Initiatives by Category

Patient Safety

Clinical Practice Improvement (CPI) Training Program

Aim: The CPI training program provides clinicians with training in a methodology to address a problem or issue they have identified as adversely affecting patients. They then undertake a project to address the problem, with the ultimate aim being to improve patient outcomes / care or patient experiences.

Benefits: The methodology, once learned, can be applied to a variety of clinical settings and enhance patient care and clinical quality. There can be savings both monetary and in decreased length of stay. Some projects successfully manage to reduce variation in what they do and therefore improve processes and standardise care. Teams are interdisciplinary and can work more closely together towards a common goal. The training helps created a pool of staff skilled in quality improvement. Participants can use being on...

CEC Ready to Implement Added: 2 June 2014|Last updated: 2 June 2014

Clinical Practice Improvement Program for Advanced Trainees and Recent Fellows

Aim: The purpose for Clinical Practice Improvement (CPI) is to build capacity in front line staff to improve healthcare processes and to achieve efficiency, reduce harm and improve satisfaction of the patient experience; A one-year program aims for Advanced Trainees to gain skills in patient safety and improvement methodology and to undertake a project to improve patient outcomes; A unique program which will help the RACP Advanced Trainees to recognise areas where improvements in the health system are needed, and to...

Benefits: The CPI Program provides an opportunity for RACP Advanced Trainees and recent FRACP graduates to focus on developing their non-technical skills as well as their medical expertise. Quality and safety is central to all aspects of patient care. This program provides the Advanced Trainees with the skills required to recognise and respond to improvement opportunities. It also gives participants some of the skills required to be future leaders in health system. The program aligns with several domains of the RACP...

CEC Ready to Implement Added: 25 February 2015|Last updated: 9 April 2015

NSW Standardised Pain Charts (adult)

Aim: Development and implementation of statewide charts to be used at the bedside when delivering Patient Controlled Analgesia (PCA), ketamine infusions and neuraxial opioid administration. To standardise practice and reduce error relating to documentation, monitoring and prescription across NSW.

Benefits: Benefits include improved safety and quality of care for patients.

ACI Ready to Implement Added: 7 November 2013|Last updated: 15 December 2014

Special Committee Investigating Deaths Under Anaesthesia

Aim: To improve the quality and safety of anaesthetic administration in NSW. To reduce anaesthesia-related mortality in NSW.

Benefits: SCIDUA looks for errors of management in the administration of anaesthesia and/or sedation. The committee also monitors anaesthetic outcomes and identify emerging trends that are associated with changes in anaesthetic, surgical and medical interventions over time. Lessons are identified and shared to facilitate improvements.

CEC Ready to Implement Added: 30 October 2013|Last updated: 30 May 2014

Clinical Variation in 30 Day Mortality for Acute Myocardial Infarction

Aim: To examine clinical variation in 30 Day mortality for patients presenting with Acute Myocardial Infarction to hospitals throughout NSW.

Benefits: Increased understanding of the factors that contribute to unwarranted clinical variation (UCV) in 30 day mortality for Acute Myocardial Infarction. If UCV is confirmed there may be opportunities to improve the quality of patient care and decrease length of stay, resulting in reduced costs.

ACI Pre-implementation Added: 6 November 2013|Last updated: 6 November 2013

REACH (Patient and Family Activated Escalation)

Aim: REACH empowers patients and families to escalate care if they are concerned about the condition of the patient by first encouraging engagement with the treating clinicians at the bedside.

Benefits: Evidence suggests there is improved patient and family experience, decreased mortality and improved operational outcomes. The REACH process aligns with the Australian Commission for Safety and Quality in Health Care (ACSQHC) National Safety and Quality Health Service Standards, Standard 9.9: Enabling patients, families and carers to initiate an escalation of care response.

CEC Ready to Implement Added: 6 November 2013|Last updated: 5 March 2015

Training in Patient Based Care

Aim: The Directorate of Patient Based Care facilitates training and education in Patient Based Care to: Board, Executive, Leaders, Senior Managers and Clinicians; Junior Clinicians; and the workforce (through Train-the-Trainer).

Benefits: Through training the Directorate assists services to provide patient based care and meet new performance goals and the Australian Commission on Safety and Quality in Health Care National Safety and Quality Health Service Standards (Standard 2.6 Implementing training for clinical leaders, senior management and the workforce on the value of and ways to facilitate consumer engagement and how to create and sustain partnerships).

CEC Ready to Implement Added: 7 November 2013|Last updated: 5 March 2015

NSW Pain Clinic Referral Form and Process

Aim: To provide a consistent method when making a referral from primary care to a tertiary pain service, irrespective of where the service is located.

