The Renfrew Victoria Hospital (RVH) in Ottawa (Renfrew), Ontario has adopted a nurse-led initiative to improve the culture of patient safety that implements and disseminates tools related to the domains of the Canadian Patient Safety Institute’s Safety Competencies framework.
The initiative focuses on three of the six domains: Contribute to a Culture of Patient Safety – apply core patient safety knowledge, skills, and attitudes to everyday work; Work in Teams for Patient Safety – work within professional teams to optimize patient safety and quality of care; and Communicate Effectively for Patient Safety – promote patient safety through effective healthcare communications.
The RVH received $40,000 in funding from the Ontario Ministry of Health and Long-Term Care to develop the initiative, implement tools and generate awareness related to hospital-wide policies focusing on patient safety.
“In preparing for accreditation, we took a look at the patient safety culture tool and these three domains stood out as logical areas to focus on to make a difference and improve the culture of safety throughout the organization,” says Chris Ferguson, Vice-President of Patient Services at RVH. “Although the funding was targeted to nursing, the nurses involved provided education to all hospital departments providing patient care and all levels of the organization, including senior management.”
Charlene Hanniman and Cindy Walker, two experienced RVH nurses completed the Patient Safety Education Program – Canada (PSEP – Canada) training and act as Project Leads for the initiative. They have organized and developed content and curriculum for education, and implemented and facilitated the education based on the three key domains. Almost 100 staff attended an introductory session related to patient safety and a total of 162 staff participated in targeted educational sessions on the three domains, held between February and March 2013.
To evaluate their program, rather than doing another survey, RVH used the patient safety culture tool to determine if the training had helped move the bar. Key improvements pre- and post the education program went from 61.3 percent to 75.2 percent in response to: “I’m rewarded for taking quick action to identify a serious mistake.” An increase from 41.0 percent to 52.3 per cent was noted in response to: “I have enough time to complete patient care tasks safety.” And, the rates increased from 84.6 per cent to 87.7 per cent in response to: “On this unit when an incident occurs we analyze thoroughly.”
“This was a way to establish best practice champions for safety,” says Chris Ferguson. “In implementing the program the Project Leads had a good education base to draw from in providing the peer-to-peer education program. By applying first-hand knowledge they can provide good examples of real life changes that can be made to improve safety.”
Chris Ferguson also acknowledged the support and guidance received from The Ottawa Hospital in developing the program: “The Ottawa Hospital freely shared their work and expertise to help us design a program unique to RVH.”
Quality and safety are embedded in the Strategic Plan for the RVH. Patient safety is one of the six key values adopted by the hospital. Values-based conversations were recently introduced as a component of performance reviews where individual employees select two values that they emulate and provide examples of how they apply them in their day-to-day work. Each issue of a quarterly newsletter also focuses on two of the values and profiles how they are being applied on the frontline.
The RVH is now looking at opportunities to access funding that will help to expand their work and to develop education programs on the other three safety domains.