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EVALUATION OF PATIENT SAFETY WEEK 5 – 11 NOVEMBER 2017 March 2018
Transcript

EVALUATION OF PATIENT SAFETY WEEK

5 – 11 NOVEMBER 2017

March 2018

Contents

Part 1: Patient Safety Week 2017Introduction..............................................................................................................................3

Focus................................................................................................................................................. 3Audience............................................................................................................................................ 3Engagement with health professionals..............................................................................................3

Learnings from Patient Safety Week 2016...............................................................................4Resources................................................................................................................................4

Resources for consumers and providers...........................................................................................4Promotion and uptake of activities in the health care community......................................................5

Communications......................................................................................................................5Media coverage................................................................................................................................. 5Commission website.......................................................................................................................... 5Social media...................................................................................................................................... 6

Digital MediPoster....................................................................................................................7

Part 2: Results and feedbackSurvey: feedback from providers.............................................................................................8

Q1: How useful did you find the 2017 Patient Safety Week resources?............................................8Q2: Do you have any specific comments about any of the resources?.............................................8Q3: How effective did you think the ‘Ask Me’ illustrated characters were when encouraging consumers to ask questions about their medicines?.......................................................................10Q4: Did you see evidence that Patient Safety Week’s messages positively impacted on patient behaviour (ie, encouraged discussion about their medicine)?.........................................................10Q5: What could be improved for Patient Safety Week next year?...................................................10

Conclusion.............................................................................................................................12Recommendations.................................................................................................................13Appendix 1: Patient Safety Week resources..........................................................................14Appendix 2: Patient Safety Week media coverage................................................................25Appendix 3: Survey Monkey answers to open-ended question 2..........................................26Appendix 4: Survey Monkey answers to open-ended question 5..........................................28

2

PART 1: Patient Safety Week 2017

Introduction

Patient Safety Week was an awareness-raising week held from 5–11 November 2017.

It was coordinated for the fourth time by the Health Quality & Safety Commission (the Commission), with the Accident Compensation Corporation (ACC) joining as partners for the second year. We also received support from PHARMAC, and were fortunate to be well supported by a skilled ideas group that included representatives from most areas of the sector.

Focus

This year’s Patient Safety Week theme was medication safety, in line with the World Health Organization’s five-year medication safety challenge.

After much consultation with medication safety experts, our focus aimed to improve communication about medication between health professionals and consumers. The main questions we communicated throughout Patient Safety Week were:

What is my medicine called? What is it for? When and how should I take it?

We viewed these questions as a starting point, leading to a bigger conversation to cover things like side effects, impact of stopping medicines, taking several medicines and so on.

Audience

The audience for Patient Safety Week were people with chronic conditions who are long-term users of multiple medicines, with an emphasis on Māori and people with English as a second language. We also talked to family and whānau (support networks) of these consumers.

The other audience for Patient Safety Week was our delivery audience, health professionals who prescribe, dispense or administer medicines.

Engagement with health professionals

Health professionals were encouraged to consider:

the importance of giving consumers time – their questions are valid what is common for you may be unusual, confusing and challenging for consumers knowledge is power – the more a consumer knows, the less likely they are to make a

mistake with their medicines cost could be a barrier to consumers filling prescriptions and continuing to take

medication – talk to them about this practising the three steps to better health literacy: find out what people know, build health

literacy skills and knowledge, and check you were clear.

District health boards (DHBs) and private providers were encouraged to take up as many activities as they wished.

An introduction to the week, including the theme and the resources available, was sent to stakeholders in August 2017. Resource orders opened in September and providers were given three weeks to place their orders. Orders were distributed late October.

3

Learnings from Patient Safety Week 2016

The Commission learnt valuable lessons from Patient Safety Week 2016 and implemented these in planning for 2017.

Continue to provide as much advance warning as possible about dates, themes and resources.

Allow DHBs to order resources to fit their needs and choose which activities to take part in.

Provide more ideas to providers about how they can use the resources to promote Patient Safety Week messages to staff.

Consider providing resources that do not include dates, to allow them to be used for a longer period of time.