Benefits: All services will have the same triage criteria and process for accepting patients from primary care.

ACI Ready to Implement Added: 7 November 2013|Last updated: 17 November 2014

Quality Systems Assessment (QSA)

Aim: The Quality Systems Assessment (QSA) is a clinical risk management program designed to provide clinicians and managers at all levels with information relevant to their local systems for clinical quality and patient safety.

Benefits: The QSA is one vehicle that contributes to resilience in our health system. Working directly with local teams and local priorities, the QSA supports continuous learning and improvement to prevent and reduce patient harm. Through the multi-level self-assessment, reporting and site visits the QSA is able to identify risks and support improvements: Locally – through detailed local data returned directly to local teams Systemically – through aggregation of local data to identify high priority themes for action All effort that...

CEC Ready to Implement Added: 24 January 2014|Last updated: 14 October 2014

Clinical Practice Improvement (CPI) Advisors Group

Aim: The CPI advisors group aims to bring quality managers together to share their knowledge and experiences with each other as well as working together to develop resources for use across the NSW public health system. This group communicates by monthly teleconference and meets face to face annually for a professional development workshop. Members have also been involved in a collaborative workshop with Clinical Redesign leads.

Benefits: The program enables quality managers to meet up with peers in a similar position, who can assist with directing or sharing policies or procedures. CPI advisors share how their organisation has responded to changes within the system around accreditation and national standards and how they are implementing or supporting CPI initiatives in their Local Health District (LHD) / Specialty Health Network (SHN). The group has a shared HSnet site where articles of interest or resources can be uploaded to share....

CEC Ready to Implement Added: 2 June 2014|Last updated: 2 June 2014

Pressure Injury Prevention Project

Aim: To foster best practice in the prevention and management of pressure injuries within NSW health facilities.

Benefits: Enhance patient safety by promoting pressure injury prevention and management among health care professionals and patients, in line with the Pan Pacific Clinical Practice Guidelines for the Prevention and Management of Pressure Injury 2012 as evidence based practice.Support local health districts (LHDs) and Networks to meet the Australian Commission on Safety and Quality in Health Care, National Safety and Quality Health Service Standards - Standard 8, Preventing and Managing Pressure Injury.

CEC Pre-implementation Added: 7 November 2013|Last updated: 2 June 2014

eChartbook

Aim: The Clinical Excellence Commission (CEC)’s eChartbook is an interactive web-based tool providing a curated, accurate and timely view with expert commentary providing an overview of the state of knowledge in relation to quality and safety of health services in NSW. It aims to be a key resource for driving change within the NSW health system. It focuses particularly on CEC’s on Projects and Programs.

Benefits: The eChartbook is designed for use by clinicians, local health district (LHD) health professionals and other interest groups. It also provides information for the public about safety and quality issues and is written in a publicly-accessible style. The eCharbook presents more timely data through the use of dynamic charts, updated in real time

CEC Ready to Implement Added: 18 February 2015|Last updated: 23 March 2015

Between the Flags

Aim: The aim of Between the Flags is to improve early recognition and response to clinical deterioration.

Benefits: The Between the Flags system is designed to protect patients from deteriorating unnoticed and to ensure they receive appropriate care. It is a ‘safety net’ for patients who are cared for in NSW public hospitals and health care facilities.

CEC Ready to Implement Added: 30 October 2013|Last updated: 9 November 2015

Open Disclosure

Aim: The Open Disclosure project aims to enhance the care and support provided to patients and/or their support people and health care staff involved in a patient safety incident, through outlining a clear process for open disclosure communications and the roles and responsibilities of health services and their staff.

Benefits: Effective open disclosure can [1]: improve patient safety through an improved understanding of how things go wrong increase trust between patients who have been harmed by a patient safety incident and health care providers when information is exchanged and an apology is received assist patients to become more active partners in their care. [1] Australian Commission on Safety and Quality in Health Care (ACSQHC) Australian Open Disclosure Framework, Sydney, 2013

CEC Ready to Implement Added: 2 June 2014|Last updated: 17 November 2014

Collaborating Hospitals’ Audit of Surgical Mortality (CHASM)

Aim: To improve the quality and safety of surgical care in NSW hospitals. To reduce the number of preventable surgical deaths in NSW hospitals.

Benefits: All surgeons who are in operative practice are required to report the clinical management of their patients who die while under their care to CHASM for peer review. CHASM provides feedback on the peer review findings to surgeons to facilitate reflective learning and improvement in surgical care.

