Ensuring patient safety with QI

Posted on 16 May 2017

Mediclinic Southern Africa is on a long-term journey to build quality improvement knowledge and capability in managerial and front-line clinical staff to ensure patient safety.

Patient safety is the first of Mediclinic’s five core values and is an inherent requirement for providing care to patients and their families. ‘Our business is making people better,’ says Ansie Prinsloo, Mediclinic’s Patient Safety Officer. ‘We are working hard at building a patient safety culture at Mediclinic that utilises quality improvement to benefit clinical patient outcomes.’

Chief Clinical Officer for Mediclinic, Dr Stefan Smuts, seconds that statement. ‘Patient safety is incredibly important to all of us. Patients entrust their lives to the clinical teams caring for them in a complex and often stressful environment where the difference between a desired clinical outcome and a preventable complication is heavily reliant on everyone in the team being aware of what could go wrong,’ he says. ‘Preventing errors from occurring is much more important than trying to implement systems to deal with errors that have already occurred. Prevention is better than cure.’

Improving patient safety
Mediclinic’s methodology for improving patient safety employs the science of quality improvement (QI) to collate and analyse data on set adverse events that happen in hospitals, for example, failing to recognise and respond to the deterioration in a patient’s vital data. The findings are then used to hypothesise and test potential solutions or fixes, using data to validate the effectiveness on a small scale before spreading it further through the system.

The approach is aligned to industry thought leaders such as the global advocacy group, the Institute of Health Improvement (IHI) and employs relatively simple methodology that can have a considerable impact on patient safety. ‘It recognises that nursing teams are best placed to understand the complexities within their units and respectfully empowers them to help design potential solutions,’ says Prinsloo.

Culture of patient safety
Quality improvement initiatives require sound reporting structures. Errors can’t be identified and eradicated if they aren’t reported. Establishing an ethos of reporting is essential to patient safety. Each staff member needs to be focused on reporting and learning from adverse events. The emphasis is on understanding contributing systems factors so that quality improvement work can be done to prevent a reoccurrence.

‘The importance of building a ‘just’ culture is fundamental to patient safety and challenges each of us to create a psychologically safe and respectful environment. In this environment staff will report incidents of patient harm and provide ideas to address contributing factors,’ says Estelle Coustas, Mediclinic’s Nursing Executive. ‘The focus is on quality improvement and not punishment.’

Mediclinic has a standard process and method for adverse event reporting and investigation, which starts with a customised template (or form) which is completed by any member of the hospital team to report the event. A systems analysis is then adopted by the clinical team to investigate serious events. During this investigation all contributing factors are considered so that quality improvements can be introduced to ensure patient safety into the future.

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