Changing culture for patient safety

Barts and The London NHS Trust continually strives to improve patient safety and was named a finalist in the 2010 Patient Safety Awards1 for its efforts in introducing the Surgical Safety Checklist. The Clinical Services Journal provides an insight into how the Trust implemented change.

Introducing the Surgical Safety Checklist was one of the many patient safety improvement activities that Barts and The London NHS Trust has implemented since signing up to Patient Safety First – the national campaign for patient safety improvement in England. The use of the checklist is part of Patient Safety First’s perioperative care intervention, which aims to improve care for patients undergoing surgical procedures in hospital. The checklist has been embraced at Barts and The London NHS Trust by members of the multiprofessional theatre teams across its three hospital sites.

The Safer Surgery Group (SSG)

Ajit Abraham, consultant hepatobiliary (HPB) Surgeon at The Royal London Hospital and the surgical champion for the intervention, explained how the Trust worked with theatre teams to implement the checklist and make sure that it suited the local environment: “To get the checklist up and running, we first established a Safer Surgery Group (SSG). This group has worked hard to ensure that our staff felt that they had ownership of the checklist. We asked staff for their views on the content of the checklist and gave them an opportunity to test it for themselves and to suggest changes. “We introduced the checklist in one theatre group at a time. We used a basic template and the PDSA (Plan, Do, Study, Act) cycles to test implementation, before spreading the change to involve more areas. Feedback was welcomed and, from this, we created our own adapted version that staff feel more committed to, because they helped to create and tailor it.” The Safer Surgery Group also worked with other specialist areas such as the cardiac labs who further adapted the checklist to suit their specialist needs. However, while appropriate local additions and changes to the checklist have been made, the core principles have been retained. Like many other Trusts that signed up to Patient Safety First, Barts and The London NHS Trust found that the group of committed multi-professional champions quickly grew. These staff members are passionate about patient safety and have proved influential in changing the hearts and minds of others around them.

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