In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In her first blog, Gina explained what motivated her to introduce Safety Chats into her Trust. In part 2, Gina reflects on how we know we are safe and the safety measures her Trust has put in place.
How do we know we are safe?
This is the Holy Grail that has led to many publications and much research. Authors such as Berwick, Dekker and Syed have written insightful and clear reports that detail that safety is about much more than mere compliance to rules, reporting of incidents and monitoring risk.
In my previous blog I shared Solent NHS Trust’s staff survey results, which show high confidence in our staff about safety, having a voice and speaking up.
The organisation works hard to define how safe we are and uses a variety of measures for this.
- Incident reporting is high for a trust of our size and is the highest in our group. The levels of harm are consistently low and the structures for scrutiny and investigation are clean and regularly audited.
- An active risk register is regularly updated and shared. We still have a long way to go on our journey towards truly triangulated data. There is a real commitment to get there.
- We seek to learn and have a 'Best in Class' Research and QI Academy. We have regular sharing events – the question on all our lips is often “How do we truly learn?”
- We monitor safe staffing regularly; even more so at times of significant pressures.
- A Rapid Quality Impact assessment process, which ensures that rapid change can take place but must be monitored for quality with regular post change follow up.
We are not alone – many trusts share these traits. So what do our staff say about this? Our staff survey (68% participation) shows our staff believe we are safe. We have a larger than normal network of Freedom to Speak Up Guardians and consistently perform well nationally in the annual guardians’ survey.
So, what’s the problem – our safety climate is good by all agreed measures? But is it as good as it can be? The key players who can comment on whether we are safe are those delivering care and those receiving it – our community.
Our wider community are central to what we do. We have a really ground-breaking community and patient engagement programme. It is the belief of our senior team that complaints are a gift of feedback that help us learn and can shine a light on safety concerns. We take these seriously. When a complaint is made our patient experience team will ask the question “How can we make this it better?” as this will help us learn and improve the experience for other people. Again, it is not perfect but comes from a place of positive intent and partnership.
Although staff say the organisation is safe, we have never asked them what that means. We have yet to get them to describe what is safe in their team and what is not safe. It is only from this perspective of safety in the ‘work as done' that an organisation can understand what the real issues are. Through this approach we can support staff to be not just the eyes and ears of safety but the mechanism of making their world safer. The learning across teams could truly drive change across our clinical teams.
It was from this position that I decided to undertake a series of “Safety Chats” in clinical areas. A brief outline of them is below but these will be covered in the next blog in this series.
If you would like to discuss Safety Chats further, please email me at: Gina.Winter-Bates@solent.nhs.uk
Other blogs in the Safety Chat series
- Safety Chats blog series: Part 1
- Part 3 - Starting the conversation
- Part 4 - Talking about safety and creating safer environments
About the Author
I have been a nurse for 25 years with experience in acute and community care. I specialised as a cardiac nurse practitioner in ED and as a diabetes specialist nurse in the community and acute settings.
Throughout my career, patient safety, governance and service improvement has been key elements of my interest. I believe that engaging with our people and respecting their knowledge is key to quality improvement. I work closely with colleagues in education, equality and diversity, Just Culture and psychological safety to ensure that we are continuously improving. I am a very proud Florence Nightingale Foundation Scholar (2021/22).
I want to be part of an NHS that will look after people safely when they need it which is what drives my passion at work. I am married with adult sons and a granddaughter.
Linkedin: Gina Winter-Bates