Patient safety and experience: our response to COVID-19
Failure to recognise or act on signs of deterioration can result in missed opportunities to provide necessary care and give patients the best possible chance of survival (Patient Safety Alerts 2016, 2018). This area therefore continues to be a major patient safety priority for the NHS during the COVID-19 outbreak. A good system of managing deterioration includes processes and solutions that enable:
- Early detection of physical deterioration. This includes a physiology assessment and early warning tools such as soft signs and the NEWS2 score. A growing number of digital solutions to support these processes are also available.
- An understanding of what is “normal” for a resident.
- Staff knowing what to do next if a person’s health deteriorates. Agreed escalation processes are required, including end-of-life preferences, advanced care and treatment escalation plans.
- Staff to effectively communicate their concerns. This includes human factors and structured communication.
We already have a south London Managing Deterioration improvement programme as part of the national patient safety improvement work. Consequently, our team is contributing to national developments and assisting regional and local efforts aimed at optimising patient outcomes during the pandemic. We are also building connections with a growing number of digital projects aimed at enabling remote assessment and monitoring of patients within the community setting.
Our Programme Director for Patient Safety and Experience, Catherine Dale, is a national co-lead for the Patient Safety Collaboratives on deterioration and was instrumental in the delivery of a very successful national webinar for GPs working hard at the front line to tackle COVID-19.
We are supporting four units in south London to adopt a standardised assessment and triage system called The Birmingham Symptom-specific Obstetric Triage System (BSOTS). This provides a framework for women to be assessed quickly and reliably when presenting with concerns and those who need urgent care are prioritised, rather than reviewing women in order of attendance.
We have also been supporting the spread of the QUiPP app – a locally born clinical decision-support tool that helps to predict the likelihood of preterm delivery when a woman presents at hospital. The supporting toolkit for adoption has been rapidly rolled out during the pandemic as this innovation helps to decrease unnecessary admissions and transfers.
In partnership with our London colleagues, we have also begun to consider safety practices and cultures in maternity and neonatal care in the coming months as we enter the next phase of the pandemic.
We are are working with trusts who are yet to establish TCAM schemes by engaging with hospital pharmacists, community pharmacists and local pharmaceutical committees (LPCs) in those areas.
High quality, safe care can be achieved through preparation, planning and education; the National Patient Safety Improvement Programme has created this important national program to rapidly develop the skills and knowledge for bedside staff to deliver safe tracheostomy care everywhere.”
Brendan McGrath – National Clinical Advisor for National Patient Safety Improvement Programme Covid-19 Response (Safe Tracheostomy Care); Intensive Care Consultant, Manchester University NHS FT