CEC Ready to Implement Added: 30 October 2013|Last updated: 30 May 2014

Medication Safety and Quality Unit

Aim: To support the safe and quality use of medicines by identifying and addressing emerging medication safety risks.

Benefits: The CEC Medication Safety and Quality unit oversees four programs, Continuity of Medication Management, High-Risk Medicines, Medication Safety Self Assessment and VTE Prevention. The Continuity of Medication Management program provides tools and resources to support medication reconciliation; the process of ensuring that patients receive all intended medicines and that accurate, current and comprehensive medicine information follows them at all transfers of care. The High-Risk Medicines program heightens awareness of the harm that can be caused and assists in improvements to...

CEC Ready to Implement Added: 8 December 2014|Last updated: 9 November 2015

Reducing Unwarranted Clinical Variation (UCV) Taskforce

Aim: To oversee the development and implementation of a system-wide approachto identify, address and reduce Unwarranted Clinical Variation (UCV).

Benefits: To refine care processes and implement evidence-based models of care tosupport improved patient outcomes.

ACI Ready to Implement Added: 8 November 2013|Last updated: 17 November 2013

Healthcare Associated Infections (HAI)

Aim: Healthcare Associated Infections (HAIs) are infections acquired in healthcare facilities and infections that occur as a result of healthcare interventions and which may manifest after people leave the healthcare facility. Prevention of HAIs and the transmission of multi-resistant organisms (MROs) are key patient safety and clinical quality initiatives for NSW Health. The HAI program at the CEC aims to reduce the risk of acquiring a HAI during care delivery in NSW health facilities. The program enables NSW Local Health Districts...

Benefits: Improved health outcomes for patients (reduced morbidity and mortality); Reduced risk of HAI transmission to patients, visitors and staff; Standardised approach to HAI prevention and control.

CEC Ready to Implement Added: 2 June 2014|Last updated: 9 April 2015

Improving Patient Outcomes from Cataract Surgery Study

Aim: The primary aim of the research is to explore patient-centred outcomes of cataract surgery in Australia and the effectiveness of currently available tools to assist Australian Ophthalmologists to appropriately plan surgery for people with cataract.

Benefits: While there is a large body of knowledge describing visual improvement following cataract surgery, we currently know little about the expectations that Australian cataract patients have of their impending surgery, or their satisfaction with post-surgical outcomes. This research will provide important information on which to shape patient-focused criteria for cataract surgery referral, including measures of driving confidence and quality of life.Up to 500 bilateral cataract patients in NSW will be assessed for vision function and quality of life prior to...

ACI Pre-implementation Added: 8 December 2014|Last updated: 8 December 2014

AMBER Care Bundle

Aim: The AMBER care bundle provides clinical teams a framework to develop a management plan that may include end of life decisions in collaboration with the patient and family for patients whose recovery is uncertain while continuing with treatment in the hope of a recovery.

Benefits: Early identification of people who may have end of life care needs is the foundation of excellent end of life care. If early identification does not occur then appropriate planning, transfer, interventions and communication with the person and their family cannot take place The AMBER care bundle: Provides a tool to help clinicians identify people for whom recovery is uncertain and who may have end of life care needs Simplifies key interventions to support best practice Supports staff to start...

CEC Ready to Implement Added: 25 June 2013|Last updated: 9 November 2015

Community Update on Patient Safety and Quality

Aim: The Community Update is designed to provide consumers with information on the progress of NSW public hospitals across key areas including: handover, hand hygiene, medication safety, falls, healthcare associated infections, sepsis and incident management. A template of the Community Update is available for Local Health Districts who would like to report on their safety and quality data locally.

Benefits: By engaging the community and partnering with patients, family and carers as team members we can improve quality in health care. The Community Update supports the Australian Commission for Safety and Quality in Health Care National Safety and Quality Health Service Standard 2.7.

CEC Ready to Implement Added: 6 November 2013|Last updated: 5 March 2015

SEPSIS KILLS Program

Aim: To improve the recognition and treatment of sepsis and septic shock in NSW healthcare facilities and to reduce their impact, mortality and financial costs.

Benefits: Successful implementation of the SEPSIS KILLS program is providing significant benefits at both clinical and system levels, including: more timely, standardised and effective detection and management of sepsis; reduced mortality, morbidity and bed-stays from sepsis-related conditions; enhanced clinician skills in sepsis recognition and management; enhanced networking opportunities across the system for clinicians and service teams; improved quality and safety of care; a better and safer patient experience.

