Introducing the Patient Safety Toolkit
The prevention of errors and adverse effects for patients is a priority for all GPs. Safety problems can happen anywhere in primary care, and these problems may occasionally result in serious harm and potentially death. A safety incident can also be a cause of emotional distress for patients and for the doctors involved.
The Patient Safety Toolkit, created in collaboration with the NIHR School for Primary Care and NIHR Greater Manchester Primary Care Patient safety Translational Research Centre, has been designed to help all staff within a practice to create a safer environment for patients.
Although widespread attention is given to patient safety in secondary care, it is becoming increasingly important for primary care to be aware of the issues involved. General practices are now facing an ever increasing workload, without the necessary increase in staff to match. Between 2008/09 and 2013/14, the number of GP consultations in England rose by 19%. Case complexity also increased: the number of patients (in England) with multi-morbidities has risen and is set to increase by 53% between 2008 and 2018. Yet the number of headcount GPs in the UK only rose by 4.1% between 2008 and 2013. In 2013 across the UK, there were 1,481 patients for every GP – up from 1,420 in 2009.1 With this in mind, safe systems which are easy to implement and assess are imperative both for patient and staff wellbeing.
The tools can help in many different aspects of the practice including safe systems, safety culture, communication, patient reported problems, diagnostic safety and prescribing safety. They can be used individually, on an ad hoc basis or used together as part of an integrated patient safety agenda throughout the year.
These tools are:
- The Trigger Tool - an efficient way of performing a case note review to highlight any potential safety concerns. It can be used as a routine tool to screen for patient harm or patient safety incidents.
- Medicine Reconciliation Tool - assesses the safety of the interface between primary and secondary care in terms of the general practice role in medication reconciliation following a patient’s discharge from hospital.
- PC SafeQuest – an on-line anonymised questionnaire that can be used by all members of a general practice team. It allows staff to rate the perceived safety climate within their practice.
- Manchester Patient Safety Framework (MaPSaF) – designed to help organisations understand how safety is perceived by staff, it allows your practice groups to reflect on their safety culture.
- Prescribing Safety Indicators – a set of computerised indicators to assess prescribing safety. The package involves the use of CHART (Care and Health Analysis in Real Time) software to identify patients at risk of medication-related injury.
- The Concise Safe Systems Checklist – allows practices to think about those background systems which are important for patient safety, but are often overlooked. It is deliberately designed not to include items already covered by legislation or mandatory requirements.
- Safety Checklist for General Practice - identifies hazards across the wider work systems that may threaten patient safety, as well as those hazards that have an impact on the health, safety and well-being of all involved.
- Patient Reported Experiences of Safety in Primary Care (PREOS-PC) - a questionnaire for patients to record their experience with respect to patient safety in general practice.
Professor Tony Avery, Clinical Lead for the Patient Safety Toolkit, said, ‘We have developed and tested the Patient Safety Toolkit over a three-year period drawing upon expert opinion and advice from around the world. Interestingly some of the most important work has been done by NHS Education Scotland and we have adapted several of their tools for the toolkit. The various tools listed above have been tried out in up to 50 general practices in England with positive feedback. We hope that other practices will find the tools a useful resource for identifying and tackling patient safety issues.’
To find out more about the Patient Safety Toolkit
We are holding four free regional events, led by clinicians who have been involved with the development of the Patient Safety Toolkit. The day will start with an introduction of the toolkit and will then focus on specific tools and how they can be used in your practice.
These events will be held in Barnsley (facilitated by the Sheffield Faculty), Bristol (RCGP Wales office and Severn Faculty), Glasgow (West of Scotland Faculty) and East Midlands (Vale of Trent Faculty in association with Leicester Faculty).
For more information and to book a place:
1 Royal College of General Practitioners, Patient Safety implications of general practice workload, July 2015