References

Australian Commission on Safety and Quality in Health Care. Communicating for safety: improving clinical communication, collaboration, and teamwork in Australian health services. 2020. https://tinyurl.com/yckvxw68 (accessed 30 March 2022)

Australian Commission on Safety and Quality in Health Care. Communicating with patients and colleagues. 2022. https://tinyurl.com/34fbndun (accessed 30 March 2022)

Care Quality Commission. Opening the door to change. NHS safety culture and the need for transformation. 2018. https://tinyurl.com/mrxkznhy (accessed 30 March 2022)

Supporting clinicians through complaints. 2022. https://tinyurl.com/bdhr4wfx (accessed 30 March 2022)

NHS Resolution. Did you know? Extravasation. 2022. https://tinyurl.com/2vp9xe38 (accessed 30 March 2022)

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Improving patient safety by learning from the experiences of others

07 April 2022
5 min read
Volume 31 · Issue 7

Abstract

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses ways of approaching the myriad of patient safety reports that are published and looks at some useful publications

I have written in previous columns about the veritable tide of patient safety and health quality reports that are regularly published, along with the difficulties busy nurses and doctors face in unpacking and applying these to their practice. Working out which publications are authoritative can be a serious challenge in a busy NHS where staff have many competing calls on their time. The seminal Care Quality Commission (CQC) report, Opening the Door to Change (CQC, 2018), articulated these difficulties well. The problems of trust information overload, time, resources, and priority setting was discussed:

‘Trusts receive too many safety-related messages from too many different sources. The trusts we spoke to said there needed to be better communication and coordination between national bodies, and greater clarity around the roles of the various organisations that send these messages.’

CQC, 2018: 23

The CQC (2018) makes this point well. Those involved with patient safety and health quality policy development and practice can often see a tide or even a tsunami of patient safety and health quality publications regularly descending on trusts and staff from a myriad sources. The organisations and writers behind these reports may also have their own agendas and it is important to recognise this and be able to weigh up their value. Nurses and other health staff face difficulties in absorbing and acting upon the key patient safety and health quality information due to time and resource constraints. Research databases, respected online sources and books, as well as professional journals, can all help when developing patient safety policy and practice.

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