CEC Ready to Implement Added: 6 November 2013|Last updated: 5 February 2015

Blood and Marrow Transplant Environmental Cleaning (BMTEC) Project

Aim: To measure level of cleanliness provided in NSW BMT program. Establish baseline level of environmental cleanliness informed by three external environmental cleaning audits per facility. To ascertain the methods by which units are cleaned (e.g. frequency and process), resourcing, training, and education of environmental service personnel and clinical governance; To pilot and validate the CEC NSW environmental cleaning audit tool against an established standard; To inform quality improvements in environmental cleaning standards in BMT/Haematology units (an extreme-risk functional area). Monitor...

Benefits: With the support of the BMT Network Council and ACI, the BMTEC project provides the following benefits: (i) Enhanced compliance with the Environmental Cleaning Policy NSW (PD2012_061, Nov 2012). Authored by the Clinical Excellence Commission (CEC), this policy was released as a policy directive by the NSW Ministry of Health in November 2012 (1). The categorisation of risk in the Policy provides a basis for recommendations of frequency and minimum cleaning standards for each functional area.Additionally, the policy outlines measures...

ACI Ready to Implement Added: 8 November 2013|Last updated: 5 August 2016

In Safe Hands Program

Aim: The In Safe Hands program aims to build and sustain effective health care teams. It is intended to give these teams the structure and tools to redesign their units into strong, interdisciplinary teams, working together to deliver highly reliable, planned care to all patients.

Benefits: Teams that have implemented In Safe Hands have identified the following benefits: Reduced patient length of stay; Reduced unexpected deaths; Reduced adverse events; More satisfied staff; Improved patient experience; Improved safety culture.

CEC Ready to Implement Added: 6 November 2013|Last updated: 12 January 2015

Clinical Analytics Initiative

Aim: To extract data from the electronic medical record and work with clinicians in using information to deliver quality and efficiency initiatives, and research the future needs for clinical analytics.

Benefits: Enable clinician led improved quality, safety and efficiency initiatives using data from the electronic medical record; Increase clinician engagement with information from the electronic medical record.

CEC Pre-implementation Added: 2 June 2014|Last updated: 2 June 2014

5x5 Antimicrobial Audit

Aim: The 5x5 Antimicrobial Audit is an initiative of the Clinical Excellence Commission that aims to improve communication and selection of empirical antimicrobial therapy among clinical teams.

Benefits: The 5x5 Antimicrobial Audit provides a platform for introducing regular, frequent and directed measurement and reporting of antimicrobial prescribing indicators in NSW local health districts and networks. The auditing process encourages clinically appropriate interventions where indications are unclear and/or empiric antimicrobial prescribing is found to be non-concordant with local guidelines. The 5x5 Antimicrobial Audit also facilitates rapid feedback of ward or unit-level antimicrobial prescribing indicators by providing tools and support to enable simple reports to be generated and discussed with...

CEC Ready to Implement Added: 2 June 2014|Last updated: 9 November 2015

Hand Hygiene

Aim: Through sustained improvement in hand hygiene by healthcare staff reduce the risk of healthcare associated infections.

Benefits: Improved health outcomes for patients (reduced morbidity and mortality); Reduced risk transmission of pathogenic organisms to patients, visitors and staff.

CEC Ready to Implement Added: 2 June 2014|Last updated: 2 June 2014

The Health Literacy Guide

Aim: The Health Literacy Guide has been developed to assist health services by providing practical strategies to address health literacy barriers for patients. The Guide also assists health services to meet new performance goals and the Australian Commission for Safety and Quality in Health Care (ACSQHC) National Safety and Quality Health Service Standards.

Benefits: By considering approaches to health literacy, health care organisations can benefit by improving safety and quality in health care. Consumers can benefit by accessing health information that is meaningful and relevant to their individual medical needs and navigating the system more easily.

CEC Pre-implementation Added: 6 November 2013|Last updated: 15 July 2014

State Cardiac Reperfusion Strategy (SCRS)

Aim: To improve care for all patients in NSW with a suspected Acute Coronary Syndrome (ACS) and reduce the time from symptom onset to reperfusion for patients with ST Elevation Myocardial Infarction (STEMI).

Benefits: Care is tailored to specific settings so that all patients, regardless of their geographical location or presentation pathway can benefit from early access to specialist medical advice and appropriate treatment. Timely reperfusion rapidly restores blood flow to the heart, which means patients with STEMI may have better outcomes and fewer days in hospital.

