Policy Directive. Data should be collected, analysed and reported to inform ongoing improvements to health services – safety metrics for virtual care may include adverse events, aggression events, patient deterioration, missed appointments and patient feedback. The roles, responsibilities, supervision, communication, risk management, and education and training needs of staff may need to be updated when delivering virtual care.
LESSONS LEARNED FROM SERIOUS ADVERSE EVENT REVIEWS 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? The latest Paediatric Watch bulletins include case studies involving a near miss 10 times adrenaline (epinephrine) dose error in anaphylaxis and red flags for non-accidental injuries in children. Access these and other lessons from the lessons learned intranet page. Developed with NSW Health clinicians and virtual care experts, the Framework promotes a consistent, state-wide approach to virtual care education that supports the delivery of safe, quality, patient-centred virtual care. Underpinned by global thinking in education, training and health workforce learning approaches, the Framework presents seven domains, providing evidence-based principles for virtual care best practice in education programs. There are significant infrastructure considerations when planning a virtual care service. This includes the physical space for clinicians, as well as the virtual environment including access, stability, security and privacy. Careful consideration should be given to determining whether an individual patient is suitable for virtual care. This must include consideration of the risk of clinical deterioration and the ability to identify, escalate and manage deterioration as well as patient acceptance of and capabilities to access and participate in virtual care. NSW Health Virtual Care Education Framework 2022-2026 The NSW Health Virtual Care Taskforce and Health Education and Training Institute (HETI) has released NSW Virtual Care Education Framework 2022-2026.
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