This blog was written by Sarah Woolley, Director of Risk and Safety at Heart of England NHS Foundation Trust.
I write this as we reflect on our experience from our month long safety extravaganza. Hundreds of colleagues put huge energy, commitment and passion into supporting this initiative, transforming our little idea into a full scale organisational reality.
The idea for Safety September was triggered through chance conversations between our patient safety team and our lead clinicians in early July. Our first task was to test the organisation’s appetite for the idea. How? We sent a simple email asking colleagues for feedback. From the responses received it was clear we’d hit on something – the idea grew and became infectious, by the end of August we had developed the campaign and had over 50 events planned across our sites.
What did we learn?
‘Variety is the spice of life’
The themes and media we chose were designed to reach as many different staff groups as possible. When we showed our medication safety video to one ward clerk, she immediately responded that she was “the worst” for interrupting staff on drug rounds. When we visited one of our Emergency Departments, an ambulance crew saw our sepsis tips and “3 + 3” tool and asked for their own copy to use.
‘Keep it simple but recognise complexity’
We didn’t have masses of project documentation, meetings, targets, business cases or the usual management bureaucracy. We held a conversation with our organisation and a team of four people coordinated the campaign across a workforce of over 11,000 staff. This was liberating. We were reminded, however, that simple ideas and approaches need to take account of the complexity of reality. One nurse commented on the challenges of ignoring necessary distractions to a drug round – like taking a handover call from ED for a new patient. Balancing and reprioritising complex processes is a continuous challenge.
‘Seek out and listen to your experts’
The interventions were mainly designed and led by our clinicians. For example: our sepsis power teaches were led by nurse professionals in the Emergency Department and Acute Medical Units, and consultant medics led sepsis mortality reviews. One of our surgical consultants held a ‘surgery’ with the Foundation Year One doctors covering risk’s in Surgical Assessment Unit and wards, taking in sepsis, speed of antibiotic administration, medication safety, communication, escalation and using recent Serious Untoward Incident’s and incidents as illustration.
‘Keep the big picture in view’
The patient safety team acted as a central coordinating team working to ensure the campaign was coordinated and aligned across all sites, supporting event leaders and key corporate functions. Our resuscitation team led weekly cardiac arrest debriefs and for September, each one was themed to coordinate with us. We found that debriefs provide an open and supportive way to discuss indivdual and team learning, and their style means the quality of discussion is very rich so teams talk about a wider range of safety issues across the hospital.
‘But remember the small things too’
Modern day healthcare is complex, high pressure and high pace, meaning that work-related stress is always a risk. As part of our staff safety week we visited clinical areas and handed out stress kits and stress balls – little things like this were an instant hit. Although for some this may seem “gimmicky” and superficial, giving away pocket-sized tip cards, banner pens, security card lanyards, paying for a pizza or sandwich lunch for the team, and taking the time to visit staff and show an interest in their everyday reality seemed to make a real difference to staff.
‘It’s ok to have a bit of fun’
Our Education Faculty were instrumental in organising fun events and competitions, like the Magnificent Seven, the Surgical Crime Scene and the Olympic Quiz. These got people talking, thinking and learning about safety in a more playful and creative way.
To sum up – the current economic challenges and the complexity of modern day healthcare demand more inspiration, imagination and innovation than ever before. I was reflecting on the experience of Safety September with a couple of senior medical colleagues a few days ago, explaining how positive I felt it had been. They were giving me a reality check describing the safety risks they see and the frustrations of enacting safety improvements. It got me thinking- maybe it’s time for us to be courageous and break the chains that are management control, bureaucracy and targets. It is only by setting ourselves and our organisations free that our natural creativity and resourcefulness will have the space and time to flourish, so that we can design the safe and caring services we all know our patients need.
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Footnote: I cannot end this column without a special mention and thank you for the help and support we received from hundreds of staff at Heart of England NHS Foundation Trust who worked to make the Safety September campaign such a tremendous success. In particular, a special thank you is due to all members of the health and safety and patient safety teams: Diane Aucott, Phil Chambers, Yvette Appleby, Sharon Read, Yvonne Higgins, Caroline Maries Tillot, Karen Barber, Nasreen Khan, Louise Berktay, Ann Keogh.
If you wish to contact me, Sarah Woolley, you are welcome to do so on: email@example.com