The South Western Sydney Local Health District (SWSLHD) Nursing and Midwifery Improvement Science Collaborative (NMISC) has developed a supportive framework for a collaborative, patient-safety focused quality improvement model which decreases hospital acquired complications, improves nursing and midwifery-led processes, increases the capability and skills of local multidisciplinary teams in patient safety and quality improvement, and improves the sustainability of projects using Improvement Science methodology.
Funded by the Nursing and Midwifery Office, its reach across SWDLHD is unprecedented, bringing together teams from various sites and services including in-patient, community health, mental health, rehabilitation, perioperative services and emergency departments. The framework includes:
- a two-day Improvement Science training workshop
- 12 weeks of intensive coaching support (minimum weekly coaching sessions)
- fortnightly collaborative team meetings for the first 12 weeks
- ongoing monthly support for 12 months
- data analysis and presentation skills workshop at six months.
Flow on effects of framework widespread
During implementation, teams were supported in six tranches, totalling 51 teams with 197 multidisciplinary participants over two years. Teams addressed problems in their units such as falls, pressure injury, surgical site infection, length of stay, breastfeeding rates, comprehensive care delivery, metabolic management, nutrition and more. Coaching was facilitated first by the project team, and then by local experts and leaders as local project leadership skills increased. Training and support was given to teams, not only individuals, which has resulted in sustainable projects despite changes in staff and the impacts of the COVID-19 pandemic.
The NMISC and use of Improvement Science methodology has been widely accepted and utilised at all levels of the organisation, changing the culture and process of quality improvement in relation to patient safety across SWSLHD. A majority off the participating teams have completed their projects, and based on these outcomes, this year SWSLHD will test the transferability by also offering this model to non-nursing-led teams. The flow on effects of the NMISC and improvements on patient outcomes are widespread.
53.49%reduction in the rate of fall-related injuries in hospital resulting in fracture or intracranial injury.
11% decrease in the incidence of surgical site infection in colorectal patients.
100%increase the average rate of breastfeeding.
67.44%reduction in the rate of hospital acquired pressure injuries.
