In Safe Hands Program

Aim

The In Safe Hands program aims to build and sustain effective health care teams. It is intended to give these teams the structure and tools to redesign their units into strong, interdisciplinary teams, working together to deliver highly reliable, planned care to all patients.

Benefits

Teams that have implemented In Safe Hands have identified the following benefits:

  • Reduced patient length of stay; 
  • Reduced unexpected deaths; 
  • Reduced adverse events; 
  • More satisfied staff; 
  • Improved patient experience; 
  • Improved safety culture.

Summary

In Safe Hands enables teams to address daily challenges of patient care by empowering them to make good decisions, with clarity on the full scope of a patient’s care. The result is that all members of a health care team are better placed to solve problems as they arise, transforming clinicians working in isolation into highly functioning health care teams.

Four key principles that enable the development of highly functioning teams are:

  • Unit-based teams
  • Co-leadership model
  • Structured Interdisciplinary Bedside Rounds
  • Continuous evaluation processes

Structured Interdisciplinary Bedside Rounds (SIBR) is one component of the program. SIBR is a process where nursing, medical and allied health professionals involved in the care of the patient meet together daily with the patient and family to discuss the patient’s care.

The team collaboratively cross-check information and hold each other accountable to a quality safety checklist. They can then synthesise and record a mutually supported plan of care ensuring all team have a voice and communicate relevant patient information in a structured format that is clear and concise. 

Background

Most clinicians participate in some kind of ward round at some time throughout the day. However, these are often unstructured, may not involve key members of the clinical team and may not even involve the patient themselves.

SIBR enables all the relevant members of the health care team, including the patient’s allocated nurse for the day, doctors and any allied health team members involved in the patients care to gather at the patient’s bedside to discuss and develop a plan of care for the patient. All members of the health care team are encouraged to contribute and collaboratively cross check any important information so that the decisions made are up to date and based on all the available information.

SIBR promote a shared mental model for teamwork and an efficient platform to transform health care teams to highly reliable health care teams. Collaboration, openness, respect and empowerment is evident within these teams.

The program is supported by a series of resources and tools as identified below.

Resources:

Brochures:

Supportive Tools:

Partnerships

  • NSW Health - Whole of Hospital Program
  • ACI - Acute CareTaskforce (Criteria Led Discharge, Clinical Management Plans, Medical Assessment Units)
  • ACI – Patient and Staff Experience Program

Key Dates

Pilot Sites

Sydney Local Health DistrictCanterbury Hospital A variation of SIBR rounds was introduced in October 2012. In this instance a structured interdisciplinary communication protocol is followed at the bedside for each patient at individual time points that are mutually agreed. This format has shown: 100% compliance with implementing VTE prophylaxis; a reduction in average length of stay in HDU, particularly for older patients; and a reduction in overall mortality.
Western NSW Local Health DistrictOrange Health Service SIBR was introduced in September 2012. There have been a number of improvements since the ward implemented SIBR. Early findings include: reduction of rapid response (70%) and clinical review calls (56%); decrease in adverse events; improvements in transfers of care; general improvement in teamwork and communication; and improved patient and staff satisfaction.

Implementation Sites

This program has been implemented in 24 clinical units with different patient populations including aged care, medical, surgical and high dependency.

Hunter New England Local Health DistrictThe Maitland Hospital
Illawarra Shoalhaven Local Health DistrictWollongong Hospital
Mid North Coast Local Health DistrictCoffs Harbour Base Hospital
Port Macquarie Base Hospital
Murrumbidgee Local Health DistrictGriffith Base Hospital
Northern NSW Local Health DistrictLismore Base Hospital
Northern Sydney Local Health DistrictRoyal North Shore Hospital
Hornsby Ku-ring-gai Hospital
Mona Vale Hospital
South Eastern Sydney Local Health DistrictPrince of Wales Hospital
Sutherland Hospital and Community Health Service
South Western Sydney Local Health DistrictCampbelltown Hospital
Bankstown Lidcombe Hospital
Liverpool Hospital
Southern NSW Local Health DistrictGoulburn Base Hospital
Bega District Hospital
St Vincent's Health NetworkSt Vincents Hospital
Sydney Local Health DistrictBalmain Hospital
Canterbury Hospital
Royal Prince Alfred Hospital
Western NSW Local Health DistrictOberon Health Service
Orange Health Service
Cowra District Hospital
Dubbo Base Hospital
Cobar District Hospital
Blayney District Hospital
Bathurst Base Hospital