1 WELCOME. 2 Presentation Vincent Kearns Regulation & Quality Regulation & Quality Vincent Kearns Inspector Manager Health Information & Quality Authority.

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WELCOME

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Presentation

Vincent Kearns

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Regulation &

Quality

Vincent Kearns Inspector Manager

Health Information & Quality Authority

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HIQA mission...• drive high quality & safe care for people

using health & social care services...

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Role of regulation:• to provide assurance to stakeholders that

services meet certain standards…

• to establish mechanisms for holding organizations/individuals to account…

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why have regulation?• many organisations have huge, unrealised

opportunities for improvement (Berwick 1996)

• quality of services varies widely from organisation to organisation and even within organisations (Brook et al 2000)

• required changes are often difficult/slow (Ferlie and Shortell 2001)

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Health Act 2007

S.I. No. 367 of 2013

National Standards 2013

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Quality improvements

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National Standards for Residential Services for Children and Adults with Disabilities 2013

• gives a framework/guide• promote/facilitate quality of life• are outcome-based• are based on key principles• are organised into eight key themes

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Responsive Regulation:

targeted

accountable

consistent proportionate

transparent

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• “Focus on the journey, not the destination. Joy is found not in finishing an activity but in doing it”.

Greg Anderson

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Project Presentation 1

Deirdre Nally

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Using the PQASSO system to

simplify compliance to the

HIQA national standards

Deirdre Nally

Project roadmap

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Define the current

situation

Measure the current

situation

Improve the current

situation

• Value stream map• Voice of the customer

• Quantitative research• Qualitative research

• Map a new process• Visual aid• Policy management

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Define – Mapping the current PQASSO process

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Define – Mapping the current HIQA process

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Measure – HIQA Inspection reports

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Improving Performance? The adoption and Implementation of Quality systems in U.K Nonprofits.

Cairns et al. 2005

“staff also did not always see the

relationship between the

quality system adopted and their

own work”

“just ticking boxes”

“Time is a particular

problem if people see quality as something separate; this makes them begrudge the time or reluctant to

devote the resources to it”

Where “quality remained an extra, to be worked on as time allowed ... reported only limited benefits”

We are all in the

same boat

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Measure – Selecting priority issue

3) Management did not see how PQASSO could help with a HIQA inspection

2) Management may not have spent the time to engage and empower all staff at all levels

1) There is a lack of understanding of how PQASSO and HIQA are related.

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Cross referencing both sets of standards

PQASSO Handbook HIQA National Standards

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PQASSO Vs HIQA; Outcome 17 - Workforce

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HIQA standards Vs PQASSO standardsOutcome

titleOutcome description

PQASSO Indicators

Theme 1: Individualised Supports and Care

 Outcome 1

 Residents

Rights, Dignity and Consultation

Residents are consulted with, and participate in, decisions about their care and

about the organisation of the centre. 

Residents have access to advocacy services and information about their rights.

 Each resident’s privacy and dignity is

respected, including receiving visitors in private.

 Each resident is enabled to exercise choice and control over his/her life in accordance with his/her preferences and to maximise

his/her independence. 

The complaints of each resident, his/her family, advocate or representative, and

visitors are listened to and acted upon and there is an effective appeals procedure.

1.1, 11.2

9.7 

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 4.7, 11.3, 12.3, 4.5

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PQASSO standards Vs HIQA standards

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PQASSO is a ‘how to guide’

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Improve the current situation – New process

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Referencing system

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Cover for PQASSO Evidence box

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Naming system for policiesHIQA Policy

PQASSO Quality Area

The prevention, detection and response to abuse, including reporting of concerns and/or allegations to statutory agencies.

3 / 4

Admissions, including transfers, discharge and the temporary absence of residents.

1 / 10

Incidents where a resident goes missing. 1 / 4 / 8

Provision of personal intimate care 1 / 4

Provision of behavioural support 1 / 4

The use of restrictive procedures and physical, chemical and environmental restraint.

1 / 4

Users_ Provision of behavioural support_XXX

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Summary• Define

– Both processes were similar• Measure

– Engaging in quality makes a difference– We are all in the same boat– Both sets of standards overlap

• Improve– Amalgamate both processes– Visual aids and policy management

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Thanks for

Listening!!

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Project Presentation 2

Alison Ryan

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Alison Ryan

WOULD YOU LIKE MORE TIME TO SPEND ON WHAT MATTERS?

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How many times..• can you not find something?• have you done something yourself as it was

easier than asking someone else?• How many minutes of meetings do you have

in your emails that are not filed?• How many meetings have you been at without

a tangible outcome?

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Quality/LeanValue Stream Map - VSM Muda – Elimination of Waste Poke yoke – Mistake ProofingWorkplace organisationStandard work techniquesSupply chainChange Management and leadership

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TQM • Cross Organisation – not just management

notion or an area need buy in across organisation

• Leadership is essential and a number of champions.

• Go with quick wins so results will motivate

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Panel Discussion

Lead Panellist – Marian MaloneyGalway Centre for Independent

Living (CIL)

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Presentation

Martin Naughton

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Project Presentation 3

Deirdre Nally

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Improving the processes involved in the

PQASSO Champions Network

Deirdre Nally

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Aim of Project

Enhance the Champions approach to implementing PQASSO.

