Canterbury Health System Quality Improvement Showcase 2018

The winners of the Canterbury Health System Quality Improvement Awards 2018

The winners of the Canterbury Health System Quality Improvement Showcase 2018

The 2018 Supreme Award winners accepting their award for the Focus on eyes: Delivering patient treatment on time project

The Canterbury Health System Quality Improvement Awards recognise, reward and publicly acknowledge excellence in quality improvements and innovations. The Awards are open to all Canterbury DHB staff and providers whose services are funded by Canterbury DHB.

This year’s Awards, held on 6 December, featured speeches, presentations, and an exhibition of all 48 poster entries. Entries came in from organisations across the Canterbury Health System, covering topics ranging from radiology, improving mental wellbeing, reducing appointment and waiting times, streamlining services, and more.

To see photos of the event, view the photo gallery.

To view 90-second overview videos created by the entrants, click on the links embedded in the project titles below.

Award winners

Improved Health and Equity for All Populations

Winner: Motivating conversations: Developing a motivational interviewing education module for primary care professionals using a continuous quality improvement approach (Population Health and Access Service Level of Alliance, Canterbury Clinical Network)

This project aimed to achieve increased interpersonal communication skill levels between patients and primary health care providers by designing an education programme, ‘Motivating Conversations’, that was peer-led, brief, and focused on the practical development of motivational Interviewing skills. Over 220 primary health care professionals attended Motivating Conversations between 2017 and mid-2018, and Motivating Conversations has maintained a high level of satisfaction among the participants and use in their workplace.

Runner-up: Sparklers: Helping tamariki live brighter (Community and Public Health)

Aiming to support tamariki to look after their own wellbeing, build positive mental health, and cope with life’s challenges, Sparklers was collaboratively developed over two years as a free online wellbeing resource for school years 1-8. Evaluations have shown that the resource has been highly valued by school staff and other professionals, providing a common wellbeing language across students, school staff and other professionals, and normalised talking about and promoting positive mental health and wellbeing for the schools involved in the evaluation.

Reducing the Triple Whammy: Small group education to improve patient safety and reduce harm in primary care (Pegasus Health)

The Triple Whammy is a potentially dangerous combination of drugs which can cause acute kidney injury and significant patient harm. Beginning in 2011, education messages alerting clinicians to watch for the Triple Whammy were delivered through relevant rounds of the regular peer-led Small Group programme run by the Pegasus Clinical Quality and Education team, and again in 2013. By the end of 2017, data showed that the number of patients on the Triple Whammy combination had fallen from 3054 in 2010 to 1821, a reduction of around 40 percent.

INTRgr8: Totara House (Specialist Mental Health Service, Totara House)

Developed in conjunction between Totara House, Emerge Aotearoa and Comcare Trust, the aim of this project was improving social recovery and physical health outcomes for clients, promoting a holistic approach to the recovery journey. The pilot began in July 2017 with the appointment of dedicated Community Support Worker (CSW) from Emerge Aotearoa, and the appointment of Active Links Worker from Comcare Trust into Totara House. Next steps include developing Peer Support into Totara, adapting written job plans for staff, and identifying/developing targeted outcome measures for integrated workers to use with clients to measure vocational, social and health outcomes.

Best Value for Public Health System Resources

Winner: The customised variant testing service: A family-specific genetic testing service in New Zealand (Hospital Support and Laboratories/Canterbury Health Laboratories/Genetics)

This project introduced a local customised service which allowed genetic testing of families with any known genetic variant at Canterbury Health Laboratories (CHL). The average turnaround time for CHL services is 22 days, as opposed to three to six months for overseas laboratories, with a cost of around $355.00, compared with $270.00 – $1600.00+ for overseas laboratory services ─ reducing anxiety for parents and their families, as well as saving money.

Runner-up: Where are my pumps?! Reducing the time spent looking for clinical equipment using wifi asset tracking and an easy-to-use website (Medical Physics & Bioengineering, Clinical Engineering Emergency Department) (no video available)

The Emergency Department’s (ED) supply of infusion pumps often end up scattered around the hospital as their patients are transferred to wards. The aim was to provide a system enabling non-techie users to instantly find their clinical equipment, increasing the number of pumps available in ED, and decreasing the amount of time staff spend looking for them through wifi and an easy-to-use website.

Radiology one-stop-shop for MRI general anaesthetic: A comprehensive solution (Radiology Department)

Young children having an MRI scan are required to stay very still for up to two hours and might require a general anaesthetic, adding to the inefficiency in a patient’s journey. The team wanted to come up with a better way to manage this. The aim of this project was to have a one stop shop for children and families, to reduce the number of stakeholder interactions, improve communication, reduce delays and reduce the movement of patients around the hospital. Patients now only visit Radiology and are discharged having seen all key staff. Pre-admission, patient care during treatment and recovery were streamlined, valuing both patient and staff time.

Keeping cool – a CDHB team project [resolving medical and laboratory refrigeration faults] (Canterbury DHB Clinical Engineering)

This project’s aim was to identify and resolve medical and laboratory refrigeration faults in real time to prevent product wastage, improve patient safety, and reduce the impact of temperature-controlled equipment faults. The project started in May 2014, and, over the next three years, the team fitted temperature monitoring tags to all 622 fridges, freezers and other temperature-controlled devices and rooms. Now, all critical Canterbury DHB medical and laboratory temperature-controlled equipment is continuously monitored. Clinical staff no longer need training to troubleshoot equipment problems as the system is identifying faults and prescribing an appropriate action to resolve it. The efficacy of monitoring has reduced critical monthly events from over 5,000 per month in September 2015 to under 200 in August 2016.

