01.04.12
Safer clinical system
Source: National Health Executive March/April 2012
Adam Hewitt looks at the work The Health Foundation and NHS trusts up and down the country are doing to improve the handover of clinical information and prescribing.
Eight NHS teams are making good progress as part of the second phase of the Safer Clinical Systems initiative, which seeks to increase reliability, better map clinical pathways, and ultimate increase patient safety.
The work, co-ordinated by charity The Health Foundation, is split into two main streams, each of which has four acute and foundation trusts taking part: one around safer handover of clinical information, and one around safer prescribing.
The contention at the heart of the programme is that usually, when something goes wrong, it is systemic rather than individual failings that are to blame: but that systems can be improved.
Interventions
In phase one, which ran from October 2008 until December 2010, four trusts and an expert technical team led by the University of Warwick worked on four separate interventions that it was felt could improve clinical systems: creating safe and resilient prescribing systems; safer handovers across the health economy; providing the right information, at the right time for the right patient, every time; and the design and implementation of a reliable handover system.
Phase two is continuing this work, by implementing and testing the defined approaches developed during phase one of the programme.
The precise work being done is set out in the side panel.
Jane Jones, assistant director at The Health Foundation said: “The Safer Clinical Systems programme is at the heart of the Health Foundation’s work to improve patient safety. We believe that by addressing the current variation in healthcare processes and by developing safer systems, culture and ways of working, we can reduce avoidable harm.
“We need to make healthcare systems more reliable and safe. People need to be sure they will receive the same high standard of care and safety wherever and whenever they access healthcare services. Improving patient safety should always be a priority for the UK health services, we are hopeful that the drive to ensure safe and reliable systems of care in the NHS will remain as important as ever.”
Spreading the word
The four trusts that worked on phase one of the programme – Hereford Hospitals NHS Trust, NHS Bolton and Royal Bolton Hospital NHS Foundation Trust, NHS Lothian and Plymouth Hospitals NHS Trust – will continue to play a role as the project continued, especially on sharing the findings with the wider NHS.
The Health Foundation commissioned earlier research into the reliability of NHS healthcare systems, illustrating the extent to which clinical systems and processes fail, and the potential that this has to cause harm. Rather than waiting until a problem has occurred, the programme aims to help healthcare teams proactively identify potential safety breaches, enabling them to build better, safer healthcare systems.
Phase two of the project will continue until September 2013, with phase three then running until the end 0f 2014, focused on rolling out the lessons learned across the whole NHS, hopefully putting clinical systems on a safer and more sustainable footing.
Safe and reliable handover of clinical information
Birmingham Children’s Hospital NHS Foundation Trust
This project focuses on developing and implementing a whole-of-hospital system for handing over care between day and night staff.
Central Manchester University Hospitals NHS Foundation Trust
This project focuses on the handover process (across primary, secondary and tertiary care) for children with complex illnesses.
East Kent Hospitals University NHS Foundation Trust
This project focuses on transfer of care processes for patients who are elderly and frail, admitted to hospital via the unscheduled care pathway.
Southmead Hospital, North Bristol NHS Trust
This project focuses on handover and communication processes for patients with end stage renal failure.
Safe and reliable prescribing
Nottingham University Hospitals NHS Trust
This project focuses on achieving better prescribing processes for patients admitted for medical reasons
NHS Dumfries & Galloway
This project focuses on prescribing practices and reducing prescribing errors in all acute medical admissions to the hospital.
Royal United Hospital Bath NHS Trust
This project focuses on creating a safe and reliable system for providing medication for patients with Parkinson’s disease.
Salford Royal NHS Foundation Trust
This project focuses on developing a reliable system that enables safe electronic prescribing.
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