Post on 08-Aug-2020
DOES THE PATIENT BENEFIT FROM NETWORKING?
Guðlaug Rakel Guðjónsdóttir Chief Executive at Landspitali, the National University Hospital in Iceland
Definition of networking
• The exchange of information or services
among individuals, groups or institutions
• It describes interactions and
communications or activities between
individuals, groups or institutions.
LNN Copenhagen 14.-16. May
Share the knowledge – enhance the experience
• Most important is how you use and share
the knowledge.
• Share the knowledge for example by
networking
• Share and learn from each other– it
becomes usable.
LNN Copenhagen 14.-16. May
Knowledge sharing networks
• Networking tools are supportive in nursing
practices and patient well being
• Social networks are significantly useful in
knowledge sharing for nurses and can
improve patient safety
LNN Copenhagen 14.-16. May
Building the network
• The LNN congress is an exceptional
venue to meet colleagues, exchange
views and socialize, both within each
country but not least between countries.
• Building the network, for the benefit of the
patient !
LNN Copenhagen 14.-16. May
What about the patient ?
• Does the patient benefit from the Nordic collaboration in your country?
• Are we active in sharing results or experiences ?
• What have we put into practice to improve the patient’s journey through our services?
• Have we learned from each other, both from succsses and pitfalls?
LNN Copenhagen 14.-16. May
The leader – yourself !
• How do we improve patient safety ?
• Learning from adverse events ?
• How do we inspire others ?
LNN Copenhagen 14.-16. May
Quality and safety
• Information technology is not only to
enhance nurse to nurse collaboration but
also nurse to patient interaction and will
improve quality and safety of healthcare.
• Information technology is a fundamental
asset for health care providers – decision
support
• Some examples – live it and share it in this
Nordic cooperation ! LNN Copenhagen 14.-16. May
Quality and safety
• CRM – Crew Resource Management
• Emphasis on cognitive and interpersonal
skills
– Communication
– Situational awareness
– Problem solving
– Decision making
– TEAMWORK
LNN Copenhagen 14.-16. May
Teamwork
LNN Copenhagen 14.-16. May
Enhance the experience
• Network – some ideas !
LNN Copenhagen 14.-16. May
Provides valuable information on various operational and safety factors
Systematically viewed and assessed, independently and in safety huddles.
Each featured with trends, displaying days, weeks and months.
REAL TIME OPERATIONAL INDICATORS
REAL TIME INDICATORS MAIN DASHBOARD
MAJOR TRACK
PATIENTS
BEDS AVAILABLE WAITING ROOM TRIAGE DOOR TO DOCTOR
TOTAL PATIENTS
MAJOR + MINOR
LENGTH OF STAY
MAJOR TRACK
TOTAL VISITS
TIME UNTIL ADMISSION LONGEST WAIT FOR
WARD BED
RISK MANAGEMENT
DEFINED PROCEDURES FOR EACH INDICATOR LEVEL
0
10
20
30
40 50
100
90
80
70
60
Green
Monitor
every hour
Red
Treat patients in
triage level1-3 only,
until stabilized
Yellow
Take immediate measures to
facilitate flow
Reallocate staff and resources
EXPERIENCE
Improved:
• Overview of operations
• Transparency
• Communication
• Teamwork / networking
• Quality
• Processes
• Resource utilization
SITUATIONAL AWARENESS MEETINGS / SAFETY HUDDLES
• The longtime goal is to prevent all unforeseen
patient adverse events
• The key component is to spot signs of trouble and
react before it escalates
• Situational awareness is a proven best practice
method to raise risk awareness, detect
abnormalities early and to initiate preventive and /
or mitigating actions.
LNN Copenhagen 14.-16. May
IMPROVING SITUATIONAL AWARENESS
• To improve situational awareness many
organizations have implemented regular
systematic situational awareness meetings
• Frontline staff come together and assess risk
factors systematically and put forth risk reducing
action plans
• Incorporate regular system wide safety huddles is
a key factor to engage and sustain situational
safety awareness in day to day operations
LNN Copenhagen 14.-16. May
IMPROVING SITUATIONAL AWARENESS CONT.
• This approach is common in aviation and military
operations and has been adopted by many
hospitals in order to provide safety for their
patients and staff
• Cincinnati´s Children's Hospital (CCHMC) in Ohio
has been the industry leader in this approach.
LNN Copenhagen 14.-16. May
SITUATIONAL AWARENESS MEETINGS
• Look back
– Safety and quality factors the last 24 hrs.
• Look forward
– See, predict and prepair to ensure safety and quality of care for the next 24 hrs.
• Follow up
– Report on risks or events from the last 24 hrs or over the last few days and provide information on how the situation is being improved
LNN Copenhagen 14.-16. May
SAFETY CHECK LIST • Acute sick patients, watchers
• Risk involving treatment, behavior or medications
• Communications and information flow – Orders or tests not completed in a safe manner – Communication barriers
• Clinical intuition – Something feels wrong, I have a concern – Patient or his/her family is concerned
• Patient flow –Patients due to be admitted and discharged – Ward unable to accommodate volume needed
• Staff – Staffing issues that possibly impact safety
• Environment – Safety issues due to facilities, equipments or systems
LNN Copenhagen 14.-16. May
LNN Copenhagen 14.-16. May
Each ward
huddles with
safety checklists
every morning
Issues the ward is
unable to resolve
on it´s own is
escalated to the
joined huddle at
11:15
Hringbraut
Joined video
huddle
Fossvogur
THE IMPLEMENTING JOURNEY
• Emergency department first to pilot daily huddles
in April 2015
• All inpatient wards followed within the next 2
years
• Ambulant wards started late 2016
• System safety awareness meetings led by chief
executives 28.December 2017
LNN Copenhagen 14.-16. May
SYSTEM MEETING
• Scripted / standardized daily huddles at 11:15 every
day of the year – Fossvogur and Hringbraut campuses conneceted by video conference
• Safety check list and follow up 10 minutes, max 15
minutes
• Breaks into two main huddles
• Fossvogur
• Hringbraut
– Able to connect via the internet
LNN Copenhagen 14.-16. May
LEADERS OF THE HUDDLES ASK…
• What immediate actions did you take?
• What is the impact on the rest of the hospital?
• How does this impact our ability to provide safe
care?
• What can we do to reduce the risk to patients,
families and caregivers?
• How can this team help you improve the situation?
• Are we resourced appropriately for this?
• That’s a Safety Critical Issue…
LNN Copenhagen 14.-16. May
LESSONS LEARNED
• Vast improvement in real-time awareness of issues
– makes problem solving much easier
• Simple as possible
• Standardized checklists or scripts are the key
• Give it time
• Involvement of all staff across clinical and non-
clinical services
LNN Copenhagen 14.-16. May
THANK YOU FOR LISTENING
Guðlaug Rakel Guðjónsdóttir Chief Executive at Landspitali, the National University Hospital in Iceland