Can digital technology help embed a strong patient safety culture?

Within a few months of joining Great Ormond Street Hospital Foundation Trust as medical director, Mat Shaw became its chief executive. Heading up the organisation clearly brought with it new responsibilities and challenges, yet he says on one important issue there was little difference between the two roles – namely, the focus on patient safety and enabling clinicians to offer the best possible care for patients.

“I lived through the time when all notes were on paper, when you had five, six volumes of thousands of pages. I lived through that time when it was very difficult to actually know what information to collect, and from where you should collect it, to make decisions around patients. And I recognise we don’t always do the right thing based on those systems.

“So for me it’s been tremendously important to try and bring a system in, and the digital tools which are needed, to make care kinder and also safer, with better outcomes for patients. In our new strategy, digital is front and centre in a way that it’s never been before, because I consider this agenda so important to how we treat patients.”

Mr Shaw was speaking at an HSJ webinar in early December. Run in association with Capsule Technologies, it considered whether digital technology might help embed a strong patient safety culture.

A constant mission

High profile and continuing failures in recent years – including, just two days after the webinar, the full details of two decades’ worth of unavoidable harm to mothers and babies at The Shrewsbury and Telford Hospital Trust – have made clear that creating such a culture throughout the service is a constant mission.

‘Bringing our electronic patient record live was probably one of the most culturally beneficial and bonding moments for the organisation’ 

Adam Thomas – who began his career in the NHS as a pharmacist, and who is now chief information officer at The Dudley Group FT – was clear that there have been changes in recent years. “The culture has evolved in many healthcare settings across the globe from one where culpability was a concern. That caused a lack of transparency, and we’ve moved that forward to learning much better from our mistakes.

“But that’s still a reactive, or responsive, way of dealing with things,” he contended during the webinar. “I think the ability to capture information, look at it in a proactive manner, and take insights from patterns and trends that we’re seeing, and then address it is central.”

John Zaleski was in full agreement. “It’s not about simply looking at where the sky has fallen with a patient,” said Dr Zaleski, a practising clinician as well as head of clinical informatics at Capsule Technologies.

“It’s about identifying those elements that, when taken together, identify that this patient is either evolving or devolving. If we can prevent patients from devolving, then the likelihood these patients will survive is higher and we can also prevent patients from having an extended length of stay.”

Digital solutions could certainly help here: presenting pertinent information to clinicians in a swifter, more comprehensible fashion. Yet Mr Shaw argued the benefits of such tools to patient safety can extend far beyond supporting better decision making.

“For me, bringing our electronic patient record live was probably one of the most culturally beneficial and bonding moments for the organisation and probably one of the most transformational elements that we could ever have had,” he said.

“It was something to focus around, and everybody bought in to the fact this was better than what we had before, and this would bring patient benefit.

“I think it has really galvanised people around their ability to change how they work, how they change the pathways and how children flow in the hospital, and how we can use this digital tool to learn from things that don’t go right in the organisation, which happens in every organisation.”

The potential benefits of digital solutions to not only safety culture but to staff culture more broadly was a theme echoed by Dr Zaleski.

“It’s not just one or two parameters, it’s not just: ‘Well, we’re reducing length of stay.’ It’s improving the staff satisfaction, it’s improving the response time, it’s improving quality from the perspective of reducing time to respond to specific patient issues, improving the patient satisfaction associated with the environment. It’s a team level, systemic level, culture improvement.”