Leadership for safety - learning from Scotland. Joanne Matthews, Head of Safety, Healthcare Improvement, Scotland and Jane Murkin, Head of Patient Safety and Improvement, NHS Lanarkshire Presentation from the Patient Safety Collaborative launch event held in London on 14 October 2014 More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx

1. Scotland's
Patient Safety Journey
Leadership & Culture , National & Local perspective

2. Session Aims
•Share the safety journey in Scotland from a..
-national and local perspective
-reflecting a policy commitment to safe , effective and person centred care
-translating this to care at the bedside

3. http://www.scottishpatientsafetyprogramme.scot.nhs.uk/programme
2008 Launch
15 % Reduction in Mortality 30% reduction in Adverse Events

4. Aims:
To deliver the highest quality healthcare services to the people of Scotland
For NHSScotland to be recognised as world- leading in the quality of healthcare it provides

5. Creating the conditions

6. 5.2 million people
£12 billion
14 Health Boards
8 Support Boards
Emphasis on partnership and collaboration
Moving to health and social care integration

7. “Safe, effective and
person-centred care which supports people to live as long as possible at home or in a homely setting.”
Sustainable delivery
of the Quality Strategy

8. Quality of Care
Primary Care
Integrated Care
Safe Care
Unscheduled and Emergency Care
Person Centred Care
Care for Multiple and Chronic Illnesses
Health of the Population
Early Years
Health Inequalities
Prevention
Value & Financial Sustainability
Innovation
Efficiency & Productivity
Workforce
12 Priority Areas for Action
ROUTE MAP TO THE 20:20 VISION

10. The SPSP Journey….
Compelling vision
Common goal
- aim high
Evidence-based
interventions
Model for
Improvement
Knowledge & skills
Collaboration

11. Leadership

13. Rogers, E. M. (2003). Diffusion of innovations. New York, Free Press.
Roger’s Adopter Categories

14. Values
Behaviour
Mindset

16. Quality Improvement
& Methodology

17. Improvement Skills Model creating the conditions

18. Toolkit

19. Measurement for Improvement

20. Communication

22. Teams

23. •Local
•Board
•National
•International
Teams

25. Safety Culture

26. Safety Culture

27. National to local
•Rhetoric to reality
•No assurance
•Don't bring me bad news
•Infrastructure
•Leadership
•Spread to soon
•Culture

29. Stories and Culture
•Easy to focus on ‘failures’
And forget how often things go right

30. Out of adversity comes opportunity
Benjamin Franklin

31. Lessons for Leadership in changing culture
Culture change and continual improvement come from what leaders do, through their commitment, encouragement, compassion and modelling of appropriate behaviours.
•Berwick Report 2013

33. For improvement to flourish it must be carefully cultivated in a rich soil bed ( a receptive organisation), given constant attention ( sustained leadership), assured the right amounts of light( training and support) and water
( measurement and data) and protected from damaging.
Stephen Shortell

34. Culture

35. Progress towards our aims
90% of all practices in Scotland
completed the Safety Climate Survey,
by April 2014

36. Participate
Results
Feed- back
Learning
Improvement
Safety Climate
Survey

37. 0.00
1.00
2.00
3.00
4.00
5.00
6.00
7.00
Workload
Communication
Leadership
Teamwork
Systems
Scotland’s Safety Climate
April 2014

38. Safety Climate Survey Results Clinical vs Non Clinical

40. 00000

41. Success , Challenges & Learning

42. Local Success

43. Safety is a process of enquiry
Source: Vincent C, Burnett S, Carthey J. The measurement and monitoring of safety. The Health Foundation, 2012.
www.health.org.uk/publications/the-measurement-and-monitoring-of-safety
Has care been safe
in the past?
Are our clinical
systems &
processes reliable?
Is care safe today?
Will care be safer in the future?
Are we responding
& learning
& improving?

44. It is not easy
It takes time
Achieve reliability before spreading
Measuring safety
Moving from scale testing to universal spread
Expanding into other areas......
Learning

45. Spread

46. qihub.scot.nhs.uk
Older People in Acute Care
Spread

47. 10 Patient Safety Essentials
Hand Hygiene
PVC Bundle
Surgical Brief & Pause
VAP Bundle
CVC Insertion
CVC Maintenance
General Ward Safety Brief
Early Warning Score
ICU Daily Goals
Leadership Walk rounds

48. Aim
Primary Drivers
Secondary Drivers
Through continually improving healthcare delivered in Scotland, we will reduce events that cause harm to people.
Strategic Priority
Ensure safety and quality are organisational priorities
Provide leadership and oversight to ensure delivery of programme
Actively develop your safety culture
Infrastructure
Develop and utilise local capacity and capability in QI
Effective measurement systems
Programme management
Effective communication
Manage transitions of care
Point of Care
Acute Adult
Maternity and Children Quality Improvement Collaborative
Primary Care
Mental Health
Organising for
the future

49. We have a Plan
At board level sufficient capacity and capability to delivery the safety aims
Capacity of the system to effectively use data to drive improvements
Capacity of the system to undertake large scale spread and sustain improvements
Effective systems to evaluate impact and capture key learning
A national infrastructure to ensure effective delivery and support locally
Integration across all safety programmes and wider

50. Questions

51. www.scottishpatientsafetyprogramme.scot.nhs.uk
www.qihub.scot.nhs.uk
Joanne Matthews
Head of Safety in Healthcare
Scottish Patient Safety Programme
Healthcare Improvement Scotland
Jane Murkin
Head of Patient Safety & Improvement
NHS Lanarkshire