1. Clinical Governance…or Quality and Safety at the GNCH Mike Mckean

2. Q&S GNCH Q: are we the Great North Children’s Hospital? 2013: review of governance Engagement Structures

3. Clinical Governance Review: Improving service quality through frontline staff Why review CG? GNCH open for 2 years. Increase in children/families choosing the GNCH for their care (workload increase estimated at 15%) Complexity of GNCH –has many departments and services –large wards with multiple teams per ward –several directorates manage children on its wards National drivers: –Quality improvement through empowering frontline staff. –Mid Staffordshire Review 6 th Feb 2013 (“The Francis report”).

4. A note from the Francis Report 290 recommendations, 164 witnesses Structured around –Warning signs –Governance and culture Failure – systems, organisations and individuals Fundamental change in culture required Change will not result from “top down” approach Need to secure the engagement of every single person serving the patient

5. A note from the Francis Report Fundamental change in culture required Need to secure the engagement of every single person serving the patient

6. Engagement Process Semi-structured interviews Collect understanding, stories Steering group meeting 1: Identify domains and themes Workshop 1: Test themes generate ideas Steering group meeting 2: Prepare themes and ideas Workshop 2: Present to Stakeholders Implementation Distillation of stories Distillation of ideas

7. Steering Group Meeting 1: identify domains and themes 5 domains identified: –Domain A: Current understanding and experience –Domain B: Culture –Domain C: Sharing and boundaries –Domain D: Datix –Domain E: Follow through and support

8. Sharing and Boundaries: Themes a.If in well defined area CG and QI can work well b.Things fall between boundaries: ward, depts., directorates, local trusts and nationally (other children’s hospitals). –a 'cloud' where things don't always get followed through –we need to create a 'bridge' between pockets of good practice c. Need education into what CG is

9. Directorate Q&S Structure

10. GNCH Symposium 2014: Risk and QI 2015: Transition –CQC –Area of risk –Poor patient experience

11. GNCH Q&S Symposium Region wide Examples of good transition –Rheumatology –GP engagement –Oncology –Diabetes Share processes, lessons Encourage transition

12. Date for diaries 18 th September at St James Park DO COME AND JOIN US