The Northern Health and Social Care Trust was established in April 2007 and is one of the five health and social care trusts in Northern Ireland. Serving a population of approximately 465,000 people, it provides a wide range of hospital services, community care and social services. The trust currently employs more than 11,000 staff, who work across a range of disciplines and professions including nurses, social workers, doctors, allied health professionals and many other technical and support staff.
Olive MacLeod took up the post of director of nursing and user experience in August 2011 and has responsibility for nurses, midwives, allied health professionals and corporate support services. Patient safety has always been the central focus of her work and since taking up post she has worked to build a culture of openness, transparency and debate. She plans to drive forward further and sustained improvements in quality and safety for all service users. Her vision is one of a forward-looking organisation that is working for, and in partnership with, its community to respond to the challenges it faces.
The overall aim of the trust is to improve the health of the population through providing excellent services that make best use of available resources. Olive says: “We seek to support clinical staff to design services that are fit for purpose, and staff working in the trust have a vital contribution to make.
“Care must be timely, safe and efficient and our frontline staff best understand the needs of patients. The trust’s person-centred ethos aims to put patients at the centre of everything we do and to ensure they are treated quickly and effectively. The trust also understands that patients must be provided with information in a format they can understand, enabling them to make informed decisions and judgements that encourage and promote as much control over their care as possible.”
The trust is continuously looking at how real-time improvement can be measured in order to assist teams in the delivery of safe patient care and improve performance.
Olive says: “We measure the things we do well, as well as the things that are not done so well. We work alongside teams to gather relevant, current data, and develop staff to use this information to drive actions that deliver real benefits and learning. If people make a mistake we want them to feel empowered to admit this without fear of recrimination, and safe in the knowledge that it will be a learning experience.”
Olive believes the emphasis on safety is maintained through conversations with staff about core values and by harnessing their dedication and commitment. To this end focus groups and forums have been established in order to ensure staff at all levels have their voice heard. She says: “Such an approach enables me to establish how change is unfolding and if the change is an improvement.”
The trust holds safety meetings each morning with ward sisters, allied health professionals, corporate support services, chaplains and management staff, at which the past 24 hours is reviewed. The team works together to solve any identified issues. Feedback from staff suggests that they feel more connected and together can try to think about ways of working smarter.
Ensuring that the right people, are in the right place, at the right time, with the right skills is another important aspect of patient safety. Olive says: “It is crucial that staff are appropriately trained, are in the right roles and have real-time data at their fingertips’.
The trust has a seven-day work plan that is now being rolled out to all clinical teams. It has seen improvements for patients with mental health needs, through the introduction of a Rapid Assessment Interface Discharge (RAID) system. This initiative has been put in place to better meet the needs of patients who present to the emergency department with mental health problems. Prior to the introduction of the RAID team, patients had to wait to be seen by a doctor and then the crisis response team. Olive says: “We have a very high satisfaction rate from both patients and staff, as patients can quickly be assessed and a safety plan agreed with their involvement.”
Strong leadership is vital to building and maintaining the momentum in relation to patient safety. Olive says: “Staff need to feel that they can speak with managers at all levels of the organisation.” The trust encourages staff to bring forward creative and innovative ideas to improve services.”
