At UH Bristol patient safety is a priority, whilst ensuring we deliver best care and improve flow though our hospitals. An award-winning patient safety checklist piloted by the adult emergency department addresses these aspects of care and has been nationally recognised for producing significant improvements.The adult emergency medicine team at the Bristol Royal Infirmary (BRI) have been recognised for their innovative work to address patient safety and care in the department with a safety checklist tool.
The checklist, developed by the team, aims to provide a safe, standardised approach to basic care which is both resilient to periods of overcrowding and a variable nursing skill mix.
Emma Redfern, consultant in emergency medicine, explains, “The checklist is an A4 document used by emergency department staff to standardise the basic care. It ensures hourly observations and NEWS scores, pain scores, analgesia and medication administration are constantly maintained despite periods of severe operational difficulty. The aim is to prevent failure to recognise deterioration.” “In addition, it provides a template for ambulance staff to work to, ensuring improved transition of patient care between the ambulance service and clinicians in the emergency department.”
An initial pilot study of the safety checklist took place at the adult emergency department of the BRI and was supported by the Health Foundation in Winter 2014/15. The Trust then successfully implemented it in Winter 2015/16.
“Our standard of care has dramatically improved with statistical significance, with no clinical incidents where failure to recognise deterioration is a contributing factor,” says Emma. “As a result of our success here at the BRI, the safety checklist has been rolled out to emergency departments in the region, providing safer care to patients using these departments, with support from the West of England Academic Health Science Network and South West Ambulance Service NHS Foundation Trust. It was also noted in the Trust’s most recent CQC report that the safety checklist was being actively managed in a way that kept patients safe during periods of crowding in the department.”
Since its launch the checklist has been continually recognised for its success to improve patient safety, and in July 2017 scooped a national award at the HSJ Patient Safety Awards for ‘best patient safety initiative in A&E’.
Jason Lugg, matron, previously lead nurse for the safety checklist project, says, “This national recognition proves that a simple, well-designed checklist such as this can greatly improve the delivery of safe care.”
A paediatric safety checklist has also been developed, which is currently being piloted in the children’s emergency department.