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Nurses should not assume 'acting differently' to Mid Staffs staff, says tsar

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Nurses and other clinicians should not assume they would have acted differently to staff at Mid Staffordshire Foundation Trust, the government’s new patient safety tsar has warned.

Professor Don Berwick has been asked to look at “making ‘zero harm’ a reality” in the NHS by prime minster David Cameron, following the publication in February of the Mid Staffordshire Foundation Trust Public Inquiry report.

Professor Berwick founded the world renowned Institute for Healthcare Improvement in the US city of Boston. He spoke publically for the first time since his recent arrival in the UK when he addressed a conference last week on his forthcoming NHS review.

He highlighted studies that had shown three quarters of people tended to doubt their own judgement if the majority of their colleagues disagreed with them, even when they were right.

“It’s easy to read the Francis report [on Mid Staffordshire Foundation Trust] and become angry. But… that is thinking we are different and we would have acted differently.

“Do not distance yourself from the staff at Mid Staffordshire, you would have committed similar errors in an unsafe environment,” he stated.

Professor Berwick also called for all nurses and medical students to be trained in methods for driving improvements in quality from “day one”. “A modern nation anxious to have excellence in care is going to have to teach workforce the basic principles of safety systems,” he said.

In an interview with Nursing Times, Professor Berwick said while the review would be wide ranging and consider the design of the NHS system and its funding.

Asked how important he thought nurse-to-patient ratios were to patient safety, he said evidence showed they were important, but any ratio was only relevant for a particular model of care.

“As important as staffing is, you have to keep remembering it’s rooted in the current processes and maybe we can be inventive enough over time to come up with processes that remove those handcuffs,” he told Nursing Times.

“That said, it is not going to be smart to place clinicians of any type under conditions that are so stressful they can’t get the job done.”

Professor Berwick has put together a National Patient Safety Advisory Committee to assist him with the review. Its only members working in the NHS full-time are both from Salford Royal Foundation Trust – executive nurse director Elaine Inglesby-Burke and chief executive David Dalton. The remaining members are US and UK academics and patient representatives.

Speaking at the same event, health secretary Jeremy Hunt said the aim of the review was not to eliminate harm, but to create a “culture where harm is totally unacceptable and treated with the utmost seriousness”.

  • 4 Comments

Readers' comments (4)

  • Yes But

    Preventing 'process' from causing harm is one challenge.

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  • There is some sense in this. Get rid of hourly rounding for everyone. Target those patients that really do need it and make sure when the boxes have been ticked the action has been carried out. In the same way not everybody needs to be on 4 hrly obs. Little things but they add up.

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  • "...he said evidence showed they were important, but any ratio was only relevant for a particular model of care."

    Call me crazy but why don't we try for that "model of care" where patients suffer less and nursing staff don't leave the profession in droves. Minimum ratios should be absolutely non-negotiable in the wake of Mid-Staffs and the Francis Report, but the government keep brushing it aside with patently meaningless and nonsensical statements.

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  • Whilst Hospitals are still allowed to staff their wards dangerously nothing will change and Stafford will happen again.

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