One plan to reduce four harms

The QIPP Safe Care workstream has developed ‘harm free’ care which it hopes will get NHS staff thinking differently about patient safety.

This ambitious programme aims to deliver care that is defined by the absence of pressure ulcers, falls, venous thromboembolism and catheter line infections by December 2012. The initiative aims to improve patient safety, and in doing so, make significant efficiency savings.

Dr Maxine Power has led the QIPP Safe Care workstream since January 2010. Dr Power and her team have developed a range of products to help NHS staff improve patient safety. Explaining the reason the workstream has been so succesful, she says: ‘Patients are at the heart of everything we do. They inspire us to change. We are committed to improving their experience of healthcare and protecting them from harm.’

Safe Care aims to effectively deliver ‘harm free’ care to all patients and does this with one plan which can be implemented at local level and integrated easily with existing workflow and routines. There has been a lot of improvement in patient safety in recent years and this inititative builds on what teams already have in place.

Where does ‘harm free’ care start?

The first driver towards ‘harm free’ care is developing a leadership and safety culture. In all clinical teams, safety leadership doesn’t just rest on the shoulders of one person, it is the role of everyone to drive the plan forward. Safe Care encourages engagement of clinical and non-clinical teams in the work. This will involve working across specialisms and not allowing organisational or geographical boundaries to hinder improvements to patient safety.

Safe Care recognises that it is the improvements that teams make in a small number of key processes, delivered in a highly reliable way, which will deliver the outcome of ‘harm free’ care.

Another driver is to revisit the supporting architecture. All succesful organisations find that they need to re-visit their support systems, such as training, education and policies, when they first start on the journey towards delivering ‘harm free’ care.

Measurement of harm can be done in many ways such as monitoring adverse events, case note review and point of care audits. Each of these approaches has its merits and pitfalls. The big challenge for safety leaders is to understand these different sources of information and what they say about their systems.

In response to requests from frontline staff, Safe Care developed its own measurement tool – the Safety Thermometer. Developed for the NHS by the NHS as a point of care survey instrument, the Safety Thermometer allows teams to measure harm and the proportion of patients that are ‘harm free’ during their working day, for example at shift handover or during ward rounds.

The NHS Safety Thermometer provides a ‘temperature check’ on harm and can be used alongside other measures of harm to measure local and system progress.

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