achieving patient safety through ipe … · ipe “occasions when two or more professionals learn...

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ACHIEVING PATIENT SAFETY THROUGH IPE Assoc.Prof.Onuma Chaiwat Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand

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Page 1: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

ACHIEVING PATIENT SAFETY THROUGH IPE

Assoc.Prof.Onuma Chaiwat

Faculty of Medicine Siriraj Hospital Mahidol

University Bangkok Thailand

Page 2: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Interprofessional Education (IPE)

■ Health profession GOAL

Improve quality of patient care by collaborating with each other

■ IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care”

■ IPE promotes interdisciplinary collaboration and teamwork, reduce the barrier and promote competency among various healthcare groups

Zwarenstein M. J Interprof Care 1999;13:417-24

Barr H.J Interprof Care 2006;20:96-104

Cusack T.Qual Prim Care 2012;20:231-8

Page 3: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

six national education associations of schools of the health professions

Page 4: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE
Page 5: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

CC 1: Value/Ethics for interprofessional Practice

Page 6: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

CC 2 : Roles/Responsibilities

Page 7: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

CC 3: Interprofessional Communication

Page 8: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

CC 4 : Teams and Teamwork

Page 9: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Thailand

Page 10: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Patients Safety

■ A discipline in the health-care sector that applies

safety science methods towards the GOAL of

achieving a trustworthy system of health-care

delivery

Page 11: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Why should we have to know about patients safety ??

■ Because patients outcomes has NOT markedly improve as

WE expected in the ERA of modern health care

■ Still have significant RISKs to Patient Safety

■ Harm results in permanent injury, increased length of stay

and death

Page 12: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE
Page 13: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE
Page 14: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE
Page 15: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

OUTCOM ES

Page 16: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

SICUs

Page 17: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE
Page 18: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Doctor

Nurse

Pharmacist

Patietns/Relatives

Worker

Physical therapist

Patients Safety Cycle

Page 19: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

1. What is patient safety

2. Human factors is important

3. Complexity of systems

4. Effective team player

5. Learning from Errors to prevent harm

6. Understanding & Managing of clinical risk

7. Quality-improvement method to improve care

8. Engaging with patients and carers

9. Infection prevention and control

10. Patient safety and invasive procedures including surgery

11. Improving medication safety

WHO : training in patient safety

Page 20: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Non-technical skills for Patient safety

Siriraj Hospital

Page 21: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Credit by Capt. Sinnop Thepraksa

Page 22: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

WHO : training in patient safety

1. What is patient safety Medical Error is the big issue

2. Human factors is importantHuman-human (stress, fatique), human-machine

3. Complexity of systemsUnderstanding with System approach

4. Effective team player Communication, teamwork

5. Learning from Errors to prevent harm Threat & Error management

6. Understanding & Managing of clinical risk Risk Management, Situation awareness

7. Quality-improvement method to improve care Intervention to fix the problems

8. Engaging with patients and carers Include Pt & carers in Team

9. Infection prevention and control Infection :Major cause of death

10. Patient safety and invasive procedures including surgery

Wrong site/procedure/patient

11. Improving medication safetyOrdering,dispending, administering medications

Page 23: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Patient safety

Training

IPE/IPP Interprofessional Practice

Page 24: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Interprofessional Practice (IPP)

■ Multiple health workers from different professional backgrounds

provide comprehensive health services by working with patients, their

families, caregivers, and communities to deliver the highest quality of

care across settings

Framework for action on interprofessional Education and Collaborative Practice, WHO 2010

Page 25: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Siriraj Safety Culture Course for High Reliability Organization

■ From Thai Airway to healthcare organization (start at 2015)

■ Proactive risk management

: Situation Awareness & Decision Making

■ Doctors, Nurses, Pharmacists, Dentists, Physical therapist

Page 26: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Education : Instruction, Narrative medicine,

Story telling, Clip video

Page 27: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Siriraj Safety Culture Course High Reliability Organization

ม.ย. 2560 อบรม พป.ตอยอดป 1 (130)

19

ม.ย. 2560 อบรม พป.ป 1 (285)

18 ม.ค., ต.ค. 2560 (2) Intensive for the Trainer รน 1 (41)

17

เม.ย. 2560

อบรมบคลากรทางคลนก (163)

