Improving the Quality of Health Care

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Patient safety is among the most frequently addressed topics in health care today. We are charged not only with diagnosing disease in our clients but also with causing them no harm. Sounds simple—but it hasn't been. In the past, there was almost a culture that expected and accepted certain complications in procedures, and we addressed accidents and injuries only after they occurred. However this decade brought about such changes as Patient Safety Learning Reports encouraging employees to report any potential problems. It takes a change in mindset to accept constructive feedback without getting defensive, to make improvements that will benefit our clients and staff. We also have to change the “good enough” mindset to one of continuous quality improvement (CQI).

Recently, many individuals from around the world had the opportunity to attend the Institute for Health Care Improvement (IHI) Conference on Quality Improvement in Health Care, either in person in Orlando, Florida, or via satellite feed in their hometowns. I had the privilege of attending, for the second time, in my hometown, and the experience was incredible. The “energy of many” was demonstrated by everyone—those on site in Orlando, all of the speakers, as well as the 196 attendees in my hometown of Sydney, Nova Scotia.

Many recounted their success stories, and some were brave and honest enough to tell us about their failures and what they learned from those mistakes. During a break in the sessions, our Quality Improvement department highlighted initiatives that are taking place in our health district in Nova Scotia. These include, “Elder Friendly,” “Wash Up,” “SBAR Communication Tool,” “Ask. Talk. Listen.” for patients, and “Greening Our Health Care.”

The goal of the “Elder Friendly” initiative is to create an environment that will keep older patients as independent as possible throughout their hospital stays. A key component in this initiative is the cooperation of family and friends of the patients. Communication is essential, and our Elder Friendly coordinator has designed a very informative pamphlet for our elders and their families and/or friends.

The “Wash Up” campaign, simple but effective, involved plastering decals everywhere throughout the 11 facilities in our district. These decals were reminders to everyone that hand washing is the most effective way to stop the spread of infection.

The “SBAR Communication Tool” was adopted in our district approximately 1 year ago, as a standardized approach to sharing information and ensuring that patient information is consistently and accurately imparted. SBAR is an acronym for the following: Situation—what is happening at the present time? Background—what are the circumstances leading up to this situation? Assessment—what do I think the problem is? Recommendation—what should we do to correct the problem? This tool is used for administrative communications as well as for shift changes, patient transfers, and use during critical events. This is being used in our emergency department with great success, and is expected to branch out into all other units soon.

The “Ask. Talk. Listen.” campaign encourages patients to become proactive and to find out more about their procedures and health care. The campaign gives patients and their families tips on how to be more involved in their health care and safety.

“Greening our Health Care” has seen our district decrease its garbage by 80%. This committee has participation by many employees, from frontline workers to department directors, and has implemented ideas that have come from our employees. One idea has been to create an idle-free zone around all of our facilities. This reduces pollution from vehicles and conserves gas.

Through these initiatives, our Quality Improvement department, has shown us all how the “energy of many” can have such a great impact on our health care community.