Drivers for change•Health care variability• Not receiving recommended care• Fragmented care•Demand issues• Increased demand• Changing patterns of need•Dynamic evidence base•Costs and resources•Health information technology
QI and Evidence•EBM/EBP: Evidence to inform quality care•Evidence as content in QI processes•Value add between EBM and QI•Emerging evidence of value of QI•QI processes as a source of new evidence
Working Together Partnership•CareSearch, NSAP, PCOC•MOU signed in 2010…common interest, informed bydifferent but aligned perspectives,in improving palliative care in Australiaby upskilling palliative care services,facilitating quality improvement andencouraging the use of evidence in practice.
Working Together: NSAP, PCOC, CareSearchAll programs funded by Department of Health and AgingAll work with Palliative Care Services to improve Service qualitySTANDARDSNSAP: National Standards Assessment Program• Services complete a self assessment snapshotevery 2 years against the standards• Create and implement a quality improvementaction plan, based on these results
OUTCOMESPCOC: Palliative Care Outcomes CollaborativeUtilises standardised validated clinical assessmenttools to benchmark and measure outcomes inpalliative careEVIDENCECareSearch:Australia’s Palliative Care knowledge baseLatest resources and evidence
Working Together Projects•Integration of current activities•Identification of services•Working Together Change Framework• WTCF Workshops• WTCF Study•Change Management Hub:• Tools registry• QI searches
How do we work together?Evidence Sources for NSAP Self AssessmentPCOC: Palliative Care Outcomes CollaborationOutcomes can be used as an evidence source for yourNSAP Self AssessmentCareSearchProvides links to quality tools which can be used forNSAP Self AssessmentQuality Improvement Results and latest evidence fordevelopment of a Quality Improvement Action PlanPCOC ReportNSAP Results & Key Improvement AreasCareSearch EvidencePCOC CareSearchNSAPPCOC NSAP CareSearchQualityImprovementAction Plan
Question 1:•Think about how you know there is aproblem. Describe the problem for others.Be specific about the problem.•Outline how big a problem it is and howit affects your work and your patients.•You also need to consider whether it is aproblem that you can solve.Is there aproblem?
Question 2:•Do some analysis on possible causes• Service characteristics• Patient population• Feedback from patients/staff•Check to see if there are reports or articleson similar problems•Speak with other services about whether similar issuesWhat iscausing theproblem?
Question 3:•Check for evidence on the specific issue.Find out if there is evidence for new ordifferent approaches.•Find out if there are tools or measures youcould use.•Review what is effective in change management.Think if some of these strategies could be used in your plan.Is thereevidenceabout what todo?
Question 4:•Check your plan indicates• Who• What• By when•Make sure your plan is suitable for your service.•Identify and include measures that can be usedto show if things are changingDoes yourplan addressthe issues?
Question 5:•Monitor what is happening as youimplement the plan.•You may need to vary your plan. Things change.People change. New information may emerge.•Keep a note of why something changed andwhat you did in response.Were youable toimplementyour plan?
Question 6:•Review everything that happened.Just because you did somethingdoes not mean that what you wanted to,or expected to, happen actually did happen.•Determine if the problem has been solved.Think about whether a different approach is needed.Have youreviewedwhat youdid?
WTCF Workshop Evaluation•Ethics received for evaluation study• Post-workshop questionnaire• Follow up survey (8 weeks)•Objectives• To determine Workshop participants’ responses to theWorking Together Change Framework• To evaluate the effectiveness of the Workshop content andformat• To determine if participation in the Workshop led tochange activity in the service
• Services can identify quality improvementopportunities through PCOC, NSAP processes• Evidence summaries on priority areas availablethrough CareSearch• Workshops and projects to build knowledge andexpertise in QI
CareSearch, NSAP and PCOC are funded by the AustralianGovernment Department of Health and Ageing.