Rebecca Dawber, Assistant Director of Physical Healthcare and Infection Prevention at Greater Manchester West Mental Health NHS Foundation Trust, discusses how the ‘Classic’ NHS Safety Thermometer has helped improve the trust in a variety of areas.
What services do you provide at GM West Mental Health Foundation Trust?
We are an integrated mental health service that provides a wide range of mental and social care services to over 700,000 people living in Bolton, Salford and Trafford. GM West has around 50 sites and manages about 692 beds, we also provide specialist services across the North West and further afield.
How did you first start working with the Safety Thermometer and what were the challenges?
We got involved in the Safety Thermometer as part of our national CQUIN for 2013/14. The initial challenge for us was making the ‘Classic’ Safety Thermometer, which is quite focused on acute care, applicable to us. Our first thoughts were “how do we implement this and make it meaningful for mental health services?”
We wanted to make it more than just a tick box exercise and get that message down to the people on the frontline who are collecting the data.
How have you implemented the Safety Thermometer and used the data?
The implementation sat with the trust’s Nursing Quality and Leadership Team who led the project. We took ownership of it by going out on a monthly basis and linking with patients and staff in clinical areas to roll-out and improve the project.
By putting the Safety Thermometer into place this led us to review our reporting system and make it much more robust, as this system for reporting harms such as pressure ulcers wasn’t in place beforehand.
The new systems put in place due to the Safety Thermometer then allowed us to triangulate the data with our incident reporting system, which made the data much more useful.
How has the Safety Thermometer helped with improvement work at the trust?
It helped us embark on a project. We wanted a consistent approach to evaluating ‘harm’ incidents within the organisation. Using the Safety Thermometer encouraged us to review our procedures and improve them, which improved the quality of care and reduced harm.
Are there examples of work that has come from rolling out the Safety Thermometer?
One example would be for pressure ulcers: due to the robust reporting system that was put into place, as soon as a pressure ulcer is identified, irrespective of origin, it is immediately reported. This report triggers a response where the case is reviewed within three days. This procedure wasn’t in place before and the Safety Thermometer highlighted the need for more robust reporting. Now, root cause analysis has also been built in for grade 2-4 pressure ulcers. This allows us to explore why it happened, where it happened and lessons we can learn from the incident.
This has taught us a lot, such as identifying if there is a training need or how the harm could be avoided and it means we are now continuously improving. We have also been able to share data with our local safeguarding boards, which can be particularly useful for pressure ulcers. This is because the person could have come from another healthcare facility or from a home where there could be safeguarding needs. This can help to ensure that the patient gets the right care wherever that may be and there are no safeguarding concerns.
What tips would you give other organisations using the Safety Thermometer?
I think the Safety Thermometer can be a great benefit and has been to us because we embraced it as an opportunity to improve all areas. It’s not just been used as a tick box exercise.
If you make the Safety Thermometer meaningful and show people that it is more than just a survey it can be very positive. It has been for GM West Mental Health Foundation Trust and now we’ve got more assurance and improved systems in place.
We have also used it to do some “off the cuff” teaching and I think that has been a positive, to encourage more junior staff to be involved in the Safety Thermometer. We have used it as an opportunity to educate about the four harms and junior staff have enjoyed the learning and being involved in the data collection.
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