• Past harm: this encompasses both psychological and physical measures.
• Reliability: this is defined as ‘failure free operation over time’ and applies to measures of behaviour, processes and systems.
• Sensitivity to operations: the information and capacity to monitor safety on an hourly or daily basis.
• Anticipation and preparedness: the ability to anticipate, and be prepared for, problems.
• Integration and learning: the ability to respond to, and improve from, safety information.

• falls with injury by 39%
• pressure injury rates by 37%
• central line–associated blood stream infections by 34%.

They also improved medication reconciliation rate by 3.3% and decreased their irretrievable specimen rate to 0.

Finally, they noted increased awareness around patient safety within clinical teams, with open discussions about patient safety becoming a routine part of patient care.

Read the summary via the link below (full access is paywalled). Authors conclude by highlighting the learning for patient safety that could be applied by peers.

• The study found successful strategies are typically associated with a concert of activities that simultaneously ensure sufficient supply of health care, manage demand and optimise the conditions within the health care system itself. 
• In England in the 2000s, a number of activities were associated with reduced waiting times. These activities were concentrated within the categories of increasing supply and optimising conditions within the health care system itself to achieve the goal of an 18‑week referral to treatment target by 2008. These activities were underpinned by a bigger idea about what the health service as a whole should look and feel like, and incorporated how waiting times are brought down as much as what activities might be used.
• For the experts interviewed, the achievement of the 18 weeks target was made possible as a result of: valuing and investing in people working in the NHS; a clear, central vision and goal for waiting and an ambition that those working within health care felt equipped to take on; cultivating relationships and leadership at all levels of the health care system; accountability, incentives and targeted support to encourage performance against waiting times targets and other measures of quality of care; and seizing the momentum of wider NHS reform. 
• Whereas the improvement in waiting times performance of nearly 20 years ago took place in a very different political and economic context, the research highlighted not only hope but opportunities to reduce waiting times in the present day: by addressing shortages of health care staff and physical resources urgently; by working with integrated care systems in the spirit of prevention, collaboration, inclusion and community‑based models of care; and by aligning a vision for the health services with a plan that brings staff, patients and the public along on the journey to get there. 

1. Working with health bodies to set appropriately ambitious delivery targets.
2. Producing a clear funding strategy including long term capital investment.
3. Developing a workforce plan to build and maintain planned care capacity.
4. Implementing system leadership arrangements to drive through the plan.
5. Ensuring its arrangements focus on managing clinical risks associated with long waits, supporting patients while they wait, and delivering care efficiently and effectively.