Read This: Noticeboards Save Hospital Lives
A hospital has cut its death rate dramatically by posting notices in wards reminding staff of basic safety measures. The rate at Luton and Dunstable Hospital in Bedfordshire plummeted 16 per cent in two years, after doctors and nurses were warned to wash their hands between patients, check drugs before dispensing them and mark patients correctly for surgery.
The “back to basics” approach pioneered by the hospital is in the vanguard of a global campaign to improve patient safety with the potential to save thousands of lives, and millions of patients from harm.
Experts led by Sir Liam Donaldson, Britain’s chief medical officer, say hospitals must be run like airlines, with doctors and nurses checking what they do as pilots check their aircraft before take-off.
Almost one million NHS patients a year suffer damage caused by errors in their treatment, and more than 2,000 die as a result. Half of all incidents could have been avoided if staff had learnt the lessons of previous mistakes, the National Audit Office said last year.
At Luton and Dunstable Hospital, the radical scheme imported from the US has saved lives, cut infections and is on course to halve the number of medical mistakes. The corridors and wards of the 550-bed hospital, built in the 1940s, are festooned with notices urging its 3,500 staff to “Fight infection – use alcohol gel”. Charts comparing the performance of doctors and nurses at cleaning their hands – doctors are worse – and recording the results of regular monthly surveys are on display.
As cleanliness has improved, MRSA infections have fallen to an average of less than two a month and are the lowest in the eastern region. In the intensive care unit, Mark Patten, consultant anaesthetist, studies a chart pinned to a noticeboard revealing a rise in “central line” infections. A printed note says the latest infection was caused by saliva running down the patient’s chin contaminating the catheter where it entered the neck, and advises using an antiseptic patch on the wound.
Dr Patten said: “Before we started this, we would have just shrugged and said the infection was one of those things. Now we look for a reason. Medicine suffers from technology creep. Some things are simple but we have been blinded by rocket science from doing them.”
The Safer Patients Initiative is not about hi-tech equipment, powerful drugs or heroic surgery but good hygiene, accurate prescribing and the avoidance of errors. On medical wards, nurses are preventing up to two cardiac arrests a week simply by checking pulse, blood pressure and temperature to detect when patients are “going off” (the term used by doctors), checks that should always be made but often are not.
Stephen Ramsden, chief executive of the trust, said: “We used to talk about risk management; it was defensive. Now we talk about patient safety; it is pro-active. It’s a transformation in the culture. Our death rates were 11 per cent worse than average and are now 5 per cent better than average. In the past quarter, they were 20 per cent better. If we can sustain that it would be quite dramatic.”
Luton is among four UK hospitals piloting the scheme, devised by the University of Boston’s Institute of Health Improvement in the US where it is estimated to have saved 122,000 lives. In the UK, the results after two years are so impressive it is being rolled out to 20 more hospitals. Another hospital in the scheme, Tayside University Hospitals Trust in Dundee, cut its medical error rate by almost three quarters.
Stephen Thornton, chief executive of the Health Foundation, a charity which is funding the project, said: “Hospitals are dangerous places. Our contention is that they don’t have to be. In 20 years we will look back and wonder at how risky they were. People will ask why we put up with it.”