NHS Tayside is an exciting place to be at the moment. Since December 2004, we have been making a concerted effort to improve patient safety across three acute sites, with support from the Health Foundation and the Institute of Healthcare Improvement.
What is the aim of this project?
NHS Tayside is an exciting place to be at the moment. Since December 2004, we have been making a concerted effort to improve patient safety across three acute sites, with support from the Health Foundation and the Institute of Healthcare Improvement. We're aiming to reduce the number of adverse events (the times when healthcare causes harm to patients) by 50 per cent by June next year and also cut the rate of infections.
What has been happening on the project so far?
We have set up five teams of really committed individuals from different professional disciplines to bring about improvements in their respective clinical areas, based on evidence. The teams have very specific patient outcomes with the focus on improvement over time. For example, the medicines management team is looking at how to reduce harm from the prescribing and use of anti-coagulation medications. And there’s an overall measurement strategy so that we can continually try to improve on successes and sustain the changes. It’s important that when we implement change, we measure it, collect data and ensure the benefits are real and that this is not just change for change’s sake.
What practical improvements are underway?
The general ward team has implemented an early warning scoring tool to help us to detect and prevent any deterioration in the acute period of care and to facilitate a speedy response to the patient if necessary. The intensive care team has been able to reduce the average length of stay for patients on mechanical ventilation by implementing a specially designed package of care. The peri-operative team is working to reduce the incidence of surgical site infections and is testing a system of ‘pre-procedural briefings’ to improve communication between medical staff. The medicines management team is, among other things, developing safer process for ordering, dispensing and administering medicines, including ‘high risk’ drugs to prevent errors.
What has been the effect on your organisation?
The teams are very committed and very motivated. We are all thinking about patient safety. The Leadership team is actively involved in embedding the culture of patient safety throughout NHS Tayside through cooperation and collaboration. Frontline staff have a valuable opportunity to discuss safety issues in what we call our Patient Safety Executive “walk-arounds”. Staff have really engaged with this initiative and most of the patients that we speak to are also impressed with what we are trying to achieve here
Have you been able to measure progress so far?
It is too early for some of the initiatives to display trends, however we are confident there will be improved outcomes. There has been a slight decrease in mortality figures. There has also been a fall in the volume of adverse event rates per 1,000 patient days, from 7 per cent in October 2004 to 1.5 per cent in July this year. But we are conscious that we need more data before making announcements about improvements.
What happens next?
We are looking to continue the process of improvement and have patient representatives on each of the teams. Part of my role as patient safety coordinator, which is a joint post with Dundee University, is to look at embedding patient safety into the education of nursing, medical and dentistry students to prevent patient harm.
The process of spreading best practice will build momentum. We are communicating and sharing what we learn with the other four UK Patient Safety Initiative sites and holding a joint conference later this year. If you find something that really works well, there’s no point in reinventing the wheel, as we’re all trying to achieve the safer patient healthcare outcomes. We’re also looking at what doesn’t work - we’re not disregarding any areas at this stage.
The Safer Patients Initiative has given us an exciting challenge to engage everyone to embed systems that really can deliver positive change. But everyone is rising to this challenge.
03 October 2005