The NHS Safety Thermometer 10 Steps to Success Series! Step 3 What is the NHS Safety Thermometer?

Journey so far: Nurse Sensitive Indicators, NHS Safety Thermometer & E4E Nurse sensitive indicators 2009 Pressure Ulcers Falls Catheters & urine VTE Linking in with E4E & QIPP safe care 2010 Pilot Monthly data collection Sept 2010 NHS ST For Safety Express Inclusion in NHS Operating Framework

Design Principles 1.The instrument must be patient focussed and measure harm free care (the absence of all four harms) as well as the individual harms. 2.The instrument must be clinically valid with pragmatic, clear operational definitions for each harm. 3.The instrument must be efficient; not take longer than 10 minutes per patient (preferably shorter) and fit within the daily work flow of frontline clinicians. 4.The instrument must be equitable and capable of being used wherever the patient is located (home, community or hospital setting) 5.The instrument must give a timely summary of results which can be used for teams in their improvement work 6.The data collected using the instrument must be easy to aggregate to show results at ward, organisation, region and national level.

Construct and Development in 2011

Point Estimate 100% of appropriate patients surveyed on ONE day per month Harm Free Care Pressure Ulcers Falls Catheters & Urine Infection VTE Prevalence & Incidence

The NHS Safety Thermometer measuring ‘harmfreecare’ at the point of care  Measures patients that are ‘harm free’ at the point of care in a systematic way  Asks questions about four key outcomes:  Pressure ulcers  Falls  Urinary infection  VTE  Integrates measurement into daily routines  Supports improvements in patient care and patient experience  Prompts immediate actions by healthcare staff  Allows us to measure in any setting where care is being delivered  Available to all from A call to action for frontline healthcare professionals Salford Royal NHS Foundation Trust are one of 170 organisations that are currently using the NHS Safety Thermometer once per month to rapidly review the proportion of patients free from harm

Standard Operational Definitions Focussed on high volume harm Complete in less than 10 mins per patient Use in all care settings Local data collection by frontline teams Auto Analysis & Graph Data Merge / Aggregation Features of the NHS ST NationalRegionalLocal

What are the Primary Outcome Measures? How can we look at the data? For each measure we can look at the proportion of patients or the number of patients Pressure Ulcers AgeSexLocationSpecialtyCategory II-IV New (Incidence) OldAll (Prevalence) Harm from Falls in a care setting (in the last 72 hours) AgeSexLocationSpecialtyHarm from falls Low harm - death Treatment of Urine Infection (in patients with urinary catheter) AgeSexLocationSpecialtyNew and old UTI Length of time in situ Treatment of new VTE AgeSexLocationSpecialtyNew VTEPE, DVT or other Harm Free Care (absence of above) AgeSexLocationSpecialtyAll harmsNo harmsNew Harms What are the Secondary Measures? For each measure we can look at the proportion or the number of patients Falls AgeSexLocationSpecialtyWithin 72 hours No harm - Death Urinary Catheters AgeSexLocationSpecialtyLength of time in situ VTE Risk Assessment AgeSexLocationSpecialtyYes, no, n/a VTE Prophylaxis AgeSexLocationSpecialtyYes, no, n/a Treatment of VTE AgeSexLocationSpecialtyOld and New VTE PE, DVT or other

Pressure ulcers Falls Urinary infections (in patients with catheters) VTE Harmfreecare Absence of harm from