Embedded quality and safety principles will enable clear management and improved care, writes a team from the HSE

Improving quality and protecting people from harm is the responsibility of us all. The Quality and Patient Safety Directorate focuses on clinical governance development and provides supports to health service providers. This article introduces the Quality and Safety Prompts for Multidisciplinary Teams completed in 2012.

The prompts provide a practical, easily assessable guide, for any multidisciplinary team to use in discussing quality and safety at regular team meetings.

Achieving safe quality care requires the vigilance and cooperation of the whole workforce including patients and members of the public. The National Standards for Safer Better Healthcare (2012) provide direction and guidance for improving the quality, safety and reliability of health care. For mental health services the Quality Framework for Mental Health Services in Ireland (2007) provides the direction.

The development of the prompts is aligned with the national standards and the 27 questions are grouped under the themes leadership, governance and management, and the following quality dimensions: person-centred care; effective care; safe care; and better health and wellbeing.

Pictured (l-r): Dr Phillip Crowley, HSE national director, quality and patient safety; Claire Mahon, INMO president; and Liam Doran, INMO general secretary. Dr Crowley met with the INMO executive council in January. The round table meeting discussed the work of the HSE Quality and Patient Safety Directorate and explored various professional, education and industrial annual delegate conference 2012 motions and opportunities for future working to progress and resolve issues

Prompts
Our focus is on ensuring that quality and safety is on everyone’s agenda. The objective is that all clinical and social care is aligned within a quality and safety (clinical governance) system. The prompts can be used to guide local team discussions on quality and safety, by:

• Communicating the quality and safety principles to all members of the team
• Acting as a guide on quality and safety
• Incorporating quality and safety into daily work.

Developing the prompts
The prompts are drawn from four key documents: National Standards for Safety Better Healthcare (2012); Clinical Governance Development Assurance Check (2012); Quality Framework for Mental Health Services in Ireland (2007); and The Integrated Framework for Quality Safety and Risk Management (2009). They were refined during six rounds of review by the Working Group for Clinical Governance Development with input from the National Clinical Programmes and a Clinical Governance Development Reference Panel.

The prompts and approach were tested by 20 acute, community, specialist, mental health and general practice teams from July to September 2012. Stakeholder feedback was invited and the endorsement of the colleges and associations received.

How to use the prompts
Below is a step-by-step guide on how to use the prompts. It is not intended that additional committees or structures are set up. The prompts can be used as a guide for action using the plan, do, study, act (PDSA) cycle (see step three).

Step one

• Display prompts in offices or staff rooms
• Provide prompts to all team members
• Set-up a process to distribute prompts to new team members as part of induction.

Step two

• Review prompts with team and identify any service gaps
• Identify changes to be made
• Identify action plans
• Identify action owners and responsibilities.

Step three

• Implement activities to improve safety and quality in patient care, through ‘small tests of change’ (PDSA)
• Review progress at regular team meetings
• Collect information to assess success.

Step four

• Continue to hold regular team meetings
• Include all members of multidisciplinary team for example doctors, nurses/ midwives, clinical managers, healthcare assistants, health and social care professionals, administrative and support staff (clerical, catering, household, portering) where possible
• Put quality and safety on the agenda for every team meeting
• Continually look for ways to improve quality and safety.

The prompts are a useful tool to help local teams to provoke discussion on quality and safety within the workplace. An integrated team approach is used that focuses on leadership and cross professional working. The approach is aligned with and focused on supporting the implementation of the National Standards for Safer Better Healthcare.

Ultimately, where the quality and safety principles are embedded we will be able to demonstrate clear management and accountability for increased patient safety and improved quality of care. For more information, see www.hse.ie/go/clinicalgovernance and pages 21-22.

Philip Crowley is the national director, quality and patient safety directorate. Maureen Flynn is national lead for clinical governance development. Thora Burgess is project manager, clinical governance development

Focus - Prompts for safety