Background to the Safer Patients Initiative:

The Health Foundation (an independent charity that aims to promote quality and safety in health services) has launched the Safer Patients Initiative.  They have selected four hospital trusts: Luton and Dunstable Hospital NHS Trust (England), NHS Tayside (Scotland), Conwy and Denbighshire NHS Trust (Wales) and Down Lisburn Health and Social Services Trust (Northern Ireland) to participate in the initiative. 

Our project will evaluate the Safer Patients Initiative (SPI); and aim’s to describe and assess the effects of this intervention and to explain (or theorise) why the interventions have worked in the way they have.

Proposed Methodology:

SPI can be categorised into two broad groups: "generic interventions" (e.g. patient safety walkrounds), which operate at a meso level (the organisational level between broad policy and practice) and center on management processes; and "specific interventions" (e.g ventilator bundles), which operate at a micro level and focus on specific clinical processes. This allows us to create an overall framework for our investigation and assists in the identification of those aspects that will be empirically observable and available for study. Building on this we have developed the following study design:

a) Generic management interventions:

i) Surveys to make quantitative comparisons of staff attitude and patient satisfaction in index and control hospitals;

ii) Stakeholder interviews to study fidelity of management practice to management plans in index hospitals only. Bayesian priors on SPI will also be elicited.

b) Specific interventions :

i) Case-note review to make a before and after evaluation of error rates in index and control hospitals;

ii) Ethnography to characterise organisational culture related to safety in acute medical wards in index hospitals;

iii) Evaluation of correct-site surgery in index hospitals and controls;

iv) Number of resuscitations (and success rate) taking place outside of ITU in index and control hospitals.