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Which Way? A Better Way Presented by
Roberta Newton, Jenny Sewter Denelle Butler
Apunipima
March 2014
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Workshop Program
• Apunipima – background
• Activating Quality Processes: Continual Improvement • Health Messages with a Twist -Thinking Outside the Box • Workshop exercise - design a poster • Present back design and story
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Apunipima Health Services
Delivery of primary health care services to the communities of Cape York enabling the peoples to live long and healthy lives • Family Health
Community based • Healthy Lifestyles
• Men’s Health
• Primary Health Care centres and Care Co-ordination • Senior Medical Officer and Doctors Fly in Fly Out
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
ISO 9001:2008 and RACGP
ISO 9001:2008 Certified by IHCA-C - June 2011 • Cairns • Mossman Gorge Clinic • Cooktown • Mapoon • Coen
RACGP Accredited by AGPAL – Feb 2011 • Mossman Gorge Clinic
Continual Improvement and Risk Management Flow Chart
EXTERNAL FEEDBACK
Client FeedbackService ProviderStakeholder
INTERNAL FEEDBACKGood IdeasMeeting
RecommendationsNon-‐ConformancesEquipment Failure
AUDITSInternal External
(corrective and preventive action)
COMPLAINTSExternal raised by
clients / stakeholders
WH&SIncidents / Near
MissHazards/Injury
SecurityCyclone / Disaster
Vehicle
COMPLIANCE ISSUES
ReportingLegislationInsurances
FEEDBACK FORM5307 CSS
CONTINUAL IMPROVEMENT
FORM 5301 CSS
AUDIT REPORTS5203 CSS
COMPLAINT FORM5303 CSS
Acknowledge complaint Day 2 once received
INCIDENT AND INJURY FORM
5602 CSSLodge within 1 working day
CONTINUAL IMPROVEMENT
FORM 5301 CSS
AUDIT REGISTER
Quality Facilitator
COMPLAINTS REGISTER
Executive AssistantSMT
WH&S INCIDENT REGISTER
Work Health & Safety Advisor
CONTRACTS and COMPLIANCE REGISTER
Mgr – Contracts & Risk Mgt
CONTINUAL IMPROVEMENT
REGISTERRoberta Newton
RISK ASSESSMENTWeekly Risk Management
Meeting
SENIOR MANAGEMENT
TEAMFortnightly Report
For Analysis
Assumption All risks are responded to and actioned through the Continual
Improvement Process
CLINICAL INCIDENT REPORTING
Clinical IncidentsNear Misses
CLINICAL INCIDENT REPORTING FORM
1007 CSS
CLINICAL INCIDENTS REGISTER
Senior Medical Officer
TEAM MEETINGS CI’s discussed and allocated to staff
Input
Forms
Registers
Central Focus
Risk Assessment
Board Reports
CI Actioned What is the level of risk?
Low, Medium FINANCE AND RISK SUB COMMITTEE or CLINICAL REVIEW
COMMITTEE For Analysis
BOARD For Action
High, Very High Extreme
Very High
Extreme
Very High
Extreme
CI closed out CI closed out
Risk Snapshot(Quarterly Report)
Risk Map(Quarterly Report)
ISSUESExternal issues in relation to other providers or services
ISSUES FORM5306 CSS
Agency required to respond within 20 days of notification
ISSUES REGISTER
Executive Assistant PHC
CLIENT FEEDBACK FOLDER
CommunicationsManager
Patients say waiting times at the Clinic are too
long
Our Health Worker says the new form that Mossman Gorge Clinic developed is
good and should be used by everyone
The wrong medication was given to a patient in our clinic. It didn’t make them
sick but it could have
The auditor says that a new Risk Management plan should be developed
Community was not told about an Apunipima meeting. Everybody missed out and Uncle wants to complain
Steps to our offices are slippery when wet
and I twisted my ankle. Someone else
might get hurt
Aunty asked me to help fix a problem with another agency’s services (e.g. RFDS, Q Health, Division of General Practice)
We have too many KPI’s to report on and it is inefficient
Initial Flow Chart
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Which Way? a Better Way
• Our starting point: Continual improvement and Risk Management – Flow Chart
– Complex – Doesn’t convey the concept – Conventional method of communication – Uninspiring
• What can we do? – Communicate the concept – Culturally Appropriate – Inspiring and engaging