Create and promote competitions that are easy for providers to participate in. Convene another planning group, including ACC and sector representatives, to meet in

early 2017.

Resources

The Commission and ACC produced a number of resources to support Patient Safety Week 2017activity. We took a fresh approach to resources this year and used a suite of illustrated characters to communicate our messages. Based on feedback from previous years, we produced a smaller set of resources, and introduced pharmacy bags (with support from PHARMAC). For visuals of the resources, see Appendix 1.

Resources for consumers and providers

Providers were able to order resources through the Commission’s website. All 20 DHBs placed orders, plus a further 207 providers/pharmacies (compared with 35 providers last year).

The resources for consumers included:

three videos of health professionals (in three languages, plus a summary combo video) Taking medicines? Have questions? Please ask. Posters, in English, Māori, Samoan,

Simplified Chinese and Hindi. Preparing to leave hospital discharge sheet to note down things to keep themselves safe

at home – in five languages. ACC’s A5 booklet Know what to ask animation for Digital MediPoster boards paid advertising through the Pacific Media Network in Auckland (coverage across a

range of language shows).

The resources for health care staff/providers included:

Ask me about your medicines stickers for health care staff/providers, in English, Māori, Samoan, Simplified Chinese and Hindi.

Ask me about your medicines lanyards for health care staff/providers in English / Māori. Let’s talk medicines pharmacy/medication bags (sponsored by PHARMAC) Infographic: Medication safety in New Zealand.

4

Promotion and uptake of activities in the health care community

We produced resources for health care providers to promote Patient Safety Week: key messages organisation interactive flyer quiz questions competition to win morning tea: share your activities to be in to win.DHBs put considerable effort into promoting Patient Safety Week. Fourteen providers shared their activities and some downloadable resources with us, which are online for others to use, including:

Promotion to staff

Staff display competition, crossword, quiz, screensaver, email signature. Grand rounds, international speaker. Medication safety cards, lanyard cards, café table cards.

Promotion to patients

Medication safety promotion in supermarket (next to health supplements). Posters/stands/displays for hospital patients, with pharmacist in public area to answer

questions at busy times. Patient safety videos/animations in public areas. Hospital tray mats with crossword, important messages, photos and information. Mindful medication colouring book for kids. Branded bags, fridge magnets and pens. Feedback touch screen terminals: happy or not?

Media

Press releases, website and newsletter updates. Social media posts and selfie competition (with Instagram cut-out, patient safety mascot). Health Navigator website update.

Communications

Media coverage

Media coverage of the week (15 online articles and seven media releases) featured work from DHB staff and highlighted the risk of overprescribing and the ‘triple whammy’ effect on kidney failure. See Appendix 2 for more media coverage.

Commission website

There was a significant increase in visits to the Commission’s website. From September to November, Patient Safety Week related pages dominated the top 3 of highest hits (after the home page).

September October NovemberMedication Safety 796 1217 1398Patient Safety Week resources 1299 1196 1095Patient Safety Week 758 1073 1335Home page 3716 3825 3638

5

Social media

ACC created three bilingual videos (plus a combo of the three videos) and promoted these through a paid Facebook campaign on the ACC and Commission Facebook pages.

The videos feature three medical practitioners who speak directly to our target audience, encouraging them to ask questions about their medicines, and about their health, in English, Māori, Chinese and Hindi. (Press CTRL + click the pictures below to open the videos online.)

The short combo video with key messages and second languages performed best across the board with highest: total video views (110K) reach (231K) and impressions (277K) number of people watching 75% or more of the video (11K).

The other well-performing video was Dr Sarah Sciascia’s video in English and Māori, due to her own engagement with the post, providing advice and support to commenters.

ACC’s full social media campaign summary report by senior social media advisor Jeff Hunkin is embedded below (double-click to open).

6

Digital MediPoster

An animated Patient Safety Week MP4 was broadcast on 41 digital MediPoster boards in the North Island, in November and December.   

HQSC November 2017 December 2017Daily Total 30 seconds played

6,803 times per day30 seconds played 6,325 times per day

Impressions (number of plays per hour + multiplied by the total time that the screens are on) ie – opening hours for the week x the days in the month.

