King’s College Hospital Foundation Trust has changed its approach to staff education about patient safety, introducing a safety forum and informal safety events
Patient safety is a clinical priority; improving safety does not only prevent harm to patients but also saves money. At King’s College Hospital Foundation Trust, the creation of a Safer Care Forum has led to a reduction in avoidable harm. As part of the initiative, Safer Care Day events were organised for all clinical staff to engage with harm prevention leads on patient safety issues. Feedback has been so positive these events have become an established part of the trust’s efforts to deliver harm-free care.
Citation: Day H et al (2017) Improving engagement with patient safety through educational events. Nursing Times [online]; 113: 5, 38-39.
Authors: Helen Day is deputy director of nursing, South Tees Hospitals Foundation Trust; Richard Greenall is venous thromboembolism prevention clinical nurse specialist; Katherine Gausden is lead falls practitioner, both at King’s College Hospital Foundation Trust.
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Patient safety is a clinical priority but also helps to reduce costs. The cost to the NHS of avoidable harm to patients is significant: for example, as well as the consequences to the patients concerned, every new grade 2-4 pressure ulcer increases a hospital stay by around 12 days at an average cost of £2,549 per patient (NHS England, 2014).
The Sign up to Safety campaign was launched in 2014 with the aim of saving 6,000 lives over three years, reducing costs and developing a stronger incident reporting and learning culture in the wake of the care failings at Mid Staffordshire Foundation Trust (Department of Health, 2014). Its website contains a wealth of resources including podcasts, webinars, posters, leaflets and toolkits to increase awareness of patient safety.
Patient safety is often viewed in isolation, which means that a nurse might present a root cause analysis (RCA) straight to the serious incident committee with little support or reflection. Furthermore, the traditional approach to staff education in response to patient harm does not take into account variables such as how different staff groups learn, the effect of leadership locally and across the organisation, patient experience and workforce challenges.
At King’s College Hospital Foundation Trust, we recognised that we needed a fundamental change in how we deliver safety education to staff so behaviours and standards would improve and the number of avoidable harm events would reduce. As such, the trust changed its approach to safety education for staff, creating a Safer Care Forum and organising a Safer Care Day.
Safer Care Forum
In 2013, we created a Safer Care Forum to enable clinical leaders to discuss patient safety across organisational boundaries. It is chaired by a senior corporate nurse and composed of patient safety managers, consultant physicians, and safeguarding, manual handling and harm prevention team leads.
The forum’s monthly meetings start with each harm prevention lead presenting their latest figures, enabling us to identify ‘hot spots’ where targeted intervention is needed. This is followed by a presentation of RCA reports and discussion of the needs of individual wards and/or unit managers. Only then are summaries of the RCA reports handed to the serious incident committee.
To date, responses to RCAs have included work to improve staff engagement, leadership coaching and bespoke harm-prevention teaching. Patient safety is no longer viewed in isolation and the approach to staff education is much wider and more imaginative, which has significantly reduced preventable harm.
On both hospital sites, we have maintained a falls rate that is below the national average, and seen a drop in the number of falls. In addition, the number of avoidable grade 3 pressure ulcers has reduced from 5-6 per month in 2013 to 0-1 per month in 2016 – this is outstanding given our large number of intensive care and trauma beds.
Safer Care Day
One of our safety education initiatives is the Safer Care Day events. They provide an informal way of learning that appeals to staff at all levels, allowing them to step out of their routine, broaden their knowledge and perspectives, and directly access specialist information on harm prevention.
Staff can drop in at any time and stay as long as they would like. Harm prevention teams have stands where they display booklets and leaflets, and engage in conversation with attendees.
Box 1 shows the safety areas typically covered during a Safer Care Day.
Box 1. Safer Care Days: subjects covered
- Falls prevention
- Tissue viability
- Acute kidney injury
- Critical care outreach
- Venous thromboembolism prevention
- Patient safety managers
- Compassionate care
- Continence care
- Safeguarding adults
- Intravenous lines
- Infection prevention and control
The events are advertised via senior managers and through ward visits, posters, emails and the electronic staff bulletin; attendance counts towards continuous professional development requirements for revalidation.
The events are made as fun as possible: there are usually treats and ‘freebies’, as well as prizes for the best safer care initiative; those running the stands often wear fancy dress costumes linked to their specialty, as a light-hearted way to draw attention to important issues.
At one event a quiz featured questions relating to each safety area; staff could find the answers by talking to the specialty teams and those who completed the quiz received a certificate of learning for their professional portfolio.
safer care day pic 2
Successes and challenges
The first and second Safer Care Days took place in 2015 and 2016 at the main King’s College Hospital site at Denmark Hill, London. Princess Royal University Hospital, the trust’s district general hospital in Orpington, also held one in 2016. Around 500 staff attended the events, including nurses, doctors and allied health professionals. There was a constant flow of staff, demonstrating that patient safety is of interest to many. Ward managers took on clinical work so junior staff could attend.
Feedback forms were collected from staff at all events in exchange of a certificate of attendance. Most attendees said their knowledge had been enhanced and they had enjoyed the event. Examples of feedback included:
“The event is interactive, all of the topics are great.”
“Hope every year we have this Safer Care Day.”
“Fab event, able to update my knowledge of safer care.”
“I am now able to really assess my patients.”
The events are hard work for the harm prevention leads, and can put a strain on their teams, who have to cover for them so they are able to oversee the stands. However, the leads also found the events useful to educate staff and foster discussion in their areas of expertise. Finding an appropriate space can also be challenging – it needs to be familiar, close enough to the wards for staff to easily attend and large enough to accommodate a number of stands and space for people to move around easily.
Patient safety education is often managed in isolation and with a ‘broad-brush’ approach. At King’s College Hospital Foundation Trust, setting up a Safer Care Forum and creating fun, informative Safer Care Day events has contributed to improving the safety culture and reducing avoidable harm. The success of the Safer Care Day means it is now planned to occur every year across our sites so we can continue to promote harm-free care.
- In the traditional approach to educating staff about patient harm, safety is often viewed in isolation
- A proactive and imaginative approach to patient safety can reduce avoidable harm, while also saving money
- Events such as the Safer Care Day, which was introduced at a large London trust, provide an informal way for staff to learn about patient safety
Department of Health (2014) Halving Avoidable Harm and Saving up to 6,000 Lives.
NHS England (2014) The Value of Safe Care.