Medicines

Greater Manchester and Eastern Cheshire Patient Safety Collaborative

The National Patient Safety Improvement Programmes (NatPatSIPs) five programmes of work collectively form the largest safety initiative in the history of the NHS. They support a culture of safety, continuous learning and sustainable improvement across the healthcare system

The aims of the medicines safety programme are:

  1. To reduce medicine administration errors in care homes by 50% by March 2024.
  2. To reduce harm from opioid medicines by reducing high dose prescribing (>120mg oral Morphine equivalent), for non-cancer pain by 50%, by March 2024

Reduce severe avoidable medication-related harm by 50% by 2024

  • Safety huddles
  • Learning from errors
  • Managing interruptions
  • 3 way communication

This workstream will conduct a diagnostic phase consisting of:

  • Scoping current provision for alternatives to opioid prescribing
  • Gaining an understanding of variation in demographics and health inequalities
  • Identifying effective ways to segment the affected population by need and harm
  • Identifying networks, partners, levers and opportunities in the system that will support a culture around the safer prescription of opioids
  • Identifying effective-interventions that lead to a reduction in opioid prescribing for chronic non-cancer pain
  • Diagnostic phase to identify system levers and potential tests of change
  • Reduce inappropriate polypharmacy.
  • Safer use of anti-coagulants

Care Homes across GMEC will be invited to take part in one of 2 cohorts of supportive education and coaching (lasting 6 months) around building workforce capability and capacity in patient safety and quality improvement (QI). The rationale for two cohorts is to test interventions (secondary drivers) from the driver diagram in the first cohort of homes and then repeat in a second cohort of homes to establish whether the interventions are transferable to a second set of homes. i.e. lend themselves to repeatable improvement and therefore national scale up.

We will employ a dosing approach to capability and capacity building and leadership as follows:

  • Each of the care homes that takes part will have free access for all staff to a full day training “Introduction to Patient Safety and Quality Improvement”
  • Each of the care homes that takes part will nominate a member of staff for the home/unit to become a “Safety Champion”.  This individual will undergo free education and coaching over a 6 month period in patient safety and QI.  These individuals will be supported to lead the implementation of intervention(s) (secondary drivers) from the driver diagram within their home/unit and measure whether the change has led to improvement (using the Model for Improvement). The care home will receive a grant from the PSC to reflect the front line staff time involved in becoming a Safety Champion.
  • Each locality that has care homes taking part will be offered free attendance on the Advanced Improvement Practitioner training (12months) for ONE individual that holds a leadership position supporting care homes across that locality.

The aim of this intervention is to develop a leadership role in safety and QI in care homes. To maximise the support for this role we will provide education of all staff within the home/ provider as well as the leadership at locality level.

The Safety Champion will be coached and supported to lead the implementation of an intervention from the secondary drivers within their home. They will be supported to use the “Model for Improvement” to develop the intervention and also to measure if the change has led to improvement. We will also undertake the “Safety Attitudes Questionnaire” at the start/ onboarding and offboarding of the home in order to establish a baseline that is indicative of the safety culture in the care homes which are engaged in the programme, using this to measure impact of the programme on the homes’ safety culture.

In Greater Manchester and Easter Cheshire (GMEC) the Medicines Safety Improvement Programme is delivered by Health Innovation Manchester (HInM) under the leadership of Simon Hammond (Senior Programme Development Lead).

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