Hospital:  The Windsor Regional Hospital 
City:  Windsor, Ontario 
Initiative:  Rounding the curve in taking a patient safety culture to the next level 

 

Overview:

Safe patient care is everyone's responsibility. Our Family Birthing Centre (FBC) team at Windsor Regional Hospital maintains patient safety as a top priority. Staff commitment to the MOREOB Program has certainly contributed to our successes. It takes a dedicated, progressive, multidisciplinary team to achieve a continued culture of patient safety.

Our safety journey over the past six years has brought us to continue advancing with MOREOB. Our focus on high quality relationships through shared goals, shared knowledge and mutual respect is one of the keys to our success. At Windsor Regional Hospital, our organizational culture results have shown improvement in the following categories: empowering people, learning, communication, patient safety, teamwork and valuing individuals. Our team takes great pride as leaders in patient safety. We have a spirit of cooperation and collaboration which has improved relationships and communication in the interest of safe patient care. Our innovative methods in group and individual exercises have proven successful over the years.

Submission:

Heading into Year Seven, we recognized that we needed to refocus:

As we headed into year seven, the Core Team with the support of Global Salus, started rounding the curve in focusing on two key components: inter-professional relationships and communication. The Family Birthing Center team undertook a 4-step process to:

  1. Take Stock of current team performance through the Relational Coordination survey,
  2. Hypothesize about what changes could improve team performance and identify key performance indicators to measure success.
  3. Experiment through a series of PDSA cycles to test the effectiveness of the change strategies.
  4. Evaluate the impact of improvements in team functioning on unit and organizational performance.

The FBC team hypothesized that three practice changes would result in improved inter-professional relationships and communication:

  • Safety Huddles
  • Multidisciplinary Huddles with Midwives
  • Bedside Handover Reports, including the Patient

The results from the three practice changes were measured, documented and tracked during the each of the PDSA cycles. Action plans were used for each of the practice changes to help guide the success. For example, with the safety huddles, they were defined as meeting a minimum of four times per 24 hours at 0900, 1400, 2100 and 0500. Each huddle was documented, and all results reviewed. In June 2012, we had 77% uptake. Challenges were reviewed such as having all disciplines attend and action plans were developed such as educating staff through a variety of venues, management supporting each huddle through the day. Each month was a new PDSA cycle and by August 2012 performance greatly improved with a 98% compliance. This has been followed by October, November and December 2012 at 100%.

Summary:

Each of the three practice changes have proven successful with the hard work and dedication of the inter-professional team in FBC. Each of these changes has a direct impact on the patients and their safety in our environment. Measurement of these changes continues and moving ahead we have planned for reviewing the changes of team performance through a second Relational Coordination survey in 2013. Patient satisfaction is another measurement that will be monitored through NRC Picker and leadership rounding. We continue to strive to enhance every step in the patient safety journey at Windsor Regional Hospital Family Birthing Centre, being aware that in the patient safety journey every moment counts.

 

Rosemary Petrakos,
Director, Women & Children’s Services
Windsor Regional Hospital
Windsor, Ontario