SAFETY in eHEALTH: The power of data and
technology to build insight and resilience
Neville Board RN, BA, MPH
Information ...
Acknowledgements
Dr Niall Johnson, Australian Commission on Safety and Quality in Health Care
A/Prof Christine Jorm, Sydne...
Health expenditure $140.2bn in 2011/12
$5,881 per person ($5711, in NSW to $8,512 in NT)
!   OVERVIEW
Australia’s Health 2012 (AIHW) p.473
Can we measure this?
Thomas EJ, Petersen LA, Measuring errors and adverse event rates in health care, J Gen Intern Med 200...
Device and procedural safety
Medication safety
Safety in eHealth
MULTI-FACETED
P Davies, 2005, Evidence-based Policy at the Cabinet Office, Impact and Insight Seminar, Overseas Developmen...
Source: A/Prof Christine Jorm, DIY Human Factors for Safety, Medical Device Safety Forum 2010
Source: A/Prof Christine Jorm, DIY Human Factors for Safety, Medical Device Safety Forum 2010
HUMAN FACTORS
Wakefield, J, Better actions, better outcomes: Human Factors Engineering (HFE) and Strength of Actions, Medical Device Saf...
Human factors engineering (HFE)
Wakefield, J, Better actions, better outcomes: Human Factors Engineering (HFE) and Strengt...
Human factors engineering (HFE)
Wakefield, J, Better actions, better outcomes: Human Factors Engineering (HFE) and Strengt...
LOW
IMPACT
HIGH
EFFORT
HIGH
IMPACT
LOW
EFFORT
X Training
Written
procedure X
Physical
change X X IT system
Wakefield, J, B...
SYSTEMATIC
Systematic monitoring and review of a cohort of
procedures/uses with measures of effort, complications,
and out...
Application of clinical quality registries
Focus on
•  high-cost high-significance procedures
•  areas with known variatio...
Registries – Example 1 NJRR
Joint replacement
•  National Joint Replacement Registry identified
sub-standard prostheses
• ...
Renal transplantation
•  Poor outcomes with transplantation lead to increased dialysis
•  Cost difference:
Transplantation...
Device and procedural safety
Medication safety
Safety in eHealth
coUMADIN	
   coVERSYL	
  
cyclosPORIN	
   cyclosERINE	
  
DEPO-medrol	
   SOLU-medrol	
  
DEPO-medrol	
   depo-PROVERA*	
 ...
SCOPING STUDY 2009
Device and procedural safety
Medication safety
Safety in eHealth
Source: A/Prof Christine Jorm, DIY Human Factors for Safety, Medical Device Safety Forum 2010
HOW TO SCARE OFF YOUR HOSPITAL MANAGERS
DEATH BY ROI
HOW TO SCARE OFF YOUR “BUSINESS”
DEATH BY PROJECT MANAGEMENT 101
HOW TO SCARE OFF YOUR CLINICAL LEADS
DEATH BY PROJECT LIBRARY
HOW TO SCARE OFF YOUR EXECUTIVE GOVERNANCE
DEATH BY SIGN-OFF
Health Affairs, 30, no.3 (2011):464-471
• choose a system that is
intuitive to use and that requires
little training for users
• choose a system that can be
modif...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Healt...
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Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Health Care - The power of data and technology to build insight and resilience for safety organisation: Safety in ehealth

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Neville Board delivered this presentation at the Safety in Action 2014 Conference in Melbourne. This conference brings thought leadership and showcases topical, innovative safety methods and practices.

For more information, please visit http://www.safetyinaction.net.au/SIA2014Melbourne

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Neville Board RN, Director: Information Strategy & Safety in eHealth, Australian Commission on Safety and Quality in Health Care - The power of data and technology to build insight and resilience for safety organisation: Safety in ehealth

