Patient Safety Events

Are you ready for the changes ahead regarding incident investigations and management?

Expectations about how incidents will be investigated are changing, including greater emphasis on proactive safety improvement activity. 

The expectations and requirements will be clear once the Patient Safety Incident Response Framework is fully launched in 2021. 

We went to start preparing out staff for the new Framework now as we know that the following will  be expected:

• A stronger emphasis on Safety culture
• Meaningful family and patient engagement in the investigative process
• Proportionality, i.e. ensuring that in-depth investigations are instructed when there is a clear indication to do so, and there is opportunity for concrete learning alongside, quality and safety improvement
• Investigation leads have been trained by someone competent to do so, and so have the necessary competencies to conduct more in-depth investigations following incidents of harm and serious near miss events
• Time is made for investigation leads to undertake their investigation role well
• Trusts can demonstrate measurable improvement in safety and quality because of the investigations conducted
• Root Cause Analysis will no longer be used, mostly because it has been consistently misused