Engaging frontline staff in safety awareness

A special patient safety event, “Patient Safety First Week” took place in late September aimed at raising awareness and celebrating the success of more than 280 Trusts in England who are now actively engaged in work to create measurable reductions in avoidable harm and death for patients. The brainchild of the national campaign, Patient Safety First, the event called on everyone working with patients to take a few moments to look at their practice and to each take “one new step” on their patient safety improvement journey. Focused on five evidence-based interventions aimed at reducing avoidable harm and avoidable death, Patient Safety First helps healthcare organisations learn from each other and share areas of best practice (see Panel 1). The voluntary Patient Safety First week offered Trusts a focal point for activity and the campaign suggested “one new step” activities for each of the five interventions. Many Trusts also took the opportunity to promote elements of their own localised safety agenda such as the prevention of falls and pressure ulcers. Murray Anderson-Wallace, Patient Safety First’s head of field strategy and communications, explained: “Evidence shows that taking even very small coordinated steps to change practice can make a really big difference. Making changes that have been tested and adapted on a small scale, for instance on one ward or on one day, means that they are much more likely to spread and in a way that can be sustained over time. These “one new step” activities were simple ideas designed to involve minimal preparation and are shown in Panel 2. Murray Anderson-Wallace continued: “The campaign team travelled the country speaking at events, while reports of regional activity flooded in. Thousands of people took part, and we can only imagine the many conversations, ideas and solutions that have been generated.” Across the country, hundreds of “Leadership Walkrounds” took place giving frontline staff and senior leaders an opportunity to discuss any issues or areas of concern. Many Trusts and individuals took one new step during the week; many held presentations and workshops to raise awareness and furthered their work already underway; and, for some, the week was the launch of their local campaign. Examples of activity at Trusts included: • Walsall Hospitals NHS Trust executive team kicking off Patient Safety First Week with “Leadership Safety Walkrounds” of all departments by five directors, and the launch of a new Early Warning Score (EWS) system to identify patient deterioration. • Great Ormond Street Hospital running 90 minute surgical safety checklist workshops for staff, three times a day, every day, plus drop-in sessions to explore challenges and solutions. • Royal Brompton and Harefield carrying out daily walkrounds with junior doctors accompanying the executive team. • University Hospitals of Leicester holding a clinical governance road-show visiting staff to discuss areas of patient safety. Thousands of people viewed the special video podcasts from the week, and read the daily blog (www.patientsafetyfirst.nhs.uk/ Content.aspx?path=/Campaign-support/ patientsafetyfirstweek/podcasts/). Patient Safety First also specifically recognised 24 Trusts for their progress in setting aims for patient safety and measuring the impact of their work. Each of these Trusts received a “certificate of progress” from Patient Safety First. Does this rallying approach have a long-term difference to the safety of patients? Patient Safety First believes that it has and the feedback from Trusts would suggest that their confidence is wellplaced. Phao Hewitson, clinical risk manager, Walsall Hospitals Trust, is among many planning further activity following the week’s success: “Patient Safety First Week has given our patient safety campaign a real boost and we’re planning more activity to keep the momentum going. Our focus is on preventing falls and pressure ulcers and we have set in motion 90-day improvement cycles. Director walkrounds will continue weekly; our campaign screensavers will remain across the Trust and activities continue to show our on-going commitment to improving services for our patients.”

Case study: South Tees NHS Foundation Trust

South Tees NHS Foundation Trust is one of the largest employers in the Tees Valley area with a workforce of around 7,000 staff. It prides itself on being a great place to work, with a mission statement of “striving for the best in healthcare”. Patient safety is seen as an integral part of this mission and the Trust has been active in making changes in practice by developing a strong leadership culture to support the patient safety agenda. During Patient Safety First Week they launched the “Patient Safety Walkrounds”. Beverley Walker, the assistant director of nursing and patient safety at the Trust said: “We were already being very proactive at making changes but Patient Safety First Week was the perfect time to start implementing the patient safety walkrounds. This entailed a group that consisted of members of the Trust’s health and safety team, clinical matron and two corporate directors visiting a clinical area to discuss patient safety issues with staff across the disciplines in order to listen to staff and inform organisational decisions. “They have gone extremely well and within 24 hours of a walkround, a briefing is written up and the needs of improvement are noted down. The walkrounds involved a lot of planning but they were well worth it and we have a plan in place to carry out one each week over the coming months. This is intended to become part of normal practice for the Trust.” Prior to Patient Safety First Week, one of the Trust’s first moves to prioritise patient safety was to launch a patient safety and risk management strategy for 2008-2011. Ann Hobson, patient safety lead at the Trust, said: “In February 2009, we were accepted onto the Leading Improvement in Patient Safety (LIPS) programme which supports and complements Patient Safety First to make patient safety the highest priority within the Trust. This also aims to build the passion, skills and confidence of staff at every level of the organisation.” The Trust has been actively introducing change at board level as well as at the frontline. For example, Beverley Walker and a divisional senior nurse from the Trust are attending a year long course while the medical director and director of nursing and patient safety (DIPC) have demonstrated their commitment to the safety agenda by attending the “Executive Quality and Safety Academy” module. Ann Hobson added: “We have also embarked upon a Patient Safety Leadership programme for staff Trustwide. The first event Leadership in Patient Safety for Trust board and senior managers was held in October 2008. Topics included why people get things wrong, error types, active and latent failure, understanding incidents, and what non executives need to know about patient safety.”