142,863 impressions

1/11/2017 to 22/11/2017

303,594 impressions

1/11/2017 to 18/12/2017

Locations 41 screens across Auckland 31, Hamilton 4 and Wellington 6.

41 screens across Auckland 31, Hamilton 4 and Wellington 6.

Minutes/Hours 71,432 minutes and 1,191 hours

151,797 minutes and 2,530 hours

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PART 2: Results and feedback

Survey: feedback from providers

A ‘Survey Monkey’ questionnaire about Patient Safety Week was conducted and emailed to communications managers, quality and risk managers and anyone who placed an order for resources.

Fifty responses were received, mostly from people in hospital settings (40 percent), general practices (22 percent) and pharmacies (20 percent). High-level feedback from respondents is included below.

Q1: How useful did you find the 2017 Patient Safety Week resources?

Taking medicines

poster

Preparing to leave hospital' A4 discharge

sheet

Stickers: ask me about your

medicines

ACC resource 'Know what to

ask'

Lanyards Pharmacy bag0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

Very useful Moderately useful Neutral/don't know Not very useful Of no use

About 78 percent of respondents thought the Taking medicines poster was useful Over 50% of respondents thought the other resources were useful

Q2: Do you have any specific comments about any of the resources?

For full unedited list of answers, see Appendix 3. In summary, feedback included:

Resource package Keep messages simple and patient-focused for future years. Best initiative so far! Really good resources that encouraged staff to think about the patients’ medications and

generate discussions with patients regarding them. Great to be able to download the individual characters to use in your own promotion, but

still having the consistency. All good and quantity about right. Resources were all useful but there is often not enough sent out. The resources are only useful if patients are interested to take and read them. Very well-made resources. Resources not hugely relevant for general practice (posters, lanyards and stickers). Not all applicable to aged care.

8

Not of any use. Could have been more advertised to the patients.

Distribution It was good to get the resources earlier this year than previously as it allowed time for

distribution around the DHB. We got the resources but really a week is not long enough to be useful. To be honest, a

waste of money. Resources were fine but I work at a PHO and we would have liked to be more involved

and be able to share resources. By the time we were informed by our local DHB there was very little time to get the general practices and community pharmacies to order any resources (or extra resources for the pharmacies).

Getting staff engaged in the theme and actually asking them to engage meaningfully with patients was really difficult!

ACC resource and discharge sheet The ACC resource was very useful for patients (somewhere to write questions and take

notes). Preparing to leave hospital has been very helpful we distribute this information to all

patients on admission to help prepare them for their discharge.

Posters Make sure interactive poster can be saved after completing. Different languages for the poster not useful since no one could speak for that language

which caused more confusion between staff and patients. No-one does posters anymore! How about a screensaver next time? Great to be able to adapt the posters – we added 'what are the side effects?' to our

promotional advertising, as this was very important to our patients.

Stickers The stickers were superb, sticky enough and popular: we didn't have enough. Would be good to have smaller stickers so we can attach to dispensing boxes/bottles, or

receipts. (x2) Stickers are for one use only – badges would be better. Stickers came off the uniforms within a very short space of time. A waste of resource. (x3)

Lanyards We would have liked more lanyards. (x2) Majority of our hospital pharmacy team now wear the pink lanyards every day. People confused about the medicine message with the ‘breast cancer’ pink Lanyards are not great for clinical people (ie, infection control issue) and not allowed

under hospital policy – can we come up with something else please? (x4)

Pharmacy bags Brown bags were really nice and also blue printing really emphasises the message,

would be useful to have them as an ongoing resource. (x3)

9

Q3: How effective did you think the ‘Ask Me’ illustrated characters were when encouraging consumers to ask questions about their medicines?

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

Very effective Moderately effective Neutral/don't know Not very effective Not effective at all

About 54 percent of respondents thought the ‘Ask me’ illustrated characters were effective, while 18 percent thought they were not (28 percent was neutral).

Q4: Did you see evidence that Patient Safety Week’s messages positively impacted on patient behaviour (ie, encouraged discussion about their medicine)?

