Since January 2018, MEERQAT has been part of a ten-month project at Epworth Richmond to engage frontline staff in quality improvement activities. The project is being conducted in two units of the hospital, with the full support of the respective Nurse Unit Managers (NUM), their staff and the Quality Unit of the hospital.
The rationale for the project stems from considerable peer-reviewed literature, as well as numerous reports to government, that demonstrate the importance of engaging frontline staff in addressing the issue of avoidable patient harm in health care settings.
The project involves a single 30–40 minute session each week for available rostered staff, where they participate in a structured conversation about routine practices in their unit relevant to achieving the outcomes and objectives of the National Quality and Safety Health Service (NSQHS) Standards. Structured conversations help teams to transform raw experiences into insights, by asking them to reflect on what they do, what works, what doesn’t and why.
The conversations at Epworth are facilitated by MEERQAT Library basemaps corresponding to NSQHS Standards, which effectively provide an “agenda” for each discussion. This ensures that all aspects of routine practice are discussed and helps to ensure the discussion stays on track. Each Epworth unit takes four or five sessions (i.e. one month) to complete each standard and the process results in a quality improvement action plan that is implemented in the ensuing period.
The results to date have been very positive on many levels. Not only have the team-based reflections identified areas for improvement, but the teams have come up with many ideas – some simple and some not – for improving their individual and collective practice. The discussions have fostered better relationships amongst team members and individual clinicians have indicated they have learned a great deal about both the standards and the corresponding hospital policies. Moreover, both NUMs have found the sessions to be very useful for enabling horizontal and vertical exchange of information and perspectives.
Importantly, in surveys conducted as part of the project, nearly 90% of participants indicated their level of interest in quality issues and quality improvement has increased as a result of the project, more than half of participants indicated they have volunteered for quality improvement projects and two-thirds of staff have noted improvements in their clinical practice.
The project will conclude by the end of November and will be written up for publication in a peer-reviewed journal.