16

ม.ค. 2560 อบรมบคลากรทางคลนก (150)

13

ธ.ค. 2559 อบรมบคลากรทางคลนก (116)

12

พ.ย. 2559 อบรมอาจารยแพทยใหม (40)

10

ธ.ค. 2559

อบรมหน.งานคลนก (52)

11

ธ.ค. 2560 อบรมหน.งานสนบสนน (100)

23

พ.ย. 2560 อบรมอาจารยแพทยใหม (40)

21

ก.พ. 2558

Training for the Trainer รน 1 (34)

1

ส.ค. 2559 ชแจงกรรมการประจ าคณะฯ (50)

8

ม.ย. 2559 อบรม พป.ป 1 (268)

7

พ.ค. 2559 Training for the Trainer รน 2 (38)

6

ต.ค.-ธ.ค. 2558

อบรมหน.งานคลนก (200)

5 4 3 2

ต.ค. 2559 อบรม นศ.พ. ป 5 (262)

9

ก.พ. 2560

อบรมบคลากรทางคลนก (331)

15 14

พ.ย. 2560 Training for the Trainer รน 3 (45)

22

ส.ค. 2560 อบรมหน.งานสนบสนน (60)

20

Page 28: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

2559 2560 2561

อาจารยแพทย/ทนตแพทย 8 49 63

บคลากรทางคลนก 228 1072 2026

บคลากรสายสนบสนน 7 116

แพทยประจ าบาน 268 285 284

แพทยประจ าบานตอยอด 130 113

นศ.พ. ชนป 5-6 262 474

รวม 511 1798 3076

511

1798

3076

0400800

120016002000240028003200

จ านว

นผเข

าอบร

จ านวนผเขาอบรมแบงตามประเภทงาน (คน) ป 2559 - 2561

จ ำนวนผเขำอบรม Situation awareness & Decision making

Page 29: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Feedback “Safety culture : Situation awareness & decision making”

Healthcare staff in Siriraj Hospital 2014-2019

Page 30: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

บคลำกรทำงคลนก

หมายเหต : จดอบรมแลวทงหมด 22 รน รวมผเขาอบรมทงหมด 2,645 คน (ป 2559 1 รน, ป 2560 5 รน, ป 2561 16 รน)

ระดบความร/ความพงพอใจในภาพรวม

สามารถน าไปประยกตใช ความพงพอใจโดยรวม

2559 4.42 4.30

2560 4.40 4.35

2561 4.50 4.37

2562 4.42 4.31

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

ระดบ

ความร/คว

ามพง

พอใจในภาพร

วม

2019

KPI > 4.2

2016

Page 31: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

ความรกอนการอบรม

ความรหลงการอบรม

การถายทอดของวทยากร

สามารถน าไปประยกตใช

สอทใชบรรยาย/กจกรรมกลม

ครอบคลมประเดน

ระยะเวลาการบรรยายเหมาะสม

ความพงพอใจโดยรวม

2559 2.91 4.27 4.44 4.42 4.37 4.13 4.30

2560 2.94 4.33 4.43 4.40 4.35 4.30 4.35

2561 3.10 4.41 4.54 4.50 4.40 4.29 4.37

Average 2.98 4.34 4.47 4.44 4.37 4.24 4.34

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

ระดบ

ความร/คว

ามพง

พอใจในภาพร

วม

บคลำกรทำงคลนก Health care staff KPI > 4.2

หมายเหต : จดอบรมแลวทงหมด 22 รน รวมผเขาอบรมทงหมด 2,645 คน (ป 2559 1 รน, ป 2560 5 รน, ป 2561 16 รน)

Page 32: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Very good+Excellent

ระดบวฒนธรรมความปลอดภยของผปวย (Patient Safety Grade)

Siriraj Patient Safety Culture Survey

1. การไมลงโทษกรณทเกดความผดพลาด (Nonpunitive

Response) 2. บคลากร (Staffing) 3. การสงตอ (Hospital Handoffs and

Transitions) 4. ความถ ของการรายงานอบตการณ (Frequency of Event

Reporting)

Page 33: Achieving patient safety through ipe … · IPE “Occasions when two or more professionals learn with, from and about each other to improve collaboration and quality of care” IPE

Thanks you for your attention