Yes No Unsure/not applicable0.00%5.00%

10.00%15.00%20.00%25.00%30.00%35.00%40.00%45.00%

About 36 percent of respondents thought the Patient Safety Week’s messages positively impacted on patient behaviour, while 24 percent thought they were not (40 percent was neutral).

People commented that some of the resources were helpful for continued use, that it gave staff confidence to speak to consumers, and that it takes time for behaviour to change.

Q5: What could be improved for Patient Safety Week next year?

For full unedited list of answers, see Appendix 4. In summary, feedback included:

Overall campaign, theme and resources I think it was a very well-run campaign. We had plenty of time to order the resources and

prepare staff that Patient Safety Week was coming. (x2) Have the same 'medication safety' theme as this is fantastic. Next year we will focus less

on staff resources and more on the patient’s experience. (x2)

10

Don't waste money on cartoon graphics – they added nothing to the campaign and were not well liked by some people. Use something more realistic and relevant.

We added pens to the promotional material and these were very well received by staff and patients. We are still seeing these floating around the place and most people will look at branding on a pen. A stronger call to action might generate more conversation.

Instead of material alone, use nurses or health coaches to relay the positive messages. Take Patient Experience Survey medicine results and incorporate into Patient Safety

Week. I would like a brief pamphlet, maybe a rip off sheet I could issue to patients and a

brighter poster.

Preparing health care providers Maybe a longer lead-in...one week seems to short. Communication leading up to the week about its themes, some ideas for practices etc on

things they could do in that week aligned to the theme. Staff education so it is effectively promoted. Was a very large topic, and as I was new to organising one of these weeks so more

guidance/ideas of what to do would have been useful. Be less prescriptive about what can and cannot be done. Have a theme and some

resources that enable DHBs to build on according to their local needs. Consider involving primary care more. Patients live out in the community not in the

hospital so very little about Patient Safety Week should be in the hospital and more should be in primary care.

Advertising National media campaign - newspapers, TV etc. (x6)

Post Patient Safety Week Follow-up after Patient Safety Week. Keep on promoting the Patient Safety Week to an everyday promotion of patient-

centeredness. (x2)

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Conclusion

The Commission and ACC are pleased with participation in the fourth annual Patient Safety Week.

Giving advance notice of the theme and opening resource orders early was well received by providers as they appreciated the extra time to plan their approach. Providers only had positive feedback about the theme ‘Let’s talk medicines’.

Providers were pleased to have resources in a range of languages and showed creativity in adapting some of the resources to suit their needs.

There was both positive and negative feedback about the lanyards and stickers, which will need reviewing with the planning group for 2018.

The morning tea competition went well and we received many photos, activity ideas and downloadable resources from DHBs and health care providers to publish on our website. This will provide a great base for the next Patient Safety Week, as a hub for people to gather inspiration and share ideas.

The positives/what worked well

The ACC videos and shared Facebook campaign was very successful, with lots of engagement and positive comments on both Facebook pages.

There was high demand for the resources produced by the Commission for Patient Safety Week, with the Commission sending out the most resources it ever has.

Pharmacies ordered a large number of resources along with DHBs. The Preparing to leave hospital and ACC’s Know what to ask resources continue to be

popular with respectively 12,000 and 11,000 copies ordered. The Patient Safety Week survey found:

o 78 percent of respondents thought the Taking medicines poster was useful, and over 50 percent thought the other resources were helpful.

o 58 percent thought the ‘Ask me’ illustrated characters were effective, with 18 percent thinking they were not effective.

o 36 percent though the Patient Safety Week’s messages positively impacted on patient behaviour, 24 percent did not agree (40 percent was unsure).

o For each positive comment, there was a negative, probably due to the different needs between providers (eg, hospital staff vs pharmacists).

DHBS and providers shared a lot of ideas and their customised downloadable resources which were published on the Commission website (linked to the morning tea competition).

The negatives/what could work better

Some respondents asked for more ideas and lead-in for promoting the week to their staff. Feedback from PHO contact about getting information too late from DHB, and then there is time pressure to properly organise.

Communicate better that the characters can be downloaded and resources can be customised.