  1. 1. SAFETY in eHEALTH: The power of data and technology to build insight and resilience Neville Board RN, BA, MPH Information Strategy Manager SAFETY IN ACTION – SIA National Convention 27 March 2014
  2. 2. Acknowledgements Dr Niall Johnson, Australian Commission on Safety and Quality in Health Care A/Prof Christine Jorm, Sydney University Dr John Wakefield (then) Executive Director, Queensland Patient Safety Centre Australian Institue of Health and Welfare (AIHW)
  3. 3. Health expenditure $140.2bn in 2011/12 $5,881 per person ($5711, in NSW to $8,512 in NT)
  4. 4. !   OVERVIEW Australia’s Health 2012 (AIHW) p.473
  5. 5. Can we measure this? Thomas EJ, Petersen LA, Measuring errors and adverse event rates in health care, J Gen Intern Med 2003;18:61-67
  6. 6. Device and procedural safety Medication safety Safety in eHealth
  7. 7. MULTI-FACETED P Davies, 2005, Evidence-based Policy at the Cabinet Office, Impact and Insight Seminar, Overseas Development Institute, 17 October 2005, London
  8. 8. Source: A/Prof Christine Jorm, DIY Human Factors for Safety, Medical Device Safety Forum 2010
  9. 9. Source: A/Prof Christine Jorm, DIY Human Factors for Safety, Medical Device Safety Forum 2010
  10. 10. HUMAN FACTORS
  11. 11. Wakefield, J, Better actions, better outcomes: Human Factors Engineering (HFE) and Strength of Actions, Medical Device Safety Forum 2010 Human factors engineering (HFE)
  12. 12. Human factors engineering (HFE) Wakefield, J, Better actions, better outcomes: Human Factors Engineering (HFE) and Strength of Actions, Medical Device Safety Forum 2010
  13. 13. Human factors engineering (HFE) Wakefield, J, Better actions, better outcomes: Human Factors Engineering (HFE) and Strength of Actions, Medical Device Safety Forum 2010
  14. 14. LOW IMPACT HIGH EFFORT HIGH IMPACT LOW EFFORT X Training Written procedure X Physical change X X IT system Wakefield, J, Better actions, better outcomes: Human Factors Engineering (HFE) and Strength of Actions, Medical Device Safety Forum 2010 Human factors engineering (HFE)
  15. 15. SYSTEMATIC Systematic monitoring and review of a cohort of procedures/uses with measures of effort, complications, and outcomes allows a genuine safety assessment and generate evidence and lessons on procedure/device efficacy, safety and best-practice implementation.
  16. 16. Application of clinical quality registries Focus on •  high-cost high-significance procedures •  areas with known variation in outcomes or practice •  economic case for improved outcomes. Australian examples: •  ANZDATA (renal) •  National Joint Replacement Registry •  ANZICS (intensive care) •  ASCTS (cardiac surgery) •  VSTORM (trauma)
  17. 17. Registries – Example 1 NJRR Joint replacement •  National Joint Replacement Registry identified sub-standard prostheses •  Found significant differences in outcome/need for revision •  Over 4 years the proportion of hip and knee procedures that are revisions has declined from 14.8 to 11.1% and from 10.4 to 7.9% respectively. •  These declines are in large part attributable to monitoring systems incorporated into the registry •  Annual cost saving ~ $44.6 million. The cost of running the Registry is $1.5 million per annum.
  18. 18. Renal transplantation •  Poor outcomes with transplantation lead to increased dialysis •  Cost difference: Transplantation: $15K p.a.; Dialysis $60K p.a. •  ANZDATA registry has contributed substantially to improved outcomes of renal transplantation (eg Perit Dial Int, 2007;27(2):184-191) Registries – Example 2 ANZDATA
  19. 19. Device and procedural safety Medication safety Safety in eHealth
  20. 20. coUMADIN   coVERSYL   cyclosPORIN   cyclosERINE   DEPO-medrol   SOLU-medrol   DEPO-medrol   depo-PROVERA*   solu-CORTEF*   SOLU-medrol  
  21. 21. SCOPING STUDY 2009
  22. 22. Device and procedural safety Medication safety Safety in eHealth
  23. 23. Source: A/Prof Christine Jorm, DIY Human Factors for Safety, Medical Device Safety Forum 2010
  24. 24. HOW TO SCARE OFF YOUR HOSPITAL MANAGERS DEATH BY ROI
  25. 25. HOW TO SCARE OFF YOUR “BUSINESS” DEATH BY PROJECT MANAGEMENT 101
  26. 26. HOW TO SCARE OFF YOUR CLINICAL LEADS DEATH BY PROJECT LIBRARY
  27. 27. HOW TO SCARE OFF YOUR EXECUTIVE GOVERNANCE DEATH BY SIGN-OFF
  28. 28. Health Affairs, 30, no.3 (2011):464-471
  29. 29. • choose a system that is intuitive to use and that requires little training for users • choose a system that can be modified and developed easily • ensure that the decision- making process for developing or selecting a system is participatory, but once this decision has been taken ensure that implementation is directed and driven. These findings need to be tested in other settings to understand the degree to which they are generalisable.

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