Safer Clinical Systems: Salford Royal NHS Foundation Trust

• Run by a team at Salford Royal NHS Foundation Trust.
• Ran from October 2011 for two years.
• Focused on the prescribing processes for non-elective medical patients from admission through A&E to 24 hours after admission.
• Aimed to improve reliability, minimise risk and reduce harm.
• Developed a new prescribing pathway that would be more efficient and give patients better care.

A team at Salford Royal NHS Foundation Trust used the Safer Clinical Systems approach to ensure the reliability of prescribing processes for non-elective medical patients from their admission to A&E to 24 hours after admission. The aim of the project was to improve reliability, minimise risks and reduce harm to patients.

The project team worked within the prescribing pathway in the emergency village, which houses A&E and the emergency admissions unit. They looked at how the prescribing system functioned, beginning when a patient is admitted to the emergency admissions unit and following through to an admission on a ward. They then analysed the system to identify why mistakes occurred with prescribing and how to minimise them.

While the prescribing pathway is designed so that errors are intercepted and rectified before they reach the patient, the potential for severe harm remains. The team developed a new prescribing pathway that would be more efficient and give patients better care, eliminating eliminate unnecessary rework and waste within the system.

The project aimed to develop a system for the medication prescribing pathway that was over 95% reliable. Within this system, the pathway would be clearly defined, roles and responsibilities of health care professionals would be clear and recognised, and skills would be deployed appropriately to ensure that all patients were safely prescribed and received the correct medicine.

The project team also set out to develop skills in improvement and research methodology.