Rethink and tweak resources for 2018 after feedback that the:o blue colour text on pharmacy bags was hard to reado lanyards are an infection risk and are against hospital policyo stickers don’t stick and can only be used once (some request for smaller ones to

add to bags and pill bottles). Some feedback from a provider about not following up after Patient Safety Week.

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Recommendations

Considering the theme: include primary care? Build on the successful Facebook campaign experience: get involved in the conversation

(early), more videos and less talking, create for the platform (see ACC’s social media summary).

Tweak the resources:o Continue pharmacy bags (better contrast of colour)o Rethink lanyards and stickerso Reconsider penso Organise email signature blocks and screensaverso Communicate that resources are customisableo Brighter colours?

Have a longer lead-in time, and approach PHOs with theme and information for staff so they have more time to prepare.

More communication: media campaign beforehand, and feedback/debrief afterwards. Have a consumer engagement representative on the PSW planning group Include a Pacific/Samoan health professional, and a patient story on video. Try to collect data (about usefulness of campaign) from consumers through website.

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Appendix 1: Patient Safety Week resources

A2 posters in English (electronic versions available here)

14

A3 posters in English (see previous page), Māori, Samoan, Simplified Chinese, Hindi

15

Stickers (English, Māori, Samoan, Simplified Chinese, Hindi)

& Lanyards (Māori / English)

16

Patient discharge sheet: Preparing to leave hospital (English)

17

Patient discharge sheet: Preparing to leave hospital (Māori)

18

Patient discharge sheet: Preparing to leave hospital (Samoan)

19

ACC resource Know what to ask – questions to get the most out of healthcare

20

Pharmacy bags

21

Animation for Digital MediPoster boards

22

PSW organisation interactive flyer

23

Infographic: Medication safety in New Zealand

24

Appendix 2: Patient Safety Week media coverage

Double-click the embedded PDF below for all links to published articles.

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Appendix 3: Survey Monkey answers to open-ended question 2

Q2: Do you have any specific comments about any of the resources?

Overall: keep messages simple and patient-focused for future years. This was the best initiative so far in that respect but could have achieved more if you made resources easier to obtain and to customise:

o The resources would be more useful if received in amendable format – for example there was a poster template that you could complete and print, but not save. No-one does posters anymore! How about a screensaver next time?

o The little people were great but because they were part of pdf docs we had to screencap them to apply them to other internal communications such as emails and newsletters. Supply graphics separately please.

o Resources such as the lanyards were in far too short supply – they really ought to have been supplied in sufficient numbers to circulate to hospital prescribers, GPs and pharmacies. We got 100 when we needed ten times that many to get widespread coverage.

o Stickers are no use as you need a new one for every change of clothes – badges would be better.

We would have liked more lanyards It was felt that the ACC resource was very useful for patients. Especially having

somewhere to write questions and take notes. It was good to get the resources earlier this year than previously as it allowed time for

distribution around the DHB. Lanyards are not great for clinical people (ie, infection control issue). Did not use the pharmacy bags. Thank you. Could have been more advertised to the patients. The stickers were superb although we didn't have enough as they were so popular. They

stuck well to the uniforms. Great to be able to adapt the posters - we added 'what are the side effects?' to our promotional advertising, as this was very important to our patients.

The resources are only useful if patients are interested enough to take them and read them.

The resources were really good. Of course for a hospital setting we only ordered what was applicable to us. It encouraged staff to think about the patients’ medications and generate discussions with patients regarding them.

I would have preferred that the stickers were a bit smaller, and then we could have attached to dispensing boxes/bottles, or receipts. We had no use for lanyards.

Private hospital - lanyards & medication paper bags not used (& didn't request to receive), staff weren't keen to wear stickers, otherwise other resources useful.

Preparing to leave hospital has been very helpful we distribute this information to all patients on admission to help prepare them for their discharge.

It would be good to have some smaller "Ask Me About Your Medicine" stickers for smaller bags. I've kept the window promo going past the official patient safety week because it highlights how we can help patients – encourage them to ask questions, any time, not limited to the week.

