Professor Jason Leitch: Scottish Patient Safety Programme (lessons ...
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Transcript of Professor Jason Leitch: Scottish Patient Safety Programme (lessons ...
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Scottish Patient Safety Programme: lessons learnt in Scotland
Professor Jason LeitchClinical Director
The Quality Unit, Scottish Government
@jasonleitch
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• 5 million people• £12 billion• 14 Health Boards• 8 Support Boards• Integrated delivery• Moving towards social care integration
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Public FinancesFall in Government expenditure
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Scotland’s approach
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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
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2020 Vision/Quality Ambitions
“Safe, effective and person‐centred care
which supports people to live as long as possible at home or in a homely
setting.”
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Implementing at scale….can it be done?
Execution
Ideas
Will
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Our change theory
A clear and stretch goalA methodPredictive, iterative testing
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How Do We View Our Measures?
Improvem
ent
Judgement
Research
Judgement Research
Improvement
Performance
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AimsTo Further Improve the Safety of People in Acute Adult
Healthcare1. Reduce Harm95% of people in acute adult health care free from harms in the Scottish Patient Safety Index by 2015:
Cardiac ArrestCatheter Acquired Urinary Tract InfectionsPressure UlcersFalls
2. Reduce Hospital Associated MortalityReduce HSMR by 20% by 2015.
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Don Berwick
• Get goals• Get bold• Get together• Get a model (and stick with it)
• Get patients and families
• Get the facts• Get to the field• Get a clock• Get the numbers• Get the stories
How has the frontline done it?
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NHSScotland Surgical Safety Briefings
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NHSScotland Surgical Mortality
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Scottish ICUs Averaged Bundle Reliabilityand VAP Rate/1000 ventilator days
60%
70%
80%
90%
100%
Oct-07
Apr-08
Oct-08
Apr-09
Oct-09
Apr-10
Oct-10
Apr-11
Oct-11
Apr-12
Oct-12
Apr-13
Oct-13
Apr-14
Oct-14
0
5
10
15
20
25
Average VAP Bundle Reliability
Average VAP rate/1000ventilator daysMedian for 2008
Better
Better
60%
70%
80%
90%
100%
Oct-07
Apr-08
Oct-08
Apr-09
Oct-09
Apr-10
Oct-10
Apr-11
Oct-11
Apr-12
Oct-12
Apr-13
Oct-13
Apr-14
Oct-14
0
5
10
15
20
25
Average VAP Bundle Reliability
Average VAP rate/1000ventilator daysMedian for 2008
Better
Better
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60%
70%
80%
90%
100%
Jul-0
7
Jul-0
8
Jul-0
9
Jul-1
0
Jul-1
1
Jul-1
2
Jul-1
3
Jul-1
4
0
1
2
3
4
5
Average Central Line InsertionBundle Reliability
Average Central line BloodStream Infection/1000 linedaysMedian in 2008
Better
Better
60%
70%
80%
90%
100%
Jul-0
7
Jul-0
8
Jul-0
9
Jul-1
0
Jul-1
1
Jul-1
2
Jul-1
3
Jul-1
4
0
1
2
3
4
5
Average Central Line InsertionBundle Reliability
Average Central line BloodStream Infection/1000 linedaysMedian in 2008
Better
Better
Scottish ICUs Average Central Line Insertion Bundle& Central Line Related Blood Stream Infection rate
/1000 days
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Hospital Standardised Mortality Ratio Scotland: 2006 to Sep 2013
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Kendra
7 year old Severe autism
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Kendra
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@jasonleitch