#WeNurses - Thursday 13th September 2018 8pm (GMT Standard Time) In the name of safety?

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Hosted by WeNurses using #WeNurses

This chat is guest hosted by @DrGillianJanes

In the name of safety? – identifying and letting go of low value safety practices

There is a tendency in the NHS to add more initiatives, protocols and interventions in an attempt to make care safer. Not only does this require more of already time-pressured staff but such processes and practices are not always evidence based or proven to actually enhance safety despite becoming embedded within the team and organisational culture.

Work is underway to actively discourage the use of ineffective or harmful clinical treatments and practices. However we need to do likewise with non-clinical safety practices, rules and procedures that do not necessarily improve safety or no longer add value if we are to build a safer healthcare system, improve the process of care and reduce costs.

With no common language for this approach of stopping low value safety practice, over 40 terms have been used to describe it, including: de-implementation, disinvestment, de-commissioning and mindful forgetting approach (Coiera, 2017). However, developing and embedding the principles of this approach in organisations could help create the space and time needed for frontline staff to deliver safer, patient-centred care. Research indicates that a conscious decision-making process is needed for individuals to let go of low-value safety practices and therefore concerted effort may be required to achieve this in practice.

We are researchers from @YH_PSTRC seeking to facilitate and investigate the impact of stopping low value safety practices in the NHS as a means of enhancing patient safety. We are keen to discuss some of the following areas with NHS clinicians and other staff during this session:

  1. What is it about this topic that made you want to join the TweetChat? 
  2. What’s good/not so good about terms like: low-value, de-implementation, disinvestment, de-commissioning, mindful forgetting etc used to describe this topic?
  3. How might we engage other staff to submit ideas and get involved?
  4. Themes emerging from some of our early responses eg. Duplication, ‘one size fits all’ KPIs, and approach to risk assessments

More background information / wider reading on this topic can be found at: http://yhpstrc.org/2018/03/02/in-the-name-of-safety/      


Coiera E (2017)The forgetting health system Learn Health Sys. 2017;1:e10023.p1-6 https://doi.org/10.1002/lrh2.10023

About our guest host

Gillian Janes is a Senior Research Fellow in the recently established NIHR Yorkshire & Humber Patient Safety Translational Research Centre (http://www.yhpstrc.org), working primarily on the workforce engagement and wellbeing theme. She is a Registered General Nurse with over 35 years’ experience as a clinician, service manager, healthcare educator and researcher encompassing acute and renal medicine, General Practice, Public Health and Higher Education. She has provided quality improvement and Higher Education consultancy for the NHS Institute for Innovation and Improvement, private, social enterprise, Higher Education and NHS organisations and was a member of the National Reference Group for Service Improvement. She has developed applied quality, safety and governance leadership programmes, including a nationally recognised Postgraduate Certificate in Human Factors in Health and Social Care. Gillian is a Senior Fellow of the Higher Education Academy, past Fellow of the Centre for Excellence in Teaching and Learning in the Health Professions (CETL4HealthNE) and member of the NHS England/Health Foundation Q Founding Cohort. She has strategic change experience as a member of Primary Care Trust, University and Academic Health Sciences Network/Patient Safety Collaborative/Q/HealthEducation England North East executive steering groups. Her PhD explored the Silences inherent in patient recovery experiences and role of social and professional norms in this. 

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