We didn't utilise the ACC leaflet and discharging hospital leaflet as it wasn't the focus of our week. But they did contain useful information. We had no way to distribute to the most relevant group. Majority of our hospital pharmacy team now wear the pink lanyards every day. We didn't use the bags as we don't usually supply medicines directly to patients. We only do inpatient dispensing.

The pharmacy bags were particularly useful and received good feedback so it would be useful to have them as an ongoing resource. Stickers were useful but not enough provided and not quite sticky enough.

It was great to be able to download the individual characters to use in your own promotion, but still having the consistency.

26

Lanyards are an infection control risk and should not be promoted to clinical staff. Getting staff engaged in the theme and actually asking them to engage meaningfully with patients was really difficult!

Lanyards not used widely in hospital setting because of infection control risks. Most people who do wear their ID's on a lanyard already have them, you can only use one lanyard at a time so they either end up putting the old lanyard away (clutter) or throwing out ones that still work (hugely wasteful and not environmentally friendly). You don't get good visibility through lanyards with only a few people using them they're basically invisible and lose their impact. Stickers only used for a day so no lasting impact.

Very colourful but people confused “ask me about my medication tag with breast cancer” promotion because of the colour pink

We advertised the poster on our waiting room poster and used the lanyards and stickers. I found the resources not hugely relevant for general practice. We used posters, wore

the lanyards and stickers. Resources were all useful but there is often not enough sent out. Stickers came off the uniforms within a very short space of time. A waste of resource. Not all applicable to aged care. We got the resources but really a week is not long enough to be useful. To be honest, a

waste of money. Didn't get any stickers. Paper bags very useful and still are being useful until we run out. Very well-made resources, but different languages for the poster isn't too useful since no

one could speak for that language and that caused more confusion between staff and patients. Brown bags were really nice and also blue printing really emphasises the message.

The lanyards are an issue as they are an infection control risk and not allowed under hospital policy - can we come up with something else please?

Resources were fine but I think the concentration of DHBs to be the point of contact for information may not always be the best place and hence may not disseminate the information correctly. I work at a PHO and we would have liked to be more involved and be able to share resources. By the time we were informed by our local DHB there was very little time to get the general practices and community pharmacies to order any resources (or extra resourced for the pharmacies).

Not of any use All good and quantity about right.

27

Appendix 4: Survey Monkey answers to open-ended question 5

Maybe more newspaper/TV coverage. No suggestions. Keep on promoting the Patient Safety Week to an everyday promotion of Patient

Centeredness. More advertising to the patients. Have the same 'medication safety' theme as this is fantastic. Next year we will focus less

on staff resources and more on the patient’s experience. Advertising prior to. I think it was a very well run campaign. We had plenty of time to order the resources and

prepare staff that the safety week was coming. Follow-up post the week. We put a lot of effort into coordinating an inter-sectorial

initiative with supermarket, took photos, collected data and fed back to the commission and heard nothing in response.

I am not sure and would need more time to contemplate this question. Maybe a longer lead in...one week seems to short. Was a very large topic, and as I was new to organising one of these weeks so more

guidance/ideas of what to do would have been useful Good to have a clear theme (i.e. medication safety) to focus on. I don't think there is much to improve. Continue same awareness. Be less prescriptive about what can and cannot be done. Have a theme and some

resources that enable DHBs to build on according to their local needs. Don't waste money on cartoon graphics - they added nothing to the campaign and were

not well liked by some people. Use something more realistic and relevant. National media campaign - newspapers, TV etc. Create a ground swell so that people do

as. We added pens to the promotional material and these were VERY well received by staff

and patients. We are still seeing these floating around the place and most people will look at branding on a pen. A stronger call to action might generate more conversation.

No comment. Show videos in media. Staff education so it is effectively promoted. Instead of material alone nurses or health coaches can be used to relay the positive

messages. Take PES medicine results and incorporate into Patient Safety Week. I would like a brief pamphlet, maybe a rip off sheet I could issue to patients and a

brighter poster. Communication leading up to the week about its themes, some ideas for practices etc on

things they could do in that week aligned to the theme. Consider involving primary care more. Patients live out in the community not in the

hospital so very little about patient safety week should be in the hospital and more should be in primary care.

National Advertising increased.

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