Hospital at Night Risk Assessment

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Hospital at Night Risk Assessment

• Sally Adams
• Incident Investigation Advisor

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Outline

• Background
• Development of Risk Assessment Guide
• Risk Assessment Approach

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Safe handover safe patients

• Guidance on clinical handover for clinicians and
  managers
• Joint project between BMA, MA and NPSA

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Transfer of Care

• The transfer of professional responsibility
  and accountability for some or all aspects of
  care for a patient, or group of patients, to
  another person or professional group on a
  temporary or permanent basis
• 
  NPSA 2004

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Priorities for action

• The DH and NPSA should develop and publish a
  standardised handover protocol and model handover
  documentation in conjunction with the BMA
• The NPSA and DH should begin work on the
  standardisation of the format of medical records
  and ensure that attention is given to ensuring
  the patient record is optimal, in order to
  facilitate effective handover of information to
  protect the safety of each patient within the
  host institution
• cont.

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Priorities for Action (contd)

• The NPSA and DH should develop generic medical
  handover guidelines to aid trusts in producing
  specific speciality and hospital based handover
  protocols

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What is Risk Assessment?
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Need for Risk Assessment

• Clinical Handover
• Ensuring Provision of Safer Patient Care

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Development of Risk Assessment Guide

• Familiarisation Visits
• Draft Guidance
• Piloting and Revision
• Feedback from Hospital at Night Team
• Final Revision
• Evaluation

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Key Messages from Familiarisation Visits

• Senior Leadership
• Engagement of Staff
• Communication
• Handover
• Bleep Policy
• Competency Assessment/Induction/Training
• Teamwork
• Change Management Impact/Interaction with
  Departments
• Need for Work Load Audit

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The HaN Risk Assessment Approach

• Overview the process
• Have a go
• Go away with a better understanding of what is
  involved in qualitative risk assess

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How To Conduct The Risk Assessment
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Task 1 Planning the Risk Assessment

• Objective
• To ensure the HaN solution provides safer care
  by
• Identifying issues that could compromise patient
  safety
• Designing them out of our solution
• Scope
• All activities for which the HaN team is
  accountable and activities changed by the HaN
  solution for which others, both within the
  hospital and external, are accountable

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Who Should be Involved?
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Task 2 Meeting Preparation

• 2a - Clearly detail the HaN solution
• Listing and mapping out the HaN solution
  activities
• Identifying interactions
• Identifying other changes resulting
• Collecting relevant documents
• 2b - Develop initial prompts
• 2c - Develop record sheet
• 2d - Obtain hospitals risk matrix
• 2e - Administrative activities

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HaN Top Level Activity Map
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HAN Second Level Activity Mapping
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Prompts

• For example
• No action 
• Action at wrong time (too early or too late) 
• Wrong action  
• Part of action  
• Error during action 

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Record Sheet
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Example Trust Risk Matrix
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Task 3 - Assessment Process
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Task 4 Follow-up and Review

• Action Plan

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Conclusion / Going Forward

• A HaN Risk Assessment approach
• Now developed and published
• Needs to be used
• Ideas please on how to
• Encourage / achieve its use
• Get feedback on its effectiveness, practicality,
  etc.
• Questions?