Paper 06 - NHS Ayrshire and Arran.

The results in the test site at Crosshouse have improved dramatically as the test
site is enriched due to the fact that there is a pharmacist in this area who
undertakes the reconciliation of medicines. The reconciliation process at Ayr
continues to be unreliable with signs of deterioration. Clinical leads are working
hard to identify issues, develop solutions and have identified that the Emergency
Care Summary (ECS) may present part of the solution.
The ECS is a summary of basic information about the patients health which might
be important when the patient needs urgent medical care when the General
Practitioner’s (GPs) surgery is closed, or when the patient goes to an Accident and
Emergency (A&E) department. The summary provides information regarding
current medication that has been prescribed by a patient’s GP and can act as one
of the two sources required for MR.
Currently the trainee doctors do not all access the ECS, making MR much more
difficult. The reasons for the lack of access by trainees are; ECS access is given no
priority in relation to medical induction and there is a subsequent poor uptake of
ECS training which must be undertaken to use the system; junior medical staff are
a rotational work force. They require to be trained and given passwords for ECS
when they enter employment with NHS Ayrshire and Arran. This is irrespective of
previous training and access in other Scottish Health Boards.
2.5 Safety Culture Work
Staff working with Maternity Services were asked to complete the Pascal Metrics
Safety Attitudes Questionnaire (SAQ). The SAQ is a psychometrically validated
tool for measuring patient safety culture using seven dimensions; teamwork
climate; safety climate; job satisfaction; stress recognition; working conditions;
perceptions of senior management and perception of local management.
In line with Pascal Metrics methodology, maternity staff were grouped into nine
distinct cohorts of staff who worked together in a work setting The safety culture
survey has now been completed for the maternity unit with a response rate of 62%.
Initial feedback has been delivered to over 200 staff by Michael Leonard of Pascal
Metrics.
Senior clinical leaders from the organisation have participated in a 2 day
conference with Pascal Metrics and senior leaders throughout the United Kingdom
to better understand the survey, how to brief staff of the results for their area and
how to identify safety issues and develop improvement plans.
3. Proposal
3.1 To continue with the ‘suite’ of actions outlined in this report and maintain
momentum and clinical engagement in relation to reduction of HSMR. Progress will
continue to be monitored and the data will be used to identify when the
interventions made have resulted in improvement and to allow improvement work
to be refocused as required to meet the target of a decrease of 30% by 2012. The
HSMR Steering Groups and CCIB will to continue to determine actions to support
the meeting of these targets.
8 of 10