A major part of Northern Health’s trusted care and High Reliability Organisation (HRO) initiative is the Comprehensive Unit Based Safety Program (CUSP). A monthly safety meeting, open to all staff, and aimed at enhancing teamwork, communication and identifying and improving quality and safety, is now making its mark in Northern Health’s emergency department (ED).

In July, Dr Kirin Channa stepped into the Chair role, following Dr Dean Pritchard’s sabbatical leave. Kirin explained the CUSP began January this year, and, due to COVID-19, meetings are being held via MS Teams.

“We have a variety of staff participating — medical, nursing, allied health and other specialties. It is a great forum for everyone to talk about quality and safety at the department, review any incidents and prevent future ones. Around 20 to 30 staff take part in these virtual meetings, and we had a peak of 50 a couple of months ago,” she said.

During the CUSP meeting, the team looks at the quality score card, reviews data from the ED and looks at incidents from the previous month. The team also discuss current quality initiatives, which can vary every month.

“For example, this month we talked about the new ED Virtual Triage, the Code AAA Procedure and then we went through different departments like allied health or clerical. The meeting usually generates a lot of discussion and, from that, action lists are pulled and projects implemented,” Kirin added.

Janice Fernandes, ED Nurse Unit Manager, said an example of an outcome from one of the CUSP meetings is how the department handles mental health patients.

“The CUSP has identified areas to streamline care for mental health patients who present to ED. They are flagged for early review, with the right medication, administered at the right place, within the ED,” she said.

Another example of a topic raised at the CUSP meeting was that conjunctivitis in the eyes could potentially be an unusual sign of COVID-19.

“One of our consultants did some research and consultations, and then we implemented new triage criteria with patients presenting with a red eye, who are now triaged in the suspected COVID-19 waiting room area,” Kirin added.

The ED staff have embraced the CUSP with open hands and minds, and are enjoying the proactive approach to quality and safety.

“The staff feel that they have a platform to express ideas, an opportunity to bring up something that hasn’t been discussed previously and make a difference,” Janice said.

Clare McCarthy, HRO Project Manager, said the ED CUSP is the ninth CUSP at Northern Health and represents a significant step forward for the quality and safety program.

“Northern Health’s ED is the busiest in Victoria and presents unique challenges for our health care workers,” she said.

“The CUSP is ideally suited to this setting — it gives us the leverage we need to identify problems, learn from mistakes, develop solutions and continue to learn while acting on them,” said Clare.