Improved Quality Safety and Experience of Care 

Winner: Focus on eyes: Delivering patient treatment on time (Ophthalmology Service)

Responding to concerns about national Ophthalmology overdue follow-up times for people diagnosed with eye disease, the Canterbury Eye Service ran over 100 outpatient clinics, including at night, weekends and during last year’s Christmas break ─ reducing an overdue Ophthalmology follow-up waiting list of 3,347 patients down to 719 in one year.

Runner-up: It's radiation therapy but not how you know it: Volumetric modulated arc therapy for breast cancer (Radiation Oncology)

The Radiation department at Christchurch Hospital treats approximately 240 breast cancer patients a year. The experience of patients receiving radiation therapy could be improved by reducing treatment times. This project aimed to successfully plan and treat a patient that required treatment to the breast, axillary nodes and internal mammary chain nodes with volumetric modulated arc therapy (VMAT). Through document reviews, education and meeting patients, using VMAT has reduced the daily appointment time by 50 percent, meaning that 12.5 hours of both patient time and treatment machine time is being saved.

Falls Prevention 2014 – 2018 (Quality and Patient Safety Team) (video not available)

Falls prevention is a key safety priority for Canterbury DHB. The initial aim of this work was to reduce the inpatient harm from falls in Canterbury DHB Inpatient Adult Services. The Releasing Time to Care modular approach was used as a vehicle for change, and to ensure visibility, consistency and standardisation of falls management. Improvements include standardisation of the Bedside Board concept to incorporate components of the safe mobility plans and the introduction of the bedside Handover. Results of the project and incident reporting system data are displayed for ward staff to review on the ‘Knowing How We are Doing’ Boards. The rate of falls resulting in injury has decreased each year, and the targets for the last three years have been achieved.

Grey Matters: Implementing Stereotactic Brain Radiation Therapy (SRT) at Christchurch Hospital (Radiation Oncology Service)

The aim of this improvement was to successfully implement Stereotactic Radiation Therapy (SRT) protocol for the treatment of cancer patients with up to three brain metastases. The primary measure was the successful treatment of a patient using the SRT technique. Since the project proposal’s acceptance in 2015, a brain SRT programme has been successfully implemented at Christchurch Hospital. Nine patients have been treated in the last year and no patients (that meet our treatment criteria) have been sent to the specialist unit in Dunedin since our first patient in 2017. The team is continuing to develop the technique, now offering it to more complex patients.

Improved Work-life

Winner: Excellence in palliative care: A new approach to supporting aged residential care facilities (Nurse Maude Hospice Service)

The Palliative Aged Residential Care Service was formed with the appointment of seven clinical nurse specialists who worked closely with facilities to identify and fulfil learning needs. In addition to staff education and collaboration, these nurses liaised with general practice and families to create a non-referral based service and a seven day a week support rostered service. As a result, 95 percent of aged residential care facilities were contacted each month and education has been held at 97 percent of facilities. Staff have provided positive feedback on how education has improved confidence and clinical practice. This is supported by audits result showing appropriate referrals for residents with complex needs.

Runner-up: Streamlining the vascular ward round: A time-out structure (Ward 10, Vascular Surgery Department)

A time-out model, loosely based off the World Health Organization’s Surgical Safety Checklist, was developed to improve workflow, hand hygiene, and communication without increasing administrative time. As a result, there was a significant improvement across a broad variety of subjective and objective measures post-introduction of the time out and no increase in time per consultation. The time-out structure is currently used in daily practice and will continue based on the encouraging results of the audit.

Gerontology Acceleration Programme – Developing our Nursing Workforce (Nursing Work Force Development team)

The Gerontology Acceleration Programme (GAP) was implemented to support the development of gerontology nursing across Canterbury. The aim of this work was to ensure a stronger culture around supporting older person’s health, while reinforcing a more collaborative system, quality innovation opportunities and leadership potential. A GAP advisory group was established and two aged residential care providers participated in the inaugural programme in 2013. Since then, 26 Registered Nurses have participated in GAP, with more than 90 percent success rate, and increased in workforce retention and recruitment stability have been observed. Additionally, One Aged Residential Care facility demonstrated a significant 60 percent decrease in acute hospital admissions.

Bronchoscopy emergencies training: introducing emergency simulation training to the bronchoscopy team (Respiratory Service)

In Christchurch Hospital, no routine training for bronchoscopy-related emergency situations was taking place – which was a clinical risk. Drawing on knowledge from Senior Medical Officers experienced in simulation training within the Emergency Department, three emergency scenarios were created and trialled with Respiratory Department staff. Feedback was overwhelmingly positive and scenarios were 12 modified based on this feedback to make them more realistic. A second round of simulation training occurred with a broader range of nursing staff within the department. A total of 62 staff attended a bronchoscopy simulation session, and, on a post-session evaluation form, the majority of attendees felt that the simulation sessions were extremely valuable. The Endoscopy Department is currently reviewing Clinical Nurse Educator support which would allow simulation sessions to be run as ‘business as usual’ without the need for external facilitators.

Consumer Council Award

Reducing the Triple Whammy: Small group education to improve patient safety and reduce harm in primary care (Pegasus Health)

People’s Choice Poster Award

Winner: Radiology one-stop-shop for MRI general anaesthetic: A comprehensive solution (Radiology Department)

The aim of this project was to have a one stop shop for children and families, to reduce the number of stakeholders, improve communication and reduce delays and reduce the movement of patients around the hospital. Changes were made to streamline pre-admission, patient care during treatment and recovery, thereby valuing both patient and staff time. Patients only visit Radiology and are discharged from recovery having seen all key staff.

Supreme Award

Winner: Focus on eyes: Delivering patient treatment on time (Ophthalmology Service).

 

Page last updated: 21 December 2018

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