The University Hospitals of Leicester trust was one of the first large acute trusts to sign up to Patient Safety First in June 2008. Representatives from the hospital heard about the campaign from networking events they had attended and since they had recently introduced a new patient safety strategy, they were keen to sign up.
Head of safety and risk at UHL, Moira Durbridge says: “It’s very hard for anyone who works in clinical practice not to put the safety of patients first so it was natural to sign up to the campaign when we heard about it. All five interventions fitted in well with our safety strategy so we chose to implement each one. We are further along on our patient safety journey with some interventions like critical care and high risk medications.”
UHL chief executive, Malcolm Lowe-Lauri felt very strongly about the importance of patient safety and quality improvement. He was keen that all staff felt that they could speak up for safety and get involved in safety initiatives within their clinical area.
The trust has made several changes to the way they work in order to implement the Leadership for Safety intervention where trust boards demonstrate that patient safety is their highest priority.
The UHL reviewed its safety and governance arrangements establishing a governance and risk management committee which reviews safety, quality and risk. They speak firsthand to representatives from directorates to see what changes can be made to make patients safer. They encourage individuals to take responsibility for their actions and see how they can learn from mistakes.
Mr Lowe-Lauri also introduced a new role within the trust – a lead in patient safety with direct access to the trust board. This is to complement the ever-strengthening governance arrangements led by the trust’s medical director with a roving role similar to that introduced by the pharmaceutical industry after safety concerns. It also recognises that UHL is so large and complex that conventional governance arrangements might not be enough to give assurance about safety.
In this case, it is Ms Durbridge who is responsible for ensuring that patient safety is of the highest standard possible. She is given free rein to go anywhere within the trust, such as operating theatres, clinics, critical areas, mortuaries and clinical wards to check that patient safety is being upheld.
Ms Durbridge says: “The most important thing is talking to people and making sure that patient safety is always on people’s minds and that they know they have senior support in implementing safety solutions.”
The trust introduced regular walkrounds for the chief executive and executives. “These happen every week within the Trust and every clinical area is visited,” continues Ms Durbridge. “This is to monitor not only patient, but staff safety too. They go all over the trust visiting all clinical and some non-clinical areas where they can support all levels of staff and see how they can help. They observe if people are washing their hands regularly, how quickly buzzers are answered, if emergency equipment is checked and speak to patients and relatives about their care.
“Patient Safety First has helped us put all of these into practice, especially the Patient Safety How-To guide for leadership which we downloaded from the website. We are trying to integrate the idea of visibly felt leadership into the executive walkabouts which prompts teams to think and talk about patient safety. So far there have been huge benefits for the organisation, patients and trusts.”
UHL is also partnering another acute trust which is similar to theirs in size and services in order to share ideas. “The other trust is another similar large size so benchmarking safety metrics with them is a good way to learn how we can develop, and to compare notes on patient safety issues. We are still in the early stages of this partnership but we are in dialogue and this has certainly helped to ensure our safety standards improve as we check how each other are getting on and encourage one another by checking each other’s patient safety data,” says Ms Durbridge.
The response from staff has been positive. Despite the difficulties in communicating the patient safety message to the thousands of staff that work there, Ms Durbridge says that tools provided by Patient Safety First have helped to define this message and disseminate it among staff.
While UHL is still on its patient safety journey, visible progress is being made in the interventions but Ms Durbridge says it is the executives at board level that can really make the difference: “Leadership is the real thing that is essential in enforcing patient safety as staff learn from above – staff follow their lead so by making a change at board level, there will be changes all over the trust.”