NHS should demand more as customer, says report
Work proposed in the Design for
Patient Safety report includes:
· Map the medicine
use process across all health care environments
· Proactively identify high-risk
situations
· Develop a body of best
practice evidence on how to design for patient safety
· Integrate medicine protocols
with patients’ medication charts
· Develop “usability” criteria
for packaging, information and the form of the
medicine
· Train all health
care staff in risk assessment techniques
· Encourage the NHS
to use its collective purchasing power to
influence manufacturers’ designs
· Establish a strategic advisory panel to
oversee a design-led approach to patient safety
|
Procurement staff should use the buying power of the NHS to make more demands on suppliers, according to Peter Buckle, director of the Robens Centre for Health Ergonomics, University of Surrey, and one of the authors of the “Design for Patient Safety” report. The report, which
was launched at the National Patient Safety Agency conference in Birmingham
in late February, was commissioned jointly by the Department of Health
and the Design Council.
The Ministry of Defence, for example, issues specifications which manufacturers
must adhere to if the ministry is to purchase their products, said Professor
Buckle. He suggested that NHS procurement staff should tell manufacturers
what safety design features should be included in packaging and labelling
to enable a product to be bought by the NHS. Another author, Roger Coleman,
professor of inclusive design at the Helen Hamlyn Research Centre, Royal
College of Art, said that a shift in thinking was required among manufacturers
to compete on the grounds of the safety of their product.
Sir Liam Donaldson, chief medical officer, Department of Health, stressed
that while there are occasions where individuals have to be held to account
for their mistakes, the vast majority of human errors are as a result of
poorly designed systems.
The report calls on the NHS to emulate the approach taken by other high-risk
industries, eg, nuclear and aviation, and inform the design process by
learning precisely how the different parts of the organisation function
and interact with each other. This includes reviewing all interactions
between patients and the health care system and connections between different
parts of the health service.
The report also proposes that there should also be a change in philosophy
from recording and reporting errors after they occur, to risk assessments
and changing practice to prevent the errors occurring at all.
Allan Karr, pharmacy business services manager at University College London
Hospitals NHS Trust and chair of the Guild of Healthcare Pharmacists Procurement
and Distribution Special Interest Group, commented that NHS procurement
and quality assurance staff from the North of England are already in the
process of developing systems to assess risk for all contracted products.
The risk assessments are intended to be made available for suppliers to
consider, so that they are aware of where improvements could be made to
their products. A similar process is also being developed in London for
unlicensed medicines. Both schemes, once fully tested, are expected to
be rolled out nationally, he said. |
Hospital Pharmacist