Delivering ‘harm free’ care to each and every patient

The ‘harm free’ care programme is ambitious yet simple. Stop dealing with safety issues in silos, think about complications from the patient’s perspective and aim for the absence of all harm to each and every patient. We are a growing community of healthcare professionals who set ourselves the challenge of redefining the possible for patient safety. We believe that by working together we can learn, innovate, improve and deliver ‘harm free’ care to every patient, every time.

Patients are at the heart of everything we do. They inspire us to change. We are committed to improving their experience of healthcare and protecting them from harm.

The initial ‘harm free’ care collaborative focussed on harm from  ‘pressure ulcers, falls, urinary catheter infections and VTE’ with a goal to deliver ‘harm free’ care to 95% of patients. The concept of patient centred improvement and lessons learned from testing this concept  have been shared and we are now seeing  improvement programmes focussing on delivering ‘harm free’ care for medications safety,  maternity services, mental health, paediatric care and the inclusion of additional harms.

Think and act differently

Our challenge is to redefine the possible for these harms in the way we have with infection. We encourage you to debate with your colleagues where you are on the road to ‘harm free’ care, and to develop a shared understanding with your patients as you work through this programme. Times are changing and with them the norms of the past. Old ideas like ‘MRSA is unavoidable, you’ll never reduce it’ are replaced by different norms and expectations, with some organisations now going a year without an MRSA bacteraemia. This programme is about challenging ourselves to think and act differently, to be bold and courageous in the face of challenge, to redefine tomorrow’s norms.

You can use our driver diagram to design and deliver ‘harm free’ care for your patients, just agree your own harms and goal locally and follow our guide to delivering ‘harm free’ care. Measurement is a core part of our improvement work and you can use the NHS Safety Thermometer ‘classic’ or one of the ‘next generation’ tools to understand the burden of harm in your area and measure improvement over time.

‘Harm free’ care is a journey and that it is one which will require continual work and resilience. We are just beginning. Despite this, we have seen impressive improvements in many organisations through innovative approaches to improving patient safety, demonstrated in our case studies and resources.

The definition of ‘harm’

We have debated the use of the word ‘harm’ and understand that, in this context, we are using it to describe only a fraction of possible healthcare complications (or harm). The healthcare issues at the heart of this programme are recognised globally as challenges to every healthcare system. These issues cannot be resolved by isolated secondary care initiatives – common harms (some of which may be unavoidable, some of which may not) are often overlooked as ‘less severe’ and therefore by association, as less of a priority for change. We want you to change that.

A joint collaboration…from the beginning

The ‘Safety Express’ community, which came together for the first time in January 2011, have generously shared their learning with us and without them this guide and website would not be possible. Our materials have been harvested from the skilful patient safety professionals within each Strategic Health Authority and the leaders of the national VTE and Energising for Excellence programme, to whom we would like to offer our personal thanks.