Continuous development of quality of care at Radboudumc

  • 10 March 2023
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Continuous development of quality of care at Radboudumc
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"Good practice examples are inspiring and people can use them immediately."
 

"We are still too often inventing the wheel ourselves. That takes time and time is always in short supply within healthcare." According to Silvia van Gils, senior consultant/auditor at Radboudumc. In clear terms and with infectious enthusiasm, Silvia talks about the innovative Good Practices project. "So it is ideal if you can benefit from good practice examples from your own organisation. This benefits the quality of care, processes and employee satisfaction. Within Radboudumc, we do a lot with quality, safety and innovation. The Good Practice Examples project fits in perfectly with that."
 

Continuously striving for improvement

"We use all the pillars of Zenya within our organisation. We secure our quality cycle by recording our agreements and processes through DOC and implementing them using iQualify and CHECK. Monitoring is done with CHECK, FLOW, Frameworks and Compliance. With FLOW, we can improve a few things. Then the PDCA starts again, because an improvement sometimes requires new agreements or better implementation. Within PDCA, the focus is put on things that go wrong. We then look at what did not go well and how we can improve or prevent it. While doing so, we keep a close eye on our standards and the agreements we have made. That is a continuous process based on improvement."
 

Straight to work

"That improvement is, of course, incredibly important, but there is much more going right than wrong in our organisation. Based on the Safety-II idea that is becoming increasingly important in healthcare, we want to focus on things that are going well and learn from them. That generates positive energy. We are an academic hospital and we naturally tend to tackle this scientifically. It can also be done in a more direct manner. There are countless examples of good practices within the organisation. We make these examples transparent so that we can learn more from each other. Colleagues struggle with similar problems or situations. When one of them shares a solution, everyone benefits. Good practices examples are inspiring and people can use them immediately."
 

Implementation in Zenya software

"We were looking for a smart way to optimally share the good practices. Of course, we have been working with Zenya software for a long time and we thought it would be good to integrate drafting into it. It fits well with the other components of the quality suite and it allows us to make connections with these other components now and in the future. Therefore, we only needed to add one new building block to Zenya. This is an important aspect, when it comes to implementation.

The Zenya software supports us and we developed this further ourselves. Organisations unable to do so themselves can leave the process building to Infoland. We added a report type inside Zenya FLOW. Both the forms and the workflow behind it are simply built. We figured out what the process around Good Practices should look like, which I then built in Zenya.

Our goal was to make it as easy as possible for the users. We chose to make a report form as clean as possible, where only the essentials need to be filled in. Here, you can think of a department or centre, the contact person and, of course, what the good practice is about. Attachments and references are allowed, but are not mandatory. Not everything needs to be described in detail. It is mainly about the essence and connecting various people through this idea. Then, the step can be taken to implement an example within one's own department or centre.

As a starting point, we have kept the workflow relatively basic. A report comes in and is then assessed by one of the two coordinators. The notification is then either included as a Good Practice Example or rejected. We initially reject it only on the basis of duplications or if something is not a Good Practice Example. For example, because someone actually wanted to report an improvement proposal. After a year, we check whether the examples are still current enough or should be moved to the archive.

We have created links with other report types that we have, such as the improvement module. When reporting an improvement suggestion and when handling an improvement action or project, the user is alerted about the Good Practice Examples."
 

Smart and accessible sharing

"Every department has a Start Portal that is customised. On all those portals, everyone has the opportunity to report their good practices via the 'report' button. It is also possible to report via a smartphone or tablet via QR codes that have been distributed within the organisation. This way, we make reporting very accessible and we are building a large database. Everyone in the organisation can report examples and smart features and benefit from them. All colleagues within the organisation can search within the database for good examples. We deliberately did not restrict this to a limited group.

For example, the Ophthalmology department has made an information film on age-related macular degeneration for patients. An anticoagulation protocol knowledge clip was made for staff and a storyboard informing patients about anticoagulation. Regarding improvement actions within the pharmacy, a weekly mail appears and this increases engagement considerably. Zenya itself also sometimes plays a role in a Good Practice example, for example with the sharing of documents via webshare with other hospitals and external audit teams by the haematology department. These are just a few concrete examples. Employees have access to all examples, but can also search by topic, as we have labelled everything.

Employees can find the examples via the overview of notifications and via the dashboard. We made sure that each portal has an interactive graphic of this report type. This allows employees to click through to specific examples in a visually appealing way."
 

Enthusiastic and more connected

"We have been live since the end of May and are now busy implementing. Our colleagues are very enthusiastic, but still somewhat modest when it comes to reporting examples. They sometimes wonder if it really is a good example, because they quickly see what could be even better. I think we could be a bit more aware of our qualities. We could pat ourselves on the back a bit more sometimes, even if it can be done better. It is now up to us to encourage people even more. We draw attention to this project in various ways within the organisation. Furthermore, we occasionally provide good examples through other means. Indirectly, this in turn generates attention for the project. It should also promote contact between employees. If you look something up and the idea is not fully worked out in the database, you can contact the person who shared the good example. So that it can be explained. Moreover, in this way the idea giver notices the other person's enthusiasm and that naturally stimulates enormously. We want to connect people with each other."
 

Sharing on a large scale

"In the future, we want to create the possibility for patients to report good practices as well, because we can also learn from that. I think learning from good practice examples is interesting for many institutions. The beauty of Zenya software is that what we have built can be exported to other users. We can share this report type with other hospitals as well as primary or secondary care providers if there is a need. Setting up Good Practices is not immensely complicated and the gains can be enormous. It can be widely implemented in the organisation and everyone working within the organisation can benefit from it, which also benefits patients. Therefore, we hope to start sharing this on a large scale and let others experience the benefits as well.

 

 


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