Nursing in Practice Autumn 2021 (issue 121) - Page 26


Leading by example : developing a strong patient safety culture

Thomas Buckley , patient safety lead at Sussex Community NHS Foundation Trust , describes his work to ensure the trust ’ s healthcare services are as safe as possible


patient safety team follows a strategy 1 designed to ‘ continuously improve patient safety ’, building on the foundations of a safe workplace culture and safe systems . These teams have dedicated patient safety leads ( PSLs ) 2 from nursing and allied health professional backgrounds , who review the quality and safety aspects of patient care , based on familiarity with the national patient safety syllabus . 3
The job of the PSLs at Sussex Community NHS Foundation Trust is to support staff , patients and families to make the NHS safer for everyone .
Of course , healthcare staff operate in complex environments and patient safety incidents do occur . A day in the life of a PSL often starts with triaging incidents reported by staff via the local risk-management system . This clinical triage helps identify harm or risks to patients occurring as a result of healthcare delivery . PSLs need good communication skills and an enquiring mind , and will often contact staff to request further information to help them assess whether an issue needs escalation to maximise potential learning .
PSLs lead on Serious Incident investigations and , as well as investigative abilities , they need the appropriate people
References 1 National Patient Safety Strategy . NHS England and NHS Improvement , 2019 . bit . ly / 2YrfvJb 2 Identifying patient safety specialists . NHS England and NHS Improvement , 2020 . bit . ly / 2Yxluwf 3 National patient safety syllabus 2.0 . Academy of Medical Royal Colleges , 2021 . bit . ly / 3tndoBx skills to ensure they can support all individuals they engage with during these investigations . These include heightened listening skills , empathy and compassion . Equally , PSLs need to reflect with colleagues and support one another while conducting inquiries that can become complex or distressing . When reporting the outcome of an investigation , they must use language that is fair and objective , while sharing investigation findings with colleagues in the patient safety team allows other perspectives to be heard and any unconscious bias to be checked .
Internal and external relationships An important part of the work of PSLs is to encourage the teams and services involved to use the learning from the investigations to make recommendations to improve working systems and processes .
PSLs work closely with other trust teams involved in quality and safety , including those responsible for medication and medical device safety , infection prevention and control , and equalities , as well as the patient advice and liaison service ( PALS ). Collaborative working helps to measure the effectiveness of improvement initiatives in practice .
The trust recently engaged with one of our inpatient teams for a wider quality and safety learning exercise , rather than looking at incidents in isolation . This provided assurance of the quality and safety measures for that team while also identifying the areas where the team could improve .
The methodology in patient safety is evolving , and underpinning this is the NHS Patient Safety Strategy 1 , which encourages the development of patient safety specialist networks , operating on a local , regional and national basis to provide peer support for those in the role , help them to keep up to date and share good practice .
Learning , not blame One of the key concepts behind the strategy is to avoid blaming individuals when things go wrong , so that staff feel safe to admit errors and learning can take place . The trust has also developed a reflection tool that helps staff learn from incidents to support their revalidation .
Honesty is also vital . Healthcare professionals abide by a professional code , which encompasses a duty to be open with patients when unexpected outcomes occur . This is also enshrined in legal regulations and monitored by the Care Quality Commission to ensure incidents are managed with transparency and compassion .
The PSLs support staff across the trust to ensure this duty is followed and embedded . It is not easy to say sorry or admit to making mistakes – but the right support and culture makes this easier and it is always the right thing to do .
Keeping patients informed from the outset when an event has occurred will reassure them that the incident will be reviewed and that their input will be important .
The PSL role aims to promote resilience among colleagues to give them the confidence to get involved in a process of shared professional accountability in order to improve safety systems and processes . Resilience is key to empowerment and learning , especially in today ’ s demanding healthcare environment . When staff are stretched , like a rubber band we want them not to snap but to be able to bounce back .
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