Continual Improvement and Risk Management Flow Chart
EXTERNAL FEEDBACK
Client FeedbackService ProviderStakeholder
INTERNAL FEEDBACKGood IdeasMeeting
RecommendationsNon-‐ConformancesEquipment Failure
AUDITSInternal External
(corrective and preventive action)
COMPLAINTSExternal raised by
clients / stakeholders
WH&SIncidents / Near
MissHazards/Injury
SecurityCyclone / Disaster
Vehicle
COMPLIANCE ISSUES
ReportingLegislationInsurances
FEEDBACK FORM5307 CSS
CONTINUAL IMPROVEMENT
FORM 5301 CSS
AUDIT REPORTS5203 CSS
COMPLAINT FORM5303 CSS
Acknowledge complaint Day 2 once received
INCIDENT AND INJURY FORM
5602 CSSLodge within 1 working day
CONTINUAL IMPROVEMENT
FORM 5301 CSS
AUDIT REGISTER
Quality Facilitator
COMPLAINTS REGISTER
Executive AssistantSMT
WH&S INCIDENT REGISTER
Work Health & Safety Advisor
CONTRACTS and COMPLIANCE REGISTER
Mgr – Contracts & Risk Mgt
CONTINUAL IMPROVEMENT
REGISTERRoberta Newton
RISK ASSESSMENTWeekly Risk Management
Meeting
SENIOR MANAGEMENT
TEAMFortnightly Report
For Analysis
Assumption All risks are responded to and actioned through the Continual
Improvement Process
CLINICAL INCIDENT REPORTING
Clinical IncidentsNear Misses
CLINICAL INCIDENT REPORTING FORM
1007 CSS
CLINICAL INCIDENTS REGISTER
Senior Medical Officer
TEAM MEETINGS CI’s discussed and allocated to staff
Input
Forms
Registers
Central Focus
Risk Assessment
Board Reports
CI Actioned What is the level of risk?
Low, Medium FINANCE AND RISK SUB COMMITTEE or CLINICAL REVIEW
COMMITTEE For Analysis
BOARD For Action
High, Very High Extreme
Very High
Extreme
Very High
Extreme
CI closed out CI closed out
Risk Snapshot(Quarterly Report)
Risk Map(Quarterly Report)
ISSUESExternal issues in relation to other providers or services
ISSUES FORM5306 CSS
Agency required to respond within 20 days of notification
ISSUES REGISTER
Executive Assistant PHC
CLIENT FEEDBACK FOLDER
CommunicationsManager
Patients say waiting times at the Clinic are too
long
Our Health Worker says the new form that Mossman Gorge Clinic developed is
good and should be used by everyone
The wrong medication was given to a patient in our clinic. It didn’t make them
sick but it could have
The auditor says that a new Risk Management plan should be developed
Community was not told about an Apunipima meeting. Everybody missed out and Uncle wants to complain
Steps to our offices are slippery when wet
and I twisted my ankle. Someone else
might get hurt
Aunty asked me to help fix a problem with another agency’s services (e.g. RFDS, Q Health, Division of General Practice)
We have too many KPI’s to report on and it is inefficient
Initial Flow Chart
Continual Improvement and Risk Management Flow Chart
EXTERNAL FEEDBACK
Client FeedbackService ProviderStakeholder
INTERNAL FEEDBACKGood IdeasMeeting
RecommendationsNon-‐ConformancesEquipment Failure
AUDITSInternal External
(corrective and preventive action)
COMPLAINTSExternal raised by
clients / stakeholders
WH&SIncidents / Near
MissHazards/Injury
SecurityCyclone / Disaster
Vehicle
COMPLIANCE ISSUES
ReportingLegislationInsurances
FEEDBACK FORM5307 CSS
CONTINUAL IMPROVEMENT
FORM 5301 CSS
AUDIT REPORTS5203 CSS
COMPLAINT FORM5303 CSS
Acknowledge complaint Day 2 once received
INCIDENT AND INJURY FORM
5602 CSSLodge within 1 working day
CONTINUAL IMPROVEMENT
FORM 5301 CSS
AUDIT REGISTER
Quality Facilitator
COMPLAINTS REGISTER
Administration Officer
Community Development
WH&S INCIDENT REGISTER
Work Health & Safety Advisor
CONTRACTS and COMPLIANCE REGISTER
Mgr – Contracts & Risk Mgt
CONTINUAL IMPROVEMENT
REGISTERRoberta Newton
RISK ASSESSMENTWeekly Risk Management
Meeting
SENIOR MANAGEMENT
TEAMFortnightly Report
For Analysis
Assumption All risks are responded to and
actioned through the Continual Improvement
Process
CLINICAL INCIDENT REPORTING
Clinical IncidentsNear Misses
CLINICAL INCIDENT REPORTING FORM
1007 CSS
CLINICAL INCIDENTS REGISTER
Senior Medical Officer
TEAM MEETINGS CI’s discussed and allocated to staff
Input
Forms
Registers
Central Focus
Risk Assessment
Board Reports
CI Actioned What is the level of risk?
