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Clinical Governance…or Quality and Safety at the
GNCH
Mike Mckean
Q&S GNCH
Q: are we the Great North Children’s Hospital?
• 2013: review of governance
• Engagement
• Structures
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 6th Feb 2013 (“The Francis report”).
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
A note from the Francis Report
• Fundamental change in culture required• Need to secure the engagement of
every single person serving the patient
Engagement ProcessSemi-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
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
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
Directorate Q&S Structure
GNCH Symposium
• 2014: Risk and QI
• 2015: Transition
– CQC– Area of risk– Poor patient experience
GNCH Q&S Symposium
• Region wide• Examples of good transition
– Rheumatology– GP engagement– Oncology– Diabetes
• Share processes, lessons• Encourage transition
Date for diaries
• 18th September at St James Park
• DO COME AND JOIN US
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