Our Closing the Gap in Patient Safety programme is supporting and funding nine project teams to test large-scale, evidence-based interventions for known patient safety issues in health and social care. Below you’ll find a snapshot of the projects and how they are planning to make care safer for patients, closing the gap between best practice and routine delivery of care.

1. Long-term conditions: safe transitions from children’s to adult services

The Advancing Quality Alliance (AQuA) is leading a project to reduce the harm young people with long-term conditions can experience when moving from child to adult health services. If their transition is not supported effectively, young people are likely to disengage from services leading to ill health and more significant use of the system in the long term. AQuA’s education programme embeds more person-centred approaches into professional practice as a way of reducing harm. Professionals are taught to use self-management support and shared decision making and use tools such as the ‘Ask 3 Questions’ resource.

2. Improving safety for vulnerable care home residents

In Essex, the PROSPER project aims to improve safety for older people who are residents of care homes and at high risk of admission to hospital, or of significant deterioration in their health and quality of life. Health professionals, residents and family members are working together to co-design quality improvements in areas including pressure ulcers, falls and catheter infections.

3. Safer prescribing in primary care

Healthcare Improvement Scotland, NHS Education for Scotland and the University of Strathclyde are working together to deliver more reliable and safer prescribing, monitoring and dispensing of high-risk medicines in primary care. Interventions being evaluated include care bundles for high-risk medicines, a medicines reconciliation bundle and safety climate surveys.

4. Redesigning care pathways in mental health services

Mental health trusts in Hertfordshire are creating safer care pathways that prioritise effective teamwork and communication. The aim is for care teams to be able to identify, understand and solve their own patient safety issues, before incidents occur. Prospective hazard analysis and human factors training are two of the interventions being tested.

5. A safety checklist for frail older patients entering acute hospital care

The FRAILsafe checklist project aims to improve quality of care for frail older patients who are admitted to NHS hospitals with medical emergencies. The checklist promotes a ‘check and challenge’ culture to support effective communication between medical staff, as well as compliance with evidence-based care interventions for safety hazards such as confusion, falls and adverse drug reactions.

6. Sepsis care: making best practice routine

In Northumbria, a safe sepsis care project aims to address lack of awareness of sepsis and low levels of recognition and early intervention, all of which result in unnecessary illness and death. Interventions include a new Sepsis Pathway for Community Hospitals, with steps for health care professionals to complete before patients reach acute care; an outreach service; and the introduction of sepsis trolleys in A&E and admissions units.

7. Reducing unnecessary restraint in mental health care

Eight mental health trusts in northwest England are working together to reduce harm to patients and staff by reducing the use of physical restraint by 40%. Led by the University of Central Lancashire, the project is based on the 6CS-UK restraint-related patient safety initiative and involves the creation of an improvement toolkit, staff training and a learning collaborative.

8. Closing the gap in paediatric safety

28 hospitals are working with the Royal College of Paediatrics and Child Health to improve outcomes for acutely unwell children in paediatric wards. The project aims to reduce variation in the quality of service delivery in the UK compared to other European countries and to enable patients and parents to be more involved in their care. Staff get together in ‘huddles’ to identify patient safety risks using a standardised tool and review patients with identified risks throughout the day, incorporating patient and carer views into their discussions.

9. Putting the patient at the heart of patient safety

At Bradford Teaching Hospitals NHS Foundation Trust, hospital volunteers are helping to give patients a voice in making their own care safer. Volunteers support health care teams to use the PRASE – Patient Reporting and Action for a Safe Environment – tool to gather patient feedback on factors such as staff communication, equipment availability, organisation and care planning.

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