Quality and safety: using information to assure quality and achieve governance
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Transcript of Quality and safety: using information to assure quality and achieve governance
Alison Moores Director of nursing and Practice
Devon Partnership NHS Trust 11.07.13
• Quality governance is the combination of structures and processes for ensuring quality performance.
• Quality performance incorporates safety, effectiveness and experience of using services and is measured across inputs, processes and outcomes.
• Quality Governance is about dynamic functions: o Ensuring required standards are achieved o Investigating and taking action on substandard performance o Sharing best practice o Identifying and managing risks to quality of care. o Measuring (and encouraging) improvement
• Quality governance requirements: o Clear lines of accountability: teams to Board
o Clarity of expectation
o Reliable and credible information
` Defining key standards and metrics:
• Seeing the wood for the trees • Board leadership and sign off • Clinical engagement • People who use services and their supporters • Regulatory and contractual • Reliable and credible information infrastructure
` Orbit: • real time data – overnight refresh • Data to team / practitioner level • principle sources are the electronic clinical record (RiO,
IAPTUS, HALO), survey data and electronic audits – direct feeds via a data warehouse.
• Available to clinicians and managers on a self service basis • Automatically generates bespoke performance reports / alerts
– can be daily to support clinical practice (eg medicines reconciliation within 72 hrs, follow up within 48hrs of discharge)
Physical health assessment within 24 hrs of admission: Medicines reconciliation within 72 hrs of admission:
` Team level self assessment (PCA) ` Modern matron / service manager verification ` Peer ‘observations of care’ visits ` Board quality and safety walkrounds
` Information overload (woods and trees) ` Tension between required information and clinically valuable
information ` Overloaded clinicians and reduced capacity ` Engagement with the use of information to make quality
improvements. ` The system will only be as effective as the structures it is
designed to inform.
` Ingredients for effective quality governance. • Team to Board lines of accountability • Clarity of standards and metrics to measure them. • Active and ‘real time’ use of information at the right level (ie
governance is not about writing reports) • Use the information to measure emerging risk and be clear
about the actions that will follow.
` How do commissioners move from ‘assurance from data’ to ‘assurance that data is being used to improve services’?
` How far should quality measures be standardised? ` How will providers, commissioners and people who use
services work together to decide the measures of quality? ` How do we balance data value with data cost?