BLOG: Why improving patient safety in Cornwall is more than mythology

Ellen Wilkinson is medical director at Cornwall Partnership NHS Foundation Trust. In her first blog for the SW AHSN, Ellen talks about her experience of establishing Patient Safety Kernow Quality Improvement (PSKQI) with the South West Patient Safety Collaborative.
Pisky
Noun, folkore: a Cornish fairy, thought to bring good luck despite being mischievous
Far from folklore, PSKQI actually translates to Patient Safety Kernow Quality Improvement – a collaborative set up under ‘Shaping Our Future’, the Sustainability and Transformation Partnership (STP) for Cornwall and the Isles of Scilly, to help improve the way health and social care partners are delivering care in the region.
When Shaping Our Future was given money to spend on building capacity in quality improvement (QI), I asked myself, could a PSKQI collaborative save lives and improve patient safety in Cornwall? I also recalled that getting people to work on a common task together, especially for patient benefit, was a good way to connect disparate teams. When funding was granted by Health Education England to train frontline staff in QI methodology, the challenge was on.
Feeling slightly daunted, I phoned a friend. Corinne Thomas had been programme director of the first mental health safety collaborative in the South West, which had formed in the shadow of successful acute safety programmes. She had also managed the South West Zero Suicide Collaborative. I asked her if a safety programme across a healthcare system could work, and she thought briefly and said yes. What’s more, she agreed to be involved.
Corinne and I drafted a proposal and started to share it tentatively with colleagues and leaders. Initially uncertain how to choose clinical topics, we considered incident reporting to boards and subjects which would cross organisational boundaries as well as having meaningful and measurable impact. From a shortlist, the Shaping our Future’s Clinical Practitioner Cabinet chose three: medication safety, falls reduction, and sepsis recognition and deterioration.
An expert faculty was formed and we started to refine our topics in line with recent publications, local expertise, and interest. Several relevant programmes were already underway locally, and it was useful to map these and to align with them where possible. The group provided some clarity about what was already in place and identified some further key players that weren’t involved. The South West AHSN wholeheartedly and enthusiastically stepped on board and offered help from senior leaders as well as event management support.
The first learning session was held in May 2018 at St Mellion resort in Plymouth. Seeing the preparations transform into reality was quite emotional. Jono Broad, the SW AHSN’s patient representative lead, gave a great session on ‘what matters to me’. Mike Davidge was a great QI bootcamp trainer and the workshops sparked teams from across organisations working together, really together. After two days of teaching and workshops, delegates left with a buzz. Back at base, people seemed to be talking with urgency and interest about what they had seen and learnt. They were motivated to do something themselves and not wait for permission.

The second learning session was held in September in Newquay. The session, on opiates, was boosted by a fantastic patient story. Sean Jennings had given up opiates originally prescribed to him therapeutically. He gave impetus to the programme looking to reduce over-prescribing. The workgroups bonded even further across organisations, sharing improvement ideas and showing better understanding for each other’s points of view.
The third learning session took place in December; there was more data and there were more ideas for improvement. Delegates had tested changes in their organisations and some even had results, including a poster or two. Participants expressed confidence that PSKQI had enhanced their improvement efforts and that shared working was an important ingredient. People reflected the views ‘little changes create ripples and big changes’, ‘think big, plan small’ and ‘listen to staff’. Participants have work underway which is crossing organisational boundaries, improving communication and teamwork across the system, and has a common goal.
So, in response to my initial question, could we use PSKQI to save lives and improve patient safety in Cornwall? Yes, we can, we have …and we still are.
For more information on PSKQI email Ellen at ellen.wilkinson@nhs.net or find her on Twitter @ellenwilkinson6