International

Whilst DAPS Global’s predominant focus has been on improving care in hospitals in the United Kingdom, we have also been making efforts in improving care internationally, not only to share the good practice and ideas that we have developed locally, but also to learn from the others (reverse innovation).

DAPS Global has run a Safety Tour twice in the past few years, which has involved taking junior healthcare professionals and students to a developing country to undertake quality improvement in conjunction with local junior healthcare professionals. In addition to this, we were asked to participate in a teaching program developed by the organisation Oxpal in bringing Patient Safety and Quality Improvement to the West Bank. We have also helped setup a Quality Improvement Program in Brisbane and have previously been attending and speaking at the Middle East Patient Safety Congress.

1. Introduce quality improvement to developing countries (where it may not already have been introduced)
2. To provide participants with an understanding that improvement principles are generic and can be applied generically
3. To appreciate that innovation, change and improvement can be achieved with minimal financial input
4. Focussed quality improvement over a short period of time can yield a significant outcome
5. Reverse innovation is something which provides an invalulable learning experience

We have run the Safety Tour twice in Lahore, Pakistan, the first time taking a larger contingent and the second time a smaller contingent. We were hosted by Services Hospital Lahore on both occasions with input from the Punjab Institute of Cardiology on the second occasion. Four excellent projects resulted from the visits:

1. Improving the adherence to discharge medication for illiterate patients
2. Reclaiming the use of resuscitation trollies
3. Improving infection control and hygiene practice
4. Improving flow in the Medical Emergency Department

The project on improving adherence to discharge medication in the illiterate population was presented at the International Forum on Quality and Safety in Paris and was extremely well received. It was also published in the BMJ Quality Improvement Reports Journal (here) and the work was also featured on BBC Health (here).

The Safety Tour has been and hopefully will continue to be an invaluable experience for all participants.

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Oxpal Collaboration
Oxpal website

DAPS Global was invited by the organisation Oxpal to collaborate in their work with the Palestinian Medical Schools and Hospitals in the West Bank. For over a decade, a team of senior clinicians based in Oxford had been making annual visits for one week at a time to Al Quds Medical School, primarily to assist with external validation of final examinations and to provide intensive bedside teaching in history and examination skills. In March 2011, a small contingent of current Oxford medical students were invited to join this annual visit. Based upon their observations of the various difficulties encountered by students to access clinical learning environments, the team looked for ways of supporting medical education in this unique geopolitical context that would sustain educational exchange between the short annual visits.

In the Spring of 2015, DAPS Global were requested to join the Oxpal team to teach Patient Safety and Quality Improvement to both Medical Students and Healthcare professionals. This was a fantastic opportunity and students from Al-Makassed Medical School in Jerusalem and healthcare professionals from An-Najah Hospital in Nablus underwent teaching in Quality Improvement. Following the visit, the idea is that healthcare professionals and students from the West Bank will be able to engage in Quality Improvement Projects with remote mentorship from the United Kingdom, including from the DAPS Global team.

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