Elinor Smith, Director of Nursing, explains the importance of patient safety and the measures taken to improve it in NHS Grampian.
Patient safety covers a wide range of topics in all parts of the NHS from protecting children, looking after adults in need of care and protection (due to age, infirmity or learning disability), through to what happens in community and hospital settings.
We record all patient-related incidents and we know that the four most common types involving patients are:
- slips, trips and falls
- medication incidents
- treatment and patient care
- access to healthcare services, onward referral and discharge.
From research evidence we know that patient safety in NHS Grampian is good by international standards, but we want to continue our work to make it even better. In 2009, we received reports which told us that some of the things we do and some of our hospital environments did not always support patient safety. We have taken these reports very seriously and have made major changes to improve patient safety. Patient safety will always remain a top priority for NHS Grampian. We want to make sure we deliver reliable healthcare so we get it right for every patient, every time.
As part of the Grampian Health Plan Consultation, we asked members of the public and staff what were their top priorities. Most people said that 'safety and cleanliness' were in their top three priorities.
How have we improved patient safety so far?
We have a Patient Safety Strategy and we are participating enthusiastically in national programmes to improve patient safety and experience. In particular, we are paying a great deal of attention to:
- The prevention of infections for example we have improved our performance against standards for hand washing, antibiotic prescribing and practice in cannula care to reduce the risks of infection.
- Regular 'Patient Safety Walkrounds', which involve senior members of staff and the public, who identify areas affecting patient and staff safety.
- Supporting our charge nurses to lead on patient safety in their ward and department areas.
- Improved safety in medicines management, where we have redesigned safer prescription sheets.
- Using tools to improve communication between staff at change of shifts and when patients are transferred to a different ward.
- Raising patient safety awareness through education of staff and students.
- Carrying out work to improve healthcare premises.
Patient safety is everybody's business and everyone can contribute in some way. Visitors are invaluable in the healing process and can help our staff in the fight against infection by heeding the messages about hand hygiene and by acting as responsible visitors.
How will we continue to improve patient safety?
Over the next few years, we will continue to focus on the following areas, which we believe will make the biggest improvements to patient safety:
- We are giving authority to the Senior Charge Nurse (ward sister) to take control of the ward environment.
- We are 'releasing time to care', to allow our nursing staff to meet individual care needs, such as protecting mealtimes to assist patients with eating and drinking.
- We will use the Feedback Service to address issues that are raised.
- We will launch our Child Protection Strategy so that all staff are clear about their role in protecting children.
- We will work with our partners in the police and local authorities to support and protect adults affected by disability, mental disorder, physical illness or mental infirmity.
- Reducing harmful events by 30% and reducing avoidable inpatient mortality (death) by 15% by 2011, in line with the aims of the Scottish Patient Safety Programme.
- Ensuring the implementation of patient safety becomes part of the daily routine in NHS Grampian, by continuing to spread good practice, such as:
- Identifying what staff need to do to prevent infections and to make sure this is carried out every time
- The use of structured communication tools to improve the handover of patients between areas
- A consistent approach in the use of the pre-operative surgical checklist to reduce complications in the operating theatre
- The introduction of Patient Safety Walkrounds to new areas.
- Reporting publicly on patient safety at NHS Grampian Board meetings.
- Working in partnership with university and further education colleagues to highlight patient safety in education programmes.
- Supporting our Falls Strategy to focus on reducing harmful falls.
- Improving the quality and standard of facilities in NHS Grampian, making our hospitals and health centres safer, more efficient and modern.
Health care is complex and with this inevitably comes risk. Our challenge is to ensure that risk is managed as part of our day-to-day activity by all our clinicians doctors, nurses and allied health professionals such as physiotherapists and dietitians as well as our support staff who are committed to working in partnership with patients and the public to make safer health care a reality.