Mind the Gaps

Initiative Type
Service Improvement
Status
Deliver
Added
07 November 2018
Last updated
11 September 2020

Summary

Mind the Gaps is a Healthcare Improvement Unit (HIU) sponsored project that was initiated by the Statewide General Medicine Clinical Network (SGMCN), and hosted by Metro South Hospital and Health Service (HHS).

The project assessed the extent to which general medicine services throughout Queensland Health public hospitals match standards outlined in the quality and safety position statement which was finalised by the SGMCN, identify problematic areas and the underlying barriers to optimal care, and develop and implement quality and safety improvement programs or business cases to redress identified problems.

The quality and safety position statement (see resources section) contains 45 evidence-based standards of care for general medicine services covering acute admission processes, inpatient care, pre-discharge care, outpatients, and communication and teamwork. This document was compiled using a rigorous methodology that incorporates the GRADE approach to rating strength of recommendations as strong or weak.

The position statement, comprising of evidence based standards, is an important innovation and could be applied nationally. It articulates practice standards that, if adhered to consistently across all general medicine services, would significantly improve patient outcomes.

Key dates
Jul 2018
Jun 2020
Implementation sites
Queensland Public Hospitals
Partnerships
Metro South Hospital and Health Service

Aim

Optimising quality and safety of general medicine services in Queensland public hospitals 2018-2020.

Benefits

  • Inform service design and operations.
  • Provide performance indicators for purposes of identifying target areas for service improvement and/or quality and safety improvement interventions.
  • Facilitate benchmarking across general medicine services.
  • Identify deficits and shortfalls which require additional resources and support to remedy
  • Encourage research into areas of practice where recommendations are graded as weak because of limited or poor-quality evidence.

Background

Queensland Health seeks to ensure optimisation of quality and safety of clinical services delivered by all public hospitals. Clinical service networks are obliged, under their terms of reference, to develop, promote and evaluate standards of care relevant to their services. This position statement of the

Statewide General Medicine Clinical Services Network (SGMCN) outlines evidence-based recommendations for optimising quality and safety of care provided by general medicine services. The statement focuses on the overall organisation of care and generic requirements of high quality patient care, rather than diagnosis and management of specific clinical conditions.

Solutions Implemented

Statewide standard-practice gaps in general medicine services have been defined, with most gaps amenable to quick win remedies. More intractable gaps with significant unfavourable impacts on service
quality will require more concerted remedial efforts at the organisational level, and, in some cases, increased funding. The SGMCN has developed, implemented and evaluated multiple recommendations
for improving general medicine services.

Evaluation and Results

The Mind the Gaps (MtG) project survey was undertaken to provide an evaluation of the level of optimisation of the quality and safety of general medicine services in Queensland public hospitals, as perceived by clinicians and managers working within those services. The MtG position statement from Statewide General Medicine Clinical Network (SGMCN) which contained 45 evidence-based recommended standards of care applicable to all general medicine units was used as the reference document in formulating questions and response options in the survey.

Following the survey, 93 responses were received from an estimated 280 invitations (33% response rate).

The survey responses showed that the overall level of service quality and safety was rated highly optimised by 68% of respondents, partially optimised by 28%, poorly optimised by
2%. The term ‘highly optimised’ is broadly used to classify consistently favourable, trackable and sustainable practices that respondents felt their workplace has established. A third (36%) of respondents
indicated unfavourable adherence to one or more standards, most frequently relating to staff and team dynamics (13%), governance and administration (8%), service resourcing (5%), and clinical care processes
(5%).

The complete survey results can be viewed in the attachment below.

 

Further Reading

Resources

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Key contact

Julie Gordon
Network Coordinator, Statewide General Medicine Clinical Network
Healthcare Improvement Unit
(07) 3328 9184
statewide-generalmedicine-network@health.qld.gov.au