Too many times in healthcare, managers and staff use what went wrong to inspire them to find a model for safe and better practice.
Several organisations have reacted to events at Mid Staffs, Maidstone and Tunbridge Wells, Care Quality Commission and other reports to try and find a way to ensure such events don’t happen where they work.
While this reactive approach is understandable and can be a useful starting point, such methods shouldn’t create a “blame game” culture, where nurses are used as scapegoats. Instead, they should also study what excellent practice, customer service and outcomes look like and model those for imitation.
In private business, people in retail or the service industry or those working in environments where safety is key (aeronautics, for example) will look at what circumstances and behaviours create a successful day, and then look at creating a checklist system to emulate them.
Exceptional businesses are confident of what is needed to create excellence, and are relentless in a drive to ensure they achieve it.
This is the approach taken at the Heart of England Foundation Trust by chief nurse Mandie Sunderland and her nursing team. The trust has launched VITAL4Care, an online platform that assesses nurses’ skills in 14 fundamental areas of care and highlights the latest thinking and learning around these areas. Only by knowing all of these areas inside out can nurses be confident that they are safe to look after patients, says Ms Sunderland. True, what led to the launch of VITAL was a series of high-profile problems at the trust. But the result is not a knee-jerk piece of faddism or a tick-box designed to placate the board. Neither did HEFT hide behind its nurses and sacrifice their professional reputations to silence the critics – and the press – for a few weeks.
Instead, it took a long hard look at what was needed to ensure that its nurses were good enough to do the jobs they were hired to do. It set about creating a system that was easy to access and provided all the knowledge the workforce needed to deliver safe care, and could verify that nurses knew and understood it all. VITAL supports staff as well as ensuring patients will be safely treated, and has had a phenomenal impact on the care being delivered.
This is proof that when things go wrong, it’s best not to retreat, but tackle the challenge head on. It’s time to stop blaming nurses and start supporting them to ensure that things go right.