The Leeds Teaching Hospitals NHS Trust

Keeping patients safe #TheLeedsWay

30 September 2015

Clinicians at LTHT are looking at new and collaborative ways of ensuring high quality care and the safety of our patients while staying in hospital.

Consultants Dr Ali Cracknell and Dr Graham Sutton have been leading an initiative looking at reducing the numbers of patients having falls and helping to prevent avoidable deterioration.

Dr Ali Cracknell and Dr Graham Sutton

Around a year ago, the doctors identified the need to improve how the Trust provides safe and effective care for our patients. They split the work into two individual projects and approached wards across LTHT likely to encounter challenges with either patients having falls or deteriorating from acute illness.

Dr Cracknell said “The main focus of the work was to look at areas of preventable harm, namely falls and the ‘deteriorating patient’, and to support ward teams testing their own innovative ideas to reduce harm to our patients, develop collaborative solutions and discover working practices that can be rolled out across the Trust.”

In total 29 wards were involved from across the Trust (including medical, surgical and children’s wards) to begin an improvement journey. Forming patient safety collaboratives in partnership with Haelo – a patient safety project team from Salford Royal Infirmary – the ward teams have been testing combinations of evidence-based solutions and innovative ideas to reduce preventable patient harm.

The wards teams have now designed “intervention bundles” and are currently learning how to implement these successfully across their wards, before sharing and supporting the spread widely across the Trust later this year .

Work around reducing avoidable deterioration– looking for early signs and taking timely action of those patients– has been led by Dr Cracknell, while Dr Sutton has focused on ways teams on wards can prevent falls.

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Dr Cracknell said “The most successful ideas behind improving care and safety come from the frontline staff and are often simple, for example sharing good ideas and practices with other teams. Understanding what does not work is as important as learning what does. The key however then, is to make sure that those ideas that are successful are embedded into the daily practice of a ward. One way we have been achieving this is to make safety everyone’s responsibility through ‘safety huddles’, where everyone on a ward can share their concerns and ideas.”

“Our work has been supported by a “Faculty” of professionals working in different areas of the Trust and backed up by the Trust’s executive team – who play a vital role as ‘sponsors’ for teams.”

“The aim of the approach is, in my case, to improve early recognition of patient deterioration, achieved by focusing on three key areas: the identification and response to deterioration, culture and teamwork, and recognising and managing patients at the end of their life.”

Dr Sutton added “In addition to the safety huddle, some of the solutions we have to prevent falls have been to ensure that patients are wearing appropriate ‘slip-proof’ footwear and grouping patients at high risk into ‘Falls Bays’, which helps to reduce the risk to the patient.”

“It’s been great to see the effort from staff at all levels in helping to make these patient safety collaboratives part of who we are and what we do, tying in really well with the spirit of the Leeds Way. By using evidence and working together, I am sure we can improve on the progress we’ve already made.”

Dr Sutton and Cracknell are excited about the next stage of supporting the scale up the interventions across the Trust.