Low, Medium FINANCE AND RISK SUB COMMITTEE or CLINICAL REVIEW
COMMITTEE For Analysis
BOARD For Action
High, Very High Extreme
Very High
Extreme
Very High
Extreme
CI closed out CI closed out
Risk Sub Committee(Quarterly Report)
ISSUESExternal issues in relation to other providers or services
ISSUES FORM5306 CSS
Agency required to respond within 20 days of notification
ISSUES REGISTER
Executive Assistant PHC
CLIENT FEEDBACK FOLDER
CommunicationsManager
Risk Dashboard SMT Risk Update Monthly Report
Patients say waiting times at the Clinic are too
long
Our Health Worker says the new form that Mossman Gorge Clinic developed is
good and should be used by everyone
The wrong medication was given to a patient in our clinic. It didn’t make them
sick but it could have
The auditor says that a new Risk Management plan should be developed
Community was not told about an Apunipima meeting. Everybody missed out and Uncle wants to complain
Steps to our offices are slippery when wet
and I twisted my ankle. Someone else
might get hurt
Aunty asked me to help fix a problem with another agency’s services (e.g. RFDS, Q Health, Division of General Practice)
We have too many KPI’s to report on and it is inefficient
Final Flow Chart
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Communications
How have we used the design?
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Meeting Agendas
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Workshops
• Team based
• Informal
• Session 1-2 hours long to review and discuss
• Concept of continual improvement – what is it?
• Current processes
• Performance of the system with focus on each team
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
What have been the benefits?
Branding “Which Way? A Better Way”
Awareness, understanding and involvement Activated Continual Quality Improvement - one of the core principles in quality management.
Lasting points of Communication
Posters – on meeting room walls Mouse mats – on everyone’s desk Cape Capers articles – monthly (internal and external circulation) Story Boards Workshops Meeting Agenda’s - Which Way? a Better Way
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Health Messages with a Twist Thinking Outside the Box
Go Physical Be Healthier Program - Starting Point Aim: To develop health messages using a variety of media in diverse settings • Radio • Social Media • Newsletters Outcome: Didn’t hit the target audience (people with chronic disease)
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
A Rethink?
Key message delivery for children to advocate healthy messages to the wider community How?
• Video Production and involvement – Indigenous Hip Hop Group
• 2013 – Produced videos for Mapoon and Coen
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Mapoon and Coen Videos
What could we improve?
• Allow more time
• Better planning
• Gaps in contracts
• More support and partnerships
• Video launch to community
• Sustainability and capacity building
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Improvements Made
• Advertise in Community 3 months prior
• Pre-workshops
• Formal agreements, MOU’s, IP, Contracts
• Partner with PCYC at a regional level
• More involvement with community – Council, Youth, Mum’s and
Bub’s, Men’s Group, Women’s Group
• Greater team involvement - Health Promotion, Tackling
Smoking Team, Team Leaders
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Outcomes of improvements
• Greater awareness of health messages
• Increased participation
• Youth leadership capacity building
• Development of resources
• Community launch
Coen Central Remix Video
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Workshop Exercise
• Table groups to create your own poster, choose one of: – Continual Improvement – Governance – Risk
• Inspirational Material
• Talk about the concepts and poster design elements 15 mins • Draw your poster 15 mins • Final - Feed back your story 2-3 mins per group (10 groups)
Apunipima Cape York Health Council PO Box 12045, Cairns DC QLD 4870 (186 McCoombe Street, Bungalow Cairns QLD 4870) Freecall 1800 653 393 Fax 07 4051 7940 Email: recepLon@apunipima.org.au
Inspiration for Poster Design
Topics : • Continual Improvement • Governance • Risk Management
• What are the main steps in the process and how does it work? • Who are the key stakeholders? • What are the benefits? • What is the key message to communicate?
HAVE FUN
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