ACI Ready to Implement Added: 11 July 2013|Last updated: 21 May 2015

Paediatric Clinical Practice Guidelines Audit Project

Aim: To assess compliance with the guidelines and assist local health districts to further improve the care of children in emergency departments.

Benefits: Empower generalist NSW hospitals, which see the majority of children presenting to an emergency department, with tools and resources to deliver the highest quality care, regardless of location.

CEC Future Initiative Added: 6 November 2013|Last updated: 9 April 2015

Supervision for Safety

Aim: It is proposed that the Supervision for Safety project address NSW Health system deficiencies related to supervision at the point of clinical care. Specifically related to ensuring patient care plans are appropriate and deterioration in patient condition is escalated to the most appropriate level.

Benefits: The Supervision project aims to ensure the appropriate support is provided to less experienced clinicians.The expected project outcomes include:Supervision of the clinical workforce is built into core work practices; Supervision is structured to allow clinicians to be trained without compromising patient care; Supervision provided by clinicians at the point of care is appropriate for the level of expertise of the clinicians involved; Practices are in place to establish the level of expertise of less experienced staff; Supervision is treated as...

CEC Pre-implementation Added: 2 June 2014|Last updated: 2 June 2014

Acute Myeloid Leukaemia (AML) Model of Care

Aim: To optimise the quality of care for patients with AML and enable a consistent approach to the provision of care. It provides a set of principles and outlines the key requirements at each stage of the patient’s journey based on evidence of best practice. It incorporates guidelines related to various components of the model.

Benefits: Key points included in this model are:Mechanisms to ensure early identification and referral to an AML treatment centreA multidisciplinary team (MDT) approach to treatment planning and the provision of care in an appropriate settingThe use of ambulatory care services to enable early discharge programs in a safe and efficient wayEffective follow-up and supportive care for all patients with AML

ACI Pre-implementation Added: 5 November 2013|Last updated: 10 July 2015

The Patient Based Care Challenge and Associated Guide

Aim: The Patient Based Care Challenge and associated provides practical strategies for transforming hospitals and health services for a patient based care focus.

Benefits: Local Health Districts sign up to The Challenge as a long term strategic commitment. The Guide provides practical advice on strategies within The Patient Based Care Challenge. Improving patient care experience is linked to improved clinical and business outcomes, including cost savings.

CEC Ready to Implement Added: 6 November 2013|Last updated: 5 March 2015

Clinical Leadership Program

Aim: The ultimate aim of the program is to build a cohort of clinical leaders with the skills and commitment to shape a sustainable culture of patient safety, professionalism and positivity within the NSW health system.It aims to enhance:the understanding of clinicians about the workings of NSW Health; knowledge of contemporary approaches to patient safety and clinical quality systems; the skills of clinicians in relation to communication, conflict resolution and team leadership within an environment of health care resource limitation; the...

Benefits: The Clinical Excellence Commission (CEC) believes that the power of clinical leadership is an essential component of the CEC’s commitment to improving patient safety and clinical quality in our healthcare system. Clinical leaders play a pivotal role in the patient safety and clinical quality environment and need to have their full potential harnessed to ensure the health system works better and more safely for staff, patients and their families. In this, the program supports clinicians to develop extraordinary leadership practice....

CEC Ready to Implement Added: 2 June 2014|Last updated: 9 November 2015

Osteoporosis Refracture Prevention Model of Care

Aim: To ensure people who sustain a minimal trauma fracture have access to early identification, diagnosis, treatment, and follow-up for osteoporosis.

Benefits: Benefits include improved patient outcomes, better utilisation of hospital services, and reductions in health system costs for at risk people.

ACI Ready to Implement Added: 7 November 2013|Last updated: 9 February 2015

TOP 5

Aim: The TOP 5 program acknowledges the value of carer information for people living with dementia and other types of cognitive impairment to improve patient outcomes and carer and staff experience.

Benefits: Benefits to individuals with dementia and carers include increased compliance, more effective treatment, less distress and shorter lengths of stay.

CEC Ready to Implement Added: 6 November 2013|Last updated: 7 April 2015

Service Quality and Communication in Emergency Department Waiting Rooms

Aim: The Clinical Excellence Commission (CEC) funded research into service quality and communication in emergency department waiting rooms. The research team was comprised of staff from Southern Cross University with applied skills and knowledge in organisational communication, culture, history, structures and operations.

Benefits: The CEC and Southern Cross University are collaborating on developing educational materials to further progress this area in NSW. Sites interested in being pilot sites for this work are encouraged to email the Directorate of Patient Based Care and express interest.

CEC Pre-implementation Added: 6 November 2013|Last updated: 5 March 2015

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