Staying on top of patient safety

Since the publication of Organisation with a Memory in 2000 there has been much progress on improving patient safety. The introduction of systematic incident reporting has raised awareness about the level of potentially preventable harm associated with healthcare and a range of collaboratives, checklists and care bundles have successfully targeted and reduced a number of specific harms, including infection rates, pressure ulcers and falls.

Despite these successes, there is much to be done to ensure tried and tested safety practices are shared widely and reliably implemented across geographical and care group boundaries. Spreading this across the more than one million employees of the NHS and to colleagues in the private and third sectors is a massive challenge. Staff providing care work in busy and pressurised environments and need ready access to resources that can help them to continue to improve the safety of the services they provide.

The Health Foundation has created a patient safety resource centre to provide a 'one stop shop' to help locate information about existing projects together with new ways of thinking about patient safety, both from the UK and from the rest of the world. Where there are gaps in understanding about patient safety, we have commissioned experts to produce new resources, such as Caroline Lecko’s highly topical paper Patient safety and nutrition and hydration in the elderly.

We recognise that people have different needs and so have created different content areas of the resource centre:

• In the safety management area, we explore the structures and reporting systems needed to know whether a change has been an improvement. Those who have already implemented a range of harm specific interventions can find out more about how to develop a comprehensive safety management system that covers safety culture, education and systems planning to make sure that care is safe today and tomorrow as well as understanding how safe is was yesterday.
• We have also developed areas addressing the specific safety needs of people who follow particular care pathways and in the first instance we have created areas for diabetes and for frail older people which provide tailored information and case studies of how the principles of patient safety have been applied in practice.

Our ambition is to develop more areas and we are looking for suggestions from users of the resource centre as to which areas should be developed next. Suggestions and feedback can be left in the comments box below.

We hope that the provision of an increasing range of resources will empower those involved in healthcare provision to design and develop their own safety interventions locally to complement the excellent national and professional body programmes that have already made healthcare a safer place. These local developments will be reviewed by our subject experts who will recommend the best to be included on the website alongside the other resources. In this way we hope to stimulate a virtuous spiral of safety improvement within all healthcare services in the United Kingdom.

Elaine is an Assistant Director at the Health Foundation