Transcript Document
Safety Express A New Journey in Patient Safety for the NHS Dr Ailsa Brotherton Ms Sally Deacon What is Safety Express • Safety Express is the name of the mobilisation vehicle for the QIPP Safe Care work stream • The programme aims to reduce harm in four defined areas using collaborative techniques and improvement methodology: Pressure ulcers Falls Catheter acquired urinary tract infections VTE • The programme is named ‘Safety Express’ because we aim to move together at a pace and scale which is previously unprecedented in English healthcare. • Safety Express is a ‘call to action’ for NHS staff who want to see a safer more reliable NHS with improved outcomes at significantly lower cost • Safety Express is a partnership with existing programmes (in particular Energising for Excellence, High Impact Actions, Patient Safety First, the Productive Series and the National VTE Implementation group) and each SHA region Safety Express programme plan • Phase 1 - pilot phase (January to June 2011) Comprising of 3 Learning sessions 60 - 90 days apart January-June New knowledge will be archived into simple bundles and change packages • Phase 2 - (September to Feb 2012) Safety nodes will replicate the Safety Express Programme supporting the new teams testing in pilot areas • Phase 3 - spread (February to August 2012) Scale up activity to the whole system Regional learning and sharing sessions will take place and exemplar CQUINS will be developed The Model for Improvement The Model for Improvement We need to use our resources wisely. • • • Rapidly improving locally Testing out the improvement Rolling out good ideas This should provide the best services, eliminate waste and adopt the best practice. What are we trying to accomplish? Level 1 Level 2 Level 3 1. 80% reduction in hospital acquired category3 or 4 pressure ulcers 2. 30% reduction in community acquired category 3 or 4 pressure ulcers (patients not in a hospital bed) 3. 50% reduction in serious harm or death from falls 4. 50% reduction in the proportion of patients with catheters being treated for UTI 5. 50% reduction in avoidable VTE events To deliver the HARM FREE [4] for 95% patients by Dec 2012 To deliver the HARM FREE [6] for 95% patients by Dec 2012 ‘HARM FREE’ defined by absence of pressure ulcers harm from falls, CA-UTI, and VTE for all patients ‘HARM FREE’ defined by absence of pressure ulcers harm from falls, CA-UTI, VTE, bloodstream infection & C diff for all patients by Dec 2012 What is the Safety Thermometer? • The Safety Express measurement strategy focuses on Measurement for Improvement • This approach differs from measurement for performance which many clinicians and commissioners are most familiar with • The Safety Thermometer is the survey tool which is used to measure for improvement • The measures used are fundamentally about PROGRESS OVER TIME. Improvement measures are usually a sample data (50% patients on specified units of a single day,) the definitions are pragmatic working definitions • Data collection systems are designed to minimise the data collection burden and maximise on the benefit of the ‘act of measurement’. • The Safety Thermometer is designed to help participants and the NHS build up a picture of patient safety issues and to help you see the impact of actions implemented • Each measurement location will measure small numbers of patients often Org (All) Data Data Copy Print Safety Thermometer: Types of Harm Types of Harm CAUTI Fall Fall:CAUTI Fall:VTE PU Harm Profile PU:CAUTI PU:Fall PU:Fall:CAUTI PU:Fall:VTE PU:VTE PU:VTE:CAUTI Patients 100% VTE 90% 80% 70% 60% Pressure Ulcers 50% 40% 30% 20% Falls 10% Catheters & Infection 0% Q2/10 Q3/10 Quarter VTE VTE:CAUTI Data Harm Free (by location) Data Harm Free (by location) How will we organise our improvement? Local teams across the provider system A. Community services B. Host HOST GP network Team composition Dream Team Team Leader AHP Patient Stores Nurse Doctor Pharmacy Manager Clerk C. Mental Health Doctor D. Nursing Home Focus for Impact Aim Primary Drivers Secondary Drivers Local Clinical Leadership To deliver harm free care defined by the absence of pressure ulcers harm from falls, CA-UTI and VTE in 95% of patients By Dec 2012 Leadership & Safety Culture Executive Support Walk rounds & rounding Clinical Care 95% reliable Active risk management Continence, skin & moisture Nutrition / Hydration Medication reconciliation Supporting Infrastructure Equipment Education and Training Ward Level Driver A breakthrough series collaborative Jan 2011 March June Sept Supportive Framework Supported Regionally and Nationally National Coalition Mobilised patients 10 regional teams in SHAs National Leadership - Safety Express Sponsor Department of Health • Jim Easton • Bruce Keogh • Christine Beasley Director Maxine Power Day to day leadership Improvement Leader (s) Maxine Power Kevin Stewart Technical expertise in improvement and BTS model Coordinator Ailsa Brotherton Leads collaborative administration with director Chair Kevin Stewart Expert in Safety & practical experience with safety improvement Faculty Leadership Team MP, KS & AB National Faculty (steering group) • • • • • • • • • • • • • David Oliver / Francis Healey Janice Stevens / Sally Batley Mike Duerden & Carole Fry Anita Thomas and Tim Browne Katherine Fenton / Julie Halliday Caroline Lecko Mike Stroud Ashley McKimm Joan Sadler John Madsen / Martin Orton Bernard Crump / Kate Jones Mike Durkin Jane Cummings Falls Infection CA-UTI VTE Pressure Ulcers Pressure Ulcers Nutrition Junior doctors PPI Measurement Improvement Medical lead SHA lead