Using data for improvement in North East London

Samantha Rokoszynski, Practice Improvement Practitioner at North East London NHS Foundation Trust, discusses the interlinked journey of the NHS Safety Thermometer and improvement at her trust. 

How did you get involved in the NHS Safety Thermometer? 

We were involved in piloting the ‘Classic’ NHS Safety Thermometer; it was tested in smaller areas and then rolled out across the organisation. We are a fairly large organisation with over 5,500 staff consisting of a variety of mental health and community teams. 

What were the challenges in implementing the Safety Thermometer? 

One of the first challenges was dealing with the variety of teams that we have within the trust. This caused difficulty at first due to the different interpretations of the harms. We overcame this by delivering bespoke training and having discussions with the teams so that they understood what the harms meant to them. 

How have you educated teams around ‘Harmfree’ care? 

We have been delivering training at the most convenient locations and times for teams, often at team meetings and at team bases.  We have done a lot of work in clearly defining operational definitions of the harms and have developed a resource to support staff with this. I think this has helped a lot because people can then easily know what the different harms are defined as and therefore strengthen the quality of the data been collected.

How have you used the data collected from the Safety Thermometer? 

The data we collect is used throughout the trust, from a team level right through to directorate level. We engage staff by sharing their Safety Thermometer data with them and showing them what their data is telling them about their area. As a practice improvement team, we use it at a wider level to support improvement work across the trust.

What improvement work has been done? 

We have working groups across the organisation, one for each of the harms, and for each of the harms we have been able to pilot and carry out improvement projects. One of the biggest projects is on pressure ulcer prevention training which we have carried out for our healthcare assistants, rehab assistants and unregistered clinical staff.

We have been carrying out that project for the last 9 months to try and prevent pressure ulcers. The project aimed to find out what our staff already know about pressure ulcers and support them by giving them more knowledge around pressure ulcer prevention.  We have delivered this in 3-hour sessions with small groups and have had a lot of positive feedback, with many saying the small groups work well.  Staff complete a quiz before and after the training and we have seen an improvement in their knowledge. Once they have completed the session they are given a workbook, which they have to complete within 3 month with their tissue viability link nurse.  Over 170 staff have completed the programme so far. Staffs feedback on the project has been captured and themed according to the 6C Compassion in practice, nursing strategy (see below)

Case Study diagram

What have been the advantages of using the Safety Thermometer? 

Having the programme in place has encouraged staff to think about their care delivery even more and has made them look at it from a patient’s point of view. It has also allowed improvement to be measured over time when improvement work has been embedded into practice. The Safety Thermometer has really supported and raised the profile of ‘harm free’ care too. 

What advice would you give to others using the Safety Thermometer? 

I think that it is important to spend time in the beginning focusing on what ‘harm free’ care means and the operational definitions of the four key harms are clearly understood. Another big thing is engaging clinicians in the improvement work and showing them that it means something by sharing their data with them regularly and showing them the improvement in care delivery. 



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