Natasha Swinscoe, national patient safety lead for the AHSN Network, looks back at the interventions that Patient Safety Collaboratives (PSCs) helped roll out at speed in response to COVID-19 and considers what we can learn about improving patient safety in future.
It was no surprise that as healthcare systems around the world struggled to comprehend and stay ahead of the COVID-19 pandemic, the safety of patients was their primary concern. It has led to an amazing global response and highlighted how effective systems can be when the circumstances demand it.
As someone who works in this field every day, I’m delighted to see patient safety firmly in the spotlight. But how can we translate this renewed focus into our long-term practice and use the learning from COVID-19 to deliver safer healthcare in future?
Like all organisations, Patient Safety Collaboratives, which are commissioned by NHS England and NHS Improvement and hosted by AHSNs, responded quickly to both the immediate crisis in March and to reprioritise their day-to-day work. Some staff went back to front-line roles or supported national teams, while PSCs had to adjust to collaborating with their networks using online and virtual methods.
PSCs took on the rapid mobilisation of a safer tracheostomy care programme to assist the high number of patients expected to need prolonged ventilator support in intensive care units. We accelerated our spread and implementation of tools to spot seriously ill patients in care homes, who are at greater risk of deterioration. And looking forward, we are rolling out virtual ward pilots to support patients in the community, generating evidence to support future waves and ways of working as part of the NHS @Home programme.
It’s been impressive to see how quickly PSCs have been able to pivot at short notice and align their work to meet these new demands, and useful to reflect on what has made that possible so we can be even more effective in our patient safety role.
Firstly, I think AHSNs and PSCs have a unique ability to connect people, and work at both system level and with individual organisations. We are able to swiftly capitalise on opportunities: such as joining together with the Royal College of General Practitioners to host a webinar on the physiology and oximetry around COVID-19. The demand was so great for this, the webinar has been watched over 10,000 times.
Secondly, we used our networks to good effect, to stay locally connected and responsive and link with our regional teams’ COVID cells. We shared tools to support the workforce to deliver safer care consistently, from the tracheostomy care toolkit to e-learning resources on the National Early Warning Score, and collaborated on creating advice for staff suddenly faced with difficult conversations with families and loved ones.
Finally, we’ve been alive to the benefits and challenges of digital applications, supporting care homes with access to digital tools and IT solutions, and quickly surveying technologies already in use to help manage deterioration and support maternity and neonatal staff.
There are some common factors to our work that I think are useful for any health or care team to consider:
- Rapid cycle learning: our model for improvement is based on rapid cycles of test and change, with measurement in place from the start to check whether an improvement has been made. We’re never afraid to try something out, and during COVID-19 these cycles became faster and happened at a much larger scale.
- Insights and solutions: the ability to gather and share knowledge became more important as the wealth of research and publications available grew exponentially. Curating the right information is of enormous value to hard-pressed front-line workers.
- Toolkits and resources: always ‘keep it simple’ – aim for high-quality, consistent guidance that is easy to follow. The tracheostomy care toolkit was supported by a fast-response bedside guide with easy-to-use action cards created by the Chartered Institute of Ergonomics and Human Factors.
- Connectivity and relevance: we are rooted in our local systems but work nationally too, so we knew that our COVID-19 programmes responded to the needs of both. We can have much greater impact the wider we seek to influence.
Patient Safety Collaboratives have been a small part of a magnificent national effort. If anything, this reinforces the point that working together – keeping it simple, sharing widely, testing and learning – can increase the speed and impact of any innovation or change in practice. We also work towards a common goal, with PSCs playing a key role in the NHS Patient Safety Strategy through the national patient safety improvement programmes.
As we consider the health and care reset, I hope we have learned from the last few months to be brave and understand that transformation doesn’t have to be slow or painful, but can start small and grow quickly when these factors are in place.
Access our resources on patient safety during Covid-19 here.
You can find your local Patient Safety Collaborative here to discuss support for patient safety where you work.