Sydney IVF

Bringing Back the Patient into IVF

The Challenge

Jbara Innovation was contracted by Sydney IVF (SIVF) to address a perceived need to improve the efforts around improving safety and quality of care. We present a comprehensive quality improvement and risk management programme that centers on the laboratory as a whole and as part of the clinical microsystem.

The Solution

We targeted areas for improvement which feed directly into recommended interventions and support innovative practices. Our combined sources of information allowed us to target problem areas at both the systemic and cultural levels with a particular emphasis on improving professional and business alignments that lead to errors and poor quality outcomes. Finally, attempts to redesign the SIVF service model will be informed by bringing the patient’s voice back into the center of all activities of the SIVF microsystem.

We did the following:

• Identified the role of the patient at SIVF using process mapping and analysis of available sources of data

• Consulted with patients about their experience and informed SIVF of strengths and areas in need of improvement

• Examined staff attitudes, organizational policies and HR documents towards work practices, safety, communication and staff welfare using survey and interview tools

• Identified needed improvements in the learning culture at SIVF around reporting of non-routine events and patient harm.

• Developed and delivered a training program that focuses on recognizing the patient as the center of the IVF process

Outcomes

Recommendations

Recommendation 1: Adopt a Team-based Risk Modification Programme that Supports a Safe and Resilient
Work Culture

1.1. Create a nurturing and safe work culture.

1.2. Address occupational practices that put SIVF and employees at risk and are non compliant with regulator requirements.

1.3. Reorganize reporting structure so that the Chief Risk Officer reports directly to the CEO and the Board.

1.4. Expand the Role of CRO in conjunction with CLO – Increase the Risk Awareness, Risk Education and Risk reporting Culture of SIVF.

1.5. Enhance the visibility of and access to SIVF management by SIVF employees.

1.6. Review present information technology strategies, support and oversight.

1.7 Expand the Role of the Board in Quality and Safety management.

Recommendation 2: Escalate and expand the integration and interdependence of SIVF employees into clinical microsystems

2.1. Nurture and develop the relationship between physicians, SIVF management and non clinical staff.

2.2. Integrate the Embryology and Andrology Laboratories.

2.3. Move expeditiously to combine Embryology and Andrology scientists into the clinical microsystems.

2.4. Formalize the role of the nurse coordinator to be the designated care manager for all patients.

2.5. Staff reception area by full-time receptionists.

Recommendation 3: Learn, Innovate and Celebrate

3.1. Create new position of Chief Learning Officer (CLO).

3.2. Develop educational efforts specific to non-task related activities, such as safety and risk, patient satisfaction, innovation in IVF, etc.

3.3. Develop opportunities for clinical teams (including physicians and nonphysician scientists) to meet, which will include scheduled time for briefing and debriefing of patient care.

3.4. Celebrate Success.

• Identified the learning culture at SIVF around reporting of non-routine events and patient harm.

• Developed and delivered a training program that focuses on recognizing the patient as the center of the IVF process

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