LENMED AIR 2019.pdf

Clinical governance report continued CUSTOMER EXCELLENCE 01 Patient experience Improving patient discharge — patient discharge information is increasingly important for improving clinical outcomes and reducing hospital costs. The Group has implemented several initiatives within this reporting period: + Customer experience workshops have been held in each region driving accountability for the customer journey, including the focus on the patient discharge process. In the coming months, we will be implementing this monthly via specific customer experience themes. It will include the use of scripting when communicating discharge information to patients. + Post discharge information pamphlets have been developed for specific clinical programmes, e.g. stroke and AMI and for the needs of our medical, surgical and maternity patients. + We have automated our nursing unit customer experience reports with each Unit Manager receiving a specific customer experience dashboard monthly. These dashboard views will include the types of issues occurring in the unit, scores and ratings, trends, and a comparison with other similar units. + Lenmed’s refurbished website will include a patient information library — on discharge each patient will receive an SMS with a link to a library of discharge information. Role of clinical pharmacy in patient experience — during the reporting period, pharmacist ward rounds were introduced, where pharmacy professionals interact directly with staff and patients. The main aim of this project is education, where adequate medicine-related information is provided to staff and patients. We have seen a positive impact on our patient experience scores, in both internal and external reporting. CLINICAL RISK MANAGEMENT AND COMPLIANCE 02 Risk assessment The Lenmed risk assessment methodology was introduced to the Group in October 2018. All hospitals were trained on the methodology and, for the first time in Lenmed hospitals, comprehensive clinical risk assessments were conducted by hospital operations teams. Each hospital has produced its own risk register and has documented risk action plans to mitigate operational risks related to patient and employee health and safety. As a Group, we will be focusing on the most serious risks across all hospitals and together, we will collaborate to ensure we mitigate these Group risks. Alert and incident reporting and management The development of an alert and incident reporting system has been a year in the making and we are happy to report that we are on the brink of launching this electronic online application, which is going to minimise the current manual and paper-based process. As a Group, it is important for us to access information to understand our alert and incident trends and to minimise any harm (or potential harm) caused to our patients, employees and customers. Access to this information will allow us to determine trends and to implement appropriate preventative or corrective actions. Underpinning this is incident investigation training for all our incident investigators. Compliance with industry benchmarks, legal requirements as well as Group standards and priorities During the reporting period, Lenmed conducted its first set of internal compliance audits of our hospital operations. The overriding objective was to assess compliance to Lenmed standards, policies and procedures and, also compliance to any relevant legislative framework, as well as to establish a benchmark. The overall score achieved by the Group indicated that we are largely compliant with internal standards. Both the Group and its hospitals have collaborated to close out all audit findings. Infection prevention and surveillance During the reporting period, Lenmed implemented an online clinical decision support system that integrates, in real time, the location, laboratory and prescribing data on all patients with possible infections. This system is called Bluebird. Bluebird assists clinicians to focus on at-risk patients and to implement therapeutic interventions. Bluebird has been implemented in all Lenmed hospitals, apart from Bokamoso Private Hospital and Maputo Private Hospital. Although it is early days in the implementation, we are encouraged by the positive results this system has already shown in improving patient safety. Through greater utilisation of the system, we hope to better identify and manage infections and improve appropriate antimicrobial utilisation. Antimicrobial stewardship (AMS) Pharmacists within Lenmed actively participate in the multi- disciplinary team providing information and guidance on the selection, use and treatment options for all antimicrobials. The key focus areas here are: to improve the awareness and understanding of antimicrobial resistance, to reduce the incidence of infection, and to optimise the use of antimicrobial agents. These key focus areas are aligned to the South African National Strategic Objectives and World Health Organisation’s Global Action Plan. Measurement of the impact of all interventions is currently manual; however, the implementation of Bluebird and the integration of SAP has provided a platform for exploring electronic reporting in the coming year. CLINICAL OUTCOMES 03 Documentation and improvement in clinical outcomes are a critical component of clinical governance and, in the period under review, we have focused on key clinical disciplines. Lenmed AMI programme The overriding objective for introducing the Lenmed AMI programme is to save lives, i.e. to reduce preventable deaths from AMI and to improve patient quality of life. With the improvement in key care components and by sustaining the success of the AMI programme, we believe that inpatient mortality rates will decrease 58 HOW WE PERFORMED