This is the 81st #WILTW

Winter pressures are right on top of emergency and urgent care services at present with hospitals and community practices throughout the UK  experiencing high demand and high acuity in a system that is already working at capacity.  Clearly maintaining patient safety in this stressed system is vitally important. I chanced upon an interesting view point from Charles Vincent in a Health Foundation blog this week:

“Very few safety strategies are aimed at managing risk in the often complex and adverse daily working conditions of health care”

He argues that current strategies are often designed in ideal environments working in optimum conditions and explores the need to identify and respond to risk in the ‘real world’.

This struck a chord as often health care providers develop specific escalation polices for adverse times only during, or after, these events have taken place. This, on reflection, is a little binary. The ‘real’ world isn’t split between normal practice vs extreme events.  While we might aim to grade our response to avoid this dichotomy (in terms of when to contact seniors, where to re-direct flow and who to move into different areas etc.)  the ‘real’ world is a variable and dynamic place.

Furthermore Vincent argued that sometimes the actions clinicians and managers take to avoid risk are not always seen under the umbrella of patient safety (and vice-versa). To explore some of the differences the Health Foundation have created a checklist for safety solutions. While it is not immediately obvious how some of the points are directly applicable to a winter crisis the checklist is food for thought in looking at risk and improving safety in any situation.

What have you learnt this week? #WILTW