Queensland Health Quality Improvement & Enhancement Program (QIEP) Quality & Safety Program (QSP) …….and ….2005 and beyond ……… 16 February 2005

Meeting the National Agenda & Setting QH’s agenda  July June 2003 Australian Health Care Agreement Part 5: Quality Improvement and Enhancement $120 million QH Quality Improvement and Enhancement Program  Quality of Health Services Framework developed for Queensland Health  Australian Health Care Agreement (AHCA) Schedule C $144 million for QLD.  QH Safety and Quality Program

National and State priorities AHCA QLD QIEP Safety & Quality Council AHCA QLD S & Q P 2006 QLD QSP

Quality of Health Services Framework developed

Clinical & non- Clinical Risk Management Consumer Participation Reducing Variation in Health Service Delivery Information Management Distance Management Quality Systems Change Management Program Delivery Incident Monitoring Infection Control Prevention of Falls Risk Management Consumer Participation Informed Consent Patient Complaints & Surveys Clinical Audit Processes Clinical Pathways Credentials & Clinical Privileges Medical Quality Processes Clinical Informatics Quality Use of Medicines Rural & Remote Telehealth Accreditation Review Measuring Quality in the Non-Government Health Sector QHPSS Quality Pathology System Education in Quality Clinician Development Program Central Zone Projects Northern Zone Projects Southern Zone Projects Australian Council on Safety & Quality in Health Care Corporate Management of Program Central Zone Quality Coordination Northern Zone Quality Coordination Southern Zone Quality Coordination Clusters Program Areas Measured Quality

Please note: All 22 “content” Program Areas in the QIEP are not represented – this diagram is indicative of the structure which would apply to all QUALITY COUNCIL Governance Committee for Quality Improvement & Enhancement Program (QIEP) PROGRAM AREA SPONSOR Program Area Manager (and Quality Reviewer) Program Area Manager (and Quality Reviewer) Program Area Board Program Area Manager (and Quality Reviewer) Direct reporting relationship Communication relationship QUALITY STRATEGY TEAM PROGRAM MANAGER

What’s been achieved to date: 1. implementing improved systems to manage the quality of our services and report on performance (Objective from Quality of Health Services Framework ) + Clinical audit + Quality pathology service + Balanced scorecard measurement approach + Credentials and clinical privileges + Collaboratives for Healthcare Improvement + Incident monitoring system + Patient complaints 1. implementing improved systems to manage the quality of our services and report on performance (Objective from Quality of Health Services Framework ) + Clinical audit + Quality pathology service + Balanced scorecard measurement approach + Credentials and clinical privileges + Collaboratives for Healthcare Improvement + Incident monitoring system + Patient complaints

Achieved: 2. Encouraging the community to actively take responsibility for its health and well being by being well informed and being involved in decision making + Informed consent + Consumer and community engagement + Zonal projects - Clinical pathways and networks 2. Encouraging the community to actively take responsibility for its health and well being by being well informed and being involved in decision making + Informed consent + Consumer and community engagement + Zonal projects - Clinical pathways and networks

Achieved: 3. Developing a culture of quality through continuous staff education + Clinician development + Risk Management + Quality Use of Medicines - Adverse Drug Event Project + Prevention of falls 3. Developing a culture of quality through continuous staff education + Clinician development + Risk Management + Quality Use of Medicines - Adverse Drug Event Project + Prevention of falls

Achieved: 4. Improving coordination of health services and programs and collaboration between health service providers and other government and non-government agencies + Telehealth + Pathology - point of care testing + Measuring quality in the non-government sector + Clinical Pathways + Central and Southern Networks 4. Improving coordination of health services and programs and collaboration between health service providers and other government and non-government agencies + Telehealth + Pathology - point of care testing + Measuring quality in the non-government sector + Clinical Pathways + Central and Southern Networks

Achieved: 5. Developing client and patient-centred information systems to facilitate the delivery and evaluation of health services + Clinical Information System + QH Pharmacy Information System + CHRISP (infection surveillance & prevention) 5. Developing client and patient-centred information systems to facilitate the delivery and evaluation of health services + Clinical Information System + QH Pharmacy Information System + CHRISP (infection surveillance & prevention)

Achieved: 6. Providing evidence based health services which are outcome focused and encourage innovative practice + Rural and remote program – Primary Clinical Care Manual – Trained indigenous health workers + Quality Use of Medicines – Rural and Isolated Practice - regular visits, training, network + Clinician development + Infection Control 6. Providing evidence based health services which are outcome focused and encourage innovative practice + Rural and remote program – Primary Clinical Care Manual – Trained indigenous health workers + Quality Use of Medicines – Rural and Isolated Practice - regular visits, training, network + Clinician development + Infection Control

15 projects continued to December to +Finalise standardised tools and procedures +Roll out information systems to next group of hospitals +Finish training and implementation +Improve communication with patients and families to June 2004

