Presentation
Leveraging Expertise to Improve Safety – Insights and Lessons Learned From Collaborative Applied Human Factors Safety Work in a Maternal Neonatal Care Setting
DescriptionCollaboration across Canada’s healthcare system is critical to improve safety. This submission details the applied safety work and lessons learned in undergoing two collaborative quality improvement (QI) projects in the area of maternal and neonatal care between the Healthcare Insurance Reciprocal of Canada (HIROC) and Markham Stouffville Hospital (MSH), part of Oak Valley Health (OVH), a community healthcare organization in Markham, Ontario. This presentation will discuss lessons learned from the collaborative work, and how leveraging the clinical, human factors and other expertise from multiple organizations can improve safety across the system.
HIROC and OVH have partnered on two initiatives to identify opportunities to improve teamwork, communication and workflow across the Childbirth and Children’s Service program at OVH. In 2022, HIROC collaborated with OVH to better understand the factors that contribute to team dynamics, safety culture, psychological safety and empathy across the labour and delivery and postpartum units. A HIROC safety and risk management specialist with human factors expertise used human-factors based techniques including focus groups with 44 interdisciplinary participants, 1-on-1 semi-structured interviews with six nurse participants, and a modified-TRIZ exercise with 11 nurse participants, to support the development of formative solutions to improve safety across the team. These solutions are currently being deployed in several improvement activities across the program.
HIROC and OVH are also currently engaged in a collaborative quality improvement initiative to better understand opportunities to enhance workflow and workload in obstetrical triage, in anticipation of a significant change to the triage environment and process. With support from HIROC safety and clinical risk specialists, observations were used to develop “spaghetti diagrams” to map nurses’ movement throughout the unit. A spaghetti diagram is a visual representation of a workflow using a continuous flow line tracing the path of activity, to observe and to optimize workflow. In addition, the NASA-Task Load Index (NASA-TLX) questionnaire is also being recorded as a measure of perceived task load for nurses completing their daily work tasks including triage, and labour and delivery for the different nursing levels on the unit. The NASA-TLX data is being collected pre- and post-, to better understand changes in perceived task load before and after the anticipated change in the triage environment and process. It is anticipated that this formative data will be collected for analysis by the end of 2023.
Through these examples, we discuss the value of leveraging the expertise shared across both organizations, including clinical, operational, QI, patient safety, human factors, and risk management. We also discuss the genesis of the collaboration, the roles that HIROC and OVH played throughout the projects, and the value of a third-party partnership in the project team. The lessons learned from this work provide insights and considerations for others looking to leverage collaboration to improve safety in maternal and neonatal care, with implications for collaborating in various other areas across the healthcare system.
HIROC and OVH have partnered on two initiatives to identify opportunities to improve teamwork, communication and workflow across the Childbirth and Children’s Service program at OVH. In 2022, HIROC collaborated with OVH to better understand the factors that contribute to team dynamics, safety culture, psychological safety and empathy across the labour and delivery and postpartum units. A HIROC safety and risk management specialist with human factors expertise used human-factors based techniques including focus groups with 44 interdisciplinary participants, 1-on-1 semi-structured interviews with six nurse participants, and a modified-TRIZ exercise with 11 nurse participants, to support the development of formative solutions to improve safety across the team. These solutions are currently being deployed in several improvement activities across the program.
HIROC and OVH are also currently engaged in a collaborative quality improvement initiative to better understand opportunities to enhance workflow and workload in obstetrical triage, in anticipation of a significant change to the triage environment and process. With support from HIROC safety and clinical risk specialists, observations were used to develop “spaghetti diagrams” to map nurses’ movement throughout the unit. A spaghetti diagram is a visual representation of a workflow using a continuous flow line tracing the path of activity, to observe and to optimize workflow. In addition, the NASA-Task Load Index (NASA-TLX) questionnaire is also being recorded as a measure of perceived task load for nurses completing their daily work tasks including triage, and labour and delivery for the different nursing levels on the unit. The NASA-TLX data is being collected pre- and post-, to better understand changes in perceived task load before and after the anticipated change in the triage environment and process. It is anticipated that this formative data will be collected for analysis by the end of 2023.
Through these examples, we discuss the value of leveraging the expertise shared across both organizations, including clinical, operational, QI, patient safety, human factors, and risk management. We also discuss the genesis of the collaboration, the roles that HIROC and OVH played throughout the projects, and the value of a third-party partnership in the project team. The lessons learned from this work provide insights and considerations for others looking to leverage collaboration to improve safety in maternal and neonatal care, with implications for collaborating in various other areas across the healthcare system.
Event Type
Oral Presentations
TimeTuesday, March 269:30am - 9:50am CDT
LocationSalon A-1
Hospital Environments