Agenda

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Define the current

situation

Measure the current

situation

Improve the current

situation

• Voice of the customer • Questionnaire feedback • Remote attendance• Training • Formalise the Network• Online Portal

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Define – What is the current process?

• The ‘Voice of the Customer’ for the Champions and DFI was gathered.

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Measure – Questionnaire feedback

Feedback from the questionnaires was analysed Positives Challenges

Meeting other Champions Time RequiredExchanging Ideas Distance to travel

Networking Evidence is different for the organisationsAllows you to benchmark

Progress Difficult to attend meetings

Its Motivating/ encouraging Cost of travel Poor attendance Same people every time Repetition of information

Culture Change!!

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Suggested improvements from the questionnaires:– Share good practices of other organisations– Develop key templates– Remote participation– More training on the inspection process– More training on how to efficiently compile and

store the vast amount of paperwork

Measure – Questionnaire feedback

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Improve• Four deliverables selected;

1. Remote attendance2. More structured training3. Formalise the network4. Online portal

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1. Remote attendance

• Equipment to be purchased for remote attendance

• Videos from meetings to be made available online

• Slides from meetings to be made available online

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2. Structured training• Champions to list desired

training needs• Champions to work with

DFI to meet those needs.

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3. Formalise the network

“If you want to go fast go alone.

If you want to go far go together.”

(African Proverb)

ChairpersonSecretary

IndependentSelf-

Supporting

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4. Online Portal

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PQASSO Champions Network site

https://disfed.sharepoint.com/sites/pqassochampions/_layouts/15/start.aspx#/SitePages/Home.aspx

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“If you want to go fast go alone.

If you want to go far go together.”

(African Proverb)

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Project Presentation 4

Declan Denny

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The Path to Quality for Wexford Disability Services andAddressing inadequacies in the Garda vetting system.

Declan Denny

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Path to Quality• PQASSO• Charity Evaluation Services (CES) training• Introduction to Total Quality Management• Specialist Diploma in Quality Management

(Lean Healthcare Systems)• Master of Science in Strategic Quality

Management (Lean Sigma Systems)

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PQASSO / Results• Standardised Care-plans• Service-user surveys• Adoption of HSE complaint procedure• Comprehensive Policy Handbook• Improved Corporate Governance

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CES Training / Results• Implementing PQASSO• Demonstrate Outcomes• Collect, Analyse, Present and Use Data ---------------------------------

Monitoring and Evaluation of Inputs, Outputs and Outcomes.

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TQM / Results• Improved HR processes• Streamlined Payroll procedure• Reassessment of service being delivered• Led to organisational change

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Specialist Diploma / Results• Reduced waiting times for service provision• Increased capacity to deliver services• Progression from FAS Scheme to Section 39

Service Provider• Increased revenue / Need to fundraise

reduced /Reserve fund created

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Specialist Diploma / Results• Respect for People• Autonomous teams• Improved work-life balance for employees• Employee Assistance Programme• Low turnover of staff• Continuity of Care

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Masters in Strategic Quality Management /Results

• Business Strategy, Problem Solving, I.T. & I.S., Organisational Culture, Quality Science.

• Thesis, resulting in contribution to public debate and policy development.

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Addressing inadequacies in the Garda vetting system

• What is Garda vetting?

• What does it do?

• What is it not?

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• 1749, the creation of the Bow Street runners and the development of a Register of crimes

• 1750, Creation of the Universal Register Office for background checks and character references

• 1869 /1891, Development of the Habitual Criminal Register

Origins and Historyof Garda vetting

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• 1922 / 1929, Responsibility of Minister for Justice

• 1929, Responsibility devolved to the Gardaí and later renamed the Dublin Criminal Register

• 1999 /Present, Creation of the Garda Central Vetting Unit

Origins and Historyof Garda vetting

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• System has evolved • Paper based system• Underutilisation of IT• No real-time update facility• Non-portable• Block to free movement of labour

Inadequacies identified

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Inadequacies identified

• Overproduction due to re-vetting leading to waste

• Means to Identify person seeking Garda vetting unsatisfactory

• Long waiting time for return of vetting forms• No list of prescribed offences

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Methodology• Comprehensive Literature Review.• Identified Customers of Garda vetting.• Utilised Quality Functional Deployment.

Analysis to identify customer requirements.• Conclusions and Recommendations.• Practitioners review of research and

recommendations.

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Recommendations for new Vetting system

• Creation of an Authorising Authority• Central registration• Robust Identity checks• Issuing of Biometric Photo I.D. Cards• Real-time updating of Central Register• Extranet access to PULSE or Central Register

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Practitioners Review• Principal Social Worker x 2 - TUSLA• Social Work Team Leader x 3 - TUSLA• CEO of Major service-provider• A qualified Barrister/Solicitor and Lecturer in

Law.

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Practitioners Comments• “reflects many of the anxieties held by frontline

child protection practitioners”• “a common misconception that Garda vetting is

Garda clearance is clearly outlined by the researcher”

• “ the research addresses an extremely important issue which affects many people and has an impact on society in general”

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Thank you for your attention

declandenny@wexfordcil.org

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Panel Discussion

Lead Panellist Stuart Lawler NCBI