Can we strengthen patient safety in our own operations?
Improvement work is about having an overview of areas for improvement within your own undertaking. Improvement work must be systematic. In areas where a risk of failure has been identified, the necessary measures should be implemented to mitigate or eliminate risk. In order for this to succeed, it could be appropriate to connect with employees or other support personnel with expertise in improvement methodology.
The regulations on management and quality improvement in the health and social care service apply to everyone who provides health and social care services at different levels in the municipality, specialist health service and private undertakings (51). The purpose of the regulations is to contribute towards professionally sound health and social care services, quality improvement and increased patient and user safety. The activities of the undertaking must be in line with other requirements set down in legislation. All undertakings must have a management system. Among other things, the management system must provide an overview of the undertaking’s allocation of responsibilities and duties, a system for learning from errors and procedures for risk and vulnerability analyses.
The regulations are accompanied by an instruction (51) that provides the responsible person with a number of tools and suggestions for how the undertaking can conduct local improvement work.
How to use the report in local improvement work
If you are a GP or a manager in CAP, the educational and psychological counselling service, the school health service or another municipal undertaking and recognise the risk areas described in the report from your own working life, there are useful tools available for working locally on systematic improvement work.
In recent years, the specialist health service has invested in developing improvement expertise among its employees and can provide assistance, guidance and support for the implementation of improvement work. If you do not have such expertise within your undertaking, you can contact your local quality advisor, patient safety coordinator or the quality and patient safety department. The municipal sector also possesses such expertise and you can, among other things, participate in the ‘Patient and user safe municipality’ patient safety programme, the Norwegian Association of Local and Regional Authorities’ learning network and the Norwegian Association of Local and Regional Authorities’ Agenda programmes on improvement expertise.
One way in which to use the report is to have an internal discussion about whether the risk areas highlighted in the report contribute to the weakening of patient and user safety within your undertaking.
In this discussion, it is important to be aware that it is not enough to have procedures put down on paper. You should also discuss how the procedures are used and how to work with the identified risks. Through dialogue, you can establish whether the way in which you carry out work is different to the way in which it should be performed. Increased awareness about such differences can help strengthen patient safety.
HIB recommends
HIB recommends that the following relevant questions are raised within the specialist health service/CAP:
- How do we ensure that children, adolescents and parents have the opportunity to participate in shaping the support, based on their own needs?
- How do we ensure that we have sufficient information about the patient’s condition when assessing a referral?
- How do we organise the work to ensure that we assess referrals in a proper and reliable manner?
- How do we ensure that we have sufficient knowledge of the services available in the municipality?
- How do we ensure that the duty of guidance contributes to the municipal health services being able to provide appropriate healthcare when we refuse a referral?
HIB recommends that the following relevant questions are raised within the municipality:
- How do we ensure that children, adolescents and parents have the opportunity to participate in shaping the support, based on their own needs?
- How do we ensure that children and adolescents are not left without support if they have undiagnosed mental health issues and need support?
- How do we ensure that objectives and measures are developed and that these are evaluated when children and adolescents require complex services but are not entitled to an individual plan? How do we ensure that the various municipal service providers interact in such cases?
- Which procedures do we have in place for interaction between the various service providers in the municipality and between municipal service providers and the specialist health service and GP?
- How do we ensure that those working with children and adolescents have an overview of the support services available and the responsibilities held by each service provider?