Safety & Quality Program The Program should: +build upon what was established in align with QH’s other strategic priorities +align with national quality and safety priorities as appropriate +move away from a project-oriented approach to mainstream the functions such as: +performance reporting and organisational and clinician development activities +reinforce the foundation of performance measurement and reporting (eg. Measured Quality)

Meeting the National Agenda April & July 2004 AHMC Meetings S & Q targets set National Targets from the April 2004 AHMC +10 tips for consumersJuly Right side surgery June-September Incident mgt systemDecember Risk mgt planDecember Sentinel event reportingDecember Medication chartJune Pharmaceutical reviewJanuary 2007

Safety & Quality Program Aligned with ISAP objectives Increased use of clinical evidence-based decision making +Queensland Health endorses a range of principles, objectives, strategies and practices to promote a safe, efficient, and effective health service. +It aims to ensure organisational development and improvement activities are coordinated and targeted to key priorities, emphasising information exchange, education, clinical innovation and reform.

Safety & Quality Program Continuously improving key business processes +Reforming the accessibility, provision and quality use of medicines +Continuing to systematically examine the performance of our hospitals on key indicators +Monitoring the safety of key clinical processes in hospitals by establishing a statewide system for reporting sentinel events and adverse clinical outcomes

Innovation Branch, IWR Directorate Role & Purpose To position Queensland Health as an innovative, adaptable and change ready organisation which drives and supports health care improvement. Identifies opportunities to create and disseminate new ideas and innovations, aligned to strategic priorities and leads the development of tangible and sustainable improvement responses.

Priority 2  Culture of Safety Priority 1  Improve standardisation of system and clinical practice Alignment of Priorities with Structure Priority 5  Workforce Design  Workforce Education Priority 3  Workforce improvement: climate and morale, staff health  Learning Services: leadership development Priority 4  Innovation Priority 3  Exploit full potential Skills Development Centre Patient Safety Centre Clinical Improvement Centre Workforce Reform Innovation Skills Development Centre

OUR PLANNING FRAMEWORK

Queensland Health Strategic Plan 2005– 2010 & Balanced Scorecard Safety & Quality Strategy & Scorecard Other Support Strategy maps &Scorecards 38 District Health Service Balanced Scorecards SUPPORT STRATEGIES & SCORECARDS SUPPORT BUSINESS PLANS Workforce Strategy & Scorecard Strategy Framework

Safety & Quality Strategic Plan Scope +To guide all services within Queensland Health towards safer healthcare delivery Benefits +greater capacity to minimise the risk of unintended harm in healthcare +better planning for future needs including increasing capacity to continuously improve health service delivery; +greater alignment between strategy and business planning processes and improved performance monitoring; +improved strategic focus to improve health service delivery

Queensland Health Strategy Map August 2004 Healthier staff Healthier people & communitiesHealthier partnershipsHealthier hospitals Healthier resources Paying for health Consumer Promoting a healthier Queensland our vision Leaders in health — partners for life our mission Promoting a healthier Queensland C1. Achieve whole-of- government approach to quality of life C2. Increase confidence in health system C3. Increase knowledge and skills for health C4. Improve access to primary health care C5. Reduce impact of chronic disease including on Indigenous peoples C6. Smooth transition between community services, hospitals and GPs C7. Ensure safe and quality health outcomes C8. Appropriate access to specialist services across Queensland IP1. Improve community participation in the planning and delivery of health services IP2. Proactive marketing and education about QH services IP3. Progress shared priorities with government and non- government sector IP4. Inform and skill health consumers IP5. Reduce risk factors in high risk consumers IP7. Increase use of clinical evidence- based decision making IP8. Continuously improve key business processes WF4. Right information at the right time at the right place in the right medium WF1. Encourage innovation and targeted research WF2. Develop values-based organisation WF3. Recruit, develop and retain an appropriately skilled workforce P1. Balanced budget P2. Leverage other sectorsP3. Maximise revenue Internal processes Shaping our workforce IP6. Primary prevention targeting areas of high return IP9. Effective service and workforce planning

Draft Safety & Quality Strategy Map Healthier staff Healthier processes Healthier services Healthier resources Paying for health Customer our vision Leaders in health – partners for lifeour mission Promoting a healthier Queensland Internal processes Learning & Growth Promoting a healthier Queensland P1. Balanced budget LG3. Workforce skilled in continuous quality improvement C4. Culture of safety & quality LG5. Right information at the right time at the right place in the right medium C1. Standardise processes for high risk areas IP1. Operationalise national & state agendas LG2. Competency based recruitment & selection IP9. Implement key decision support systems to inform decision making (clinical & business) IP6. Standardise process of incident management IP5. Partner with educational institutions & professional bodies P2. Identify revenue opportunities LG1. Support mechanisms to share learnings C3. Use of evidenced based management IP3. Identify gaps in communication processes C2. Improve key business processes LG4. Engage clinical & business leaders C5. Use of information technology to support safety & quality IP4. Eliminate rework, duplication & waste IP2. Prioritise areas of high impact IP8. Develop a reporting culture IP7. Managers/leaders demonstrate a culture of safety & quality November 2004 v 5