20 hospitals join pioneering safety improvement initiative

Each hospital will receive £165,000 plus a tailored support package of similar value. The hospitals will work in pairs on the safety improvement work and will work with international patient safety experts from the US-based Institute for Healthcare Improvement (IHI). They will build on and learn from the impressive progress being made by the four hospitals already involved in the initiative.

Research from across the globe estimates that approximately one in ten patients experiences unnecessary harm or suffering due to mistakes that happen in hospitals. Such mistakes also cost the NHS vast amounts of money each year. Over the next two years, the hospitals will develop their expertise to drive forward system-wide improvements so that medical mistakes are less likely to happen. The initiative will test out ways of making care safer in three areas of the hospital – on the wards, before, during and after operations and in critical care. In each of these settings staff will look at ways to improve infection control, the management of drugs and communication between staff teams and patients.

Results released today show impressive safety improvements at the four UK hospitals already involved in the Safer Patients Initiative. In just two years, the four hospitals have halved their number of medical mistakes. NHS Tayside has seen its adverse event (medical mistakes) rate fall by almost three quarters. In addition, the hospitals are seeing some knock-on improvements in their mortality rates. For example, Luton and Dunstable Hospital NHS Foundation Trust has seen its standardised mortality ratio fall from above the national average to below average (from 111 in 2003 to approximately 90 at present)[3].

Highlights from the work include:

• At Conwy and Denbighshire NHS Trust, pneumonia on the intensive care unit associated with assisted ventilation has been virtually eliminated from a previous level of 30%. Patients now spend less time in the unit and need fewer medications. This has resulted in a saving of £78,000 in the medicines budget and has also allowed 350 more patients to be treated over the last two years.
• NHS Tayside has increased its hand hygiene compliance to 96% on the general wards which is helping to reduce hospital-acquired infections.
• Down Lisburn Health and Social Services Trust has reduced the number of medication errors following the development of a system for tracking and managing the drugs their patients take. At present, the rate of unreconciled medications is below 10%. This means that 90% of medicines are documented correctly when a patient arrives so the hospital knows what the patient is taking, they are maintained correctly throughout the hospital stay and are correct on discharge so that each patient receives the right medication at the right dose. The system is also linked to GP patient records and is helping to reduce mistakes in the primary care setting.
• Luton and Dunstable Hospital NHS Foundation Trust estimates that there are between one and two fewer cardiac arrests per week since the introduction of an early warning score system on the wards. The system allows staff to monitor patients’ conditions and to take rapid action if they go into decline. It has led to a fall in the crash call rate as the rapid response team can now take action sooner to avoid patients developing serious life threatening conditions.

Don Berwick, President and CEO of the Institute for Healthcare Improvement said, “What the Safer Patients Initiative has achieved in the UK so far is remarkable - both organisation-wide commitment and unprecedented results that can inspire us all. The new hospitals announced today represent an exciting next wave of spread and innovation. I appreciate and admire the trust they are showing by their willingness to join in and add their wisdom and energy to this effort. They will build on what they already know, and will learn, improve and become the examples we need to build universal confidence that far safer and much more effective hospital care is within our reach.”

Stephen Thornton, Chief Executive of The Health Foundation said, “We’re delighted that as of today 20 further hospitals will be part of the Safer Patients Initiative. Working in partnership with each other and with our existing SPI hospitals, they will be part of a nation-wide drive to make UK hospitals the safest in the world. Our SPI hospitals are pioneers of today and safety champions of tomorrow.”