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Increasing patient safety through structured conversations

Sign up to Safety’s national campaign director, Dr Suzette Woodward, explains how structured conversations and helping people talk to each other can be vital key in improving patient safety.

Conversation is a powerful thing. Done right, it can lay the foundations for a safety culture – helping people to connect, learn and improve. Sadly, poor conversations have led to avoidable harm to patients and significantly impacted on those that care for them. 

The Sign up to Safety Campaign, launched in 2014, is raising awareness of the importance of conversations to create the right safety culture that helps reduce avoidable harm across the NHS.  

Sign up to Safety was formed in order to build a ‘social movement’ to promote and help people build the right safety culture in the NHS in England. In particular, it has built a locally-owned, self-directed approach to improving patient safety. We know that change is more likely to be successful if locally-owned rather than because of instructions from the top, so as a campaign we do not tell people what they have to work on. We don’t need to add to the mass of targets and central commands. We trust people to work on what matters to them, their organisation and their patients. 

Over 415 members have joined across the whole NHS community in all care settings. These members have turned the campaign aims into their own aims. So, rather than one campaign, it is 415 campaigns; a form of collaborative and distributed leadership. This does not mean it is ‘structureless’ but more an interdependent relationship between the central campaign team and the members. 

We have purposefully used a particular tone and style and created a brand that is synonymous with kindness, caring and compassion. We have shown that kindness works; thanking people, valuing them and being thoughtful of all around us are vital to creating the right culture for safety and are leadership traits that we both embody and promote. Key to achieving this is being positive, personalised and telling stories with hope. The stories are about why patient safety matters, and why we need to act.  

Experimental learning using conversations 

We have started to use a method of experiential learning using conversations and storytelling.  We are testing structured conversations by gathering people together and sharing their challenges, obstacles and how they are learning to overcome them. Conversations connect people, create relationships and help us work better together. They’re also how we identify common goals, problems or needs, which could lead to wider conversations and actions. 

But conversation isn’t always easy. Despite conversation being a core human skill we still need help to speak, help to listen and help to ask the right questions. Listening, talking and observing so that we forge meaningful connections with the people we’re speaking to, making us feel more comfortable talking with them again in the future.  

Questions are the starting point for every conversation – the way we share what we know, find commonalities, learn something new and ultimately change things; but it is how we build on these questions that count. Therefore, Sign up to Safety is calling on all NHS staff to answer a simple question: “What one question would you like someone to ask you when you’re next at work?” using the hashtag #justaskme on Twitter. For example, a simple “how is your week shaping up?” might reveal when someone is overloaded and stressed. Over the coming months, at Sign up to Safety we will be building on our work related to structured conversations and helping people talk to each other about what they know about keeping people safe. Kick-start the conversation now with #justaskme @signuptosafety.

For more information

W: www.england.nhs.uk/signuptosafety/justaskme

© Rui Vieira/Press Association Images

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