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Interim support on an electronic risk management system for a large acute trust

The Client

Large acute trust

Challenge

Governance issues

Over the last two years the trust board has undertaken a number of service improvement initiatives.  The trust asked Verita to provide interim support on its electronic risk management system (Safeguard) following concerns raised by staff. A number of concerns were raised about the quality of reports coming out of the system due to variation in figures.

The trust has been using the Safeguard system for a number of years. Historically the trust had a single person acting as the administrator with no other staff being allowed access to the system or shown how to manage it. When Verita was asked to support the trust it did not employ anyone who could manage the system.

The management itself had been haphazard. Crucial system upgrades had been slow or non-existent due to the lack of capacity. There were also instances of major changes to the system’s structure being made without clear processes and records being made. These changes made it difficult to reconcile data across the system.

Scope

Due to the nature of the issues the trust urgently needed to increase their capacity.  What they needed to achieve as a minimum was an assurance that the correct process and structures existed within the system to allow good quality data to be entered and retrieved.

Process

Verita sent one of our system experts to join the trust in an interim capacity. This member of staff assumed the role of the Safeguard administrator which allowed them to work directly with the Quality and Safety team to assess the problems and implement effective solutions for the system.

The approach taken by the system expert was focused on four main work streams:

  1. Structural – This involved a root and branch review of the system to identify weakness in how the system was currently configured. Part of this built on existing work that the trust had already begun in order to improve how incidents were recorded. Our expert then made changes to the structure of the system to ensure that the correct information was available to reports and that the underlying features were working optimally.
  2. Operational – By taking on the role of system administrator our expert become the main point of contact for the system’s technical support across the entire organisation. Our expert worked with staff across the trust’s disciplines to build confidence in the system and quickly resolve any issues. Our expert worked with member of the Quality and Safety team, upskilling them so that they could also perform system administration functions.
  3. Reporting – One of the key concerns the trust had was around the quality of data that was being reported. The trust was already using Ulysses software to develop new reports. Our expert worked with the trust to produce these reports to a high standard and then to design a wide suite of further reports that would support the trust’s daily operations, compliance against KPIs and high-level reporting to the board. The reports are tailored for a range audiences within the organisation allowing useful engagement. One such report is a daily report that goes to the chief nurse, medical director and quality and safety team that highlights any harm incidents, allowing for quick identification of potential SIs. The report includes a number of performance metrics and enables the chief nurse and medical director to quickly involve themselves in incidents that they feel need additional support.
  4. Strategic – Our expert worked with the leads for the different trust departments to ensure that processes were in place to use the system effectively. This involved meeting with key stakeholders across the organisation and agreeing what steps needed to be taken. It also involved ensure that processes were in place for adhering to the Duty of Candour, the Serious Incident process and ensuring that normal incidents are handled appropriately.

The Verita expert also provided support to a number of different trust initiatives as an advisor on systems and data.

Outcome

As a result of the work carried out the trust has regained confidence in its Safeguard system and the information it is providing. The trust is also set up with a suite of specialised reports that help it put the data from the system at the heart of the Quality and Safety agenda.

In order to ensure that the improvements made are sustained in the long-term the trust has hired a new substantive member of staff to the administrator role. Verita have worked with the trust to train this person to ensure that they can carry out the role to a high standard.

Verita have also identified a number of ways that the system could be further improved and a number of additional features that would be beneficial to the trust. The trust is currently in talks with Ulysses in order to implement them.

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