Improving Healthcare With Safety1st

Over almost two years (from 1 January 2015 to 30 November 2016), 58,157 forms were entered into Safety1st, the South Island DHBs incident risk management system. These forms provide valuable information that can be used to inform and support local improvements. Below are a few examples of how South Island DHBs are using this data to make improvements in their local areas. 

Patient falls targeted with Safety1st at Southern DHB

Planning ahead to prevent patient falls is a more streamlined process for Southern DHB, using integrated incident and risk management system, Safety1^st.

Kim Caffell, Patient Safety and Policy Advisor, says a lot of work has been done using the data from an organisational perspective, since the system was implemented. “We use Safety1st data extracted each month for falls to populate a template, which I update each month and send out to staff. This gives each ward/unit a view of the total falls for their area, as well as the total falls for each DHB since March 2015. It also details the numbers for the previous month, date of the last assessment, falls with and without injury, the time of day each fall happened, and the contributory factors.”

She says one of the most significant uses of the system is being able to show staff what organisational data looks like. “If I have any discussions around falls, I will usually ask – when do you think the falls occur? And they would often say ‘at night or first thing in the morning.’ But Safety1^st data categorically shows that falls are pretty evenly spread across the day and there are some months that the morning shift is the biggest problem for our fall patients.”

The system is starting to dispel myths and has inspired staff to think outside the square, Kim says. “We then have a discussion about the data – I ask, what can you do with that information? How can you do things differently? It’s about getting them to think about what the data is telling them – it’s not about placing blame. The data is there to tell a story and help identify opportunities for improvement.”

Streamlined system supports improvements at West Coast DHB

For West Coast DHB, one of the greatest advantages of Safety1^st is the ability to provide evidence to support progress and quality improvement.

Vicki Piner, Safety1^st Administrator, says when you can see multiple incidents pointing towards a particular theme, it’s easier to make effective change. “Safety1^st is vastly superior to our previous manual system, as it’s a central repository. We are able to interrogate the system to provide real evidence supporting our incident claims, which before were little bits of disparate information, and sometimes anecdotal.” 

Recently, the DHB has been able to interrogate the system to determine how many employee incidents are related to manual handling technique/use of equipment, she says. “Safety1^st has provided evidence from across the broad spectrum of WCDHB services and has identified where training needs to be targeted. This has a real benefit to our staff’s health and safety.”

Safety1^st is used across both primary and secondary care services provided on the West Coast, which means any incident overlaps can be dealt with promptly. Rolling out the system across both sectors has enabled a more streamlined approach to service delivery between primary and secondary care, Vicki says. “Incidents once investigated by the manager of the area in which it occurred are then brought to a multi-disciplinary incident review group and reviewed.  Representatives from all service areas are present at these meetings, which means we can often look at where we can improve the patient journey through the whole health system.  It also provides us with an opportunity to put a timely solution into place.” 

Safety1^st has been well received, she says, as staff submitting files can see that they are contributing to effective change.  “It also makes auditing easier. The information we get is backed by evidence, which shows where we need to put our focus to fine tune how we use our resources. Staff really appreciate it and are always eager to have meaningful data to back up what was previously just a bit of anecdotal evidence here, there and everywhere.”

Rich, timely data increases efficiency at Canterbury DHB

The timeliness of Safety1^st ensures a clear snapshot of what’s happening at any given time, says Vicki Dent, Canterbury DHB Clinical Manager for the Quality and Patient Safety team. “In terms of having real data, it means we can see instantly which areas we need to focus on.”

She says when concerns are raised at unit level regarding the challenges raised by acuity, it is visible straight away from the data. “As soon as a staff member enters an incident, the clinical and charge nurse managers, the Service Leadership teams and the Quality and Safety team can see it. We have a much, much better sense of how the incident levels are looking, what’s happening for staff, and what’s going on from a patient safety perspective.”

Previous to the roll-out of Safety1^st, staff were required to fill out an incident form or staff accident form, which was then submitted to their manager, and investigated. “The information would then be sent to the Quality and Safety team, who would review it and enter it into a database,” Vicki says. “The whole process would probably put us about three months behind in terms of knowing what’s happening right now. The data we pull off now is so much richer and the timeliness of the information is of huge benefit.”

Table timeline: 1 January 2015 to 30 November 2016

About Safety1st

Safety1^st is an online incident risk management system created specifically for healthcare. It supports users to improve processes to prevent harm and errors, improve safety, and manage risk more effectively – from identification through to resolution. The incident management component of the application is now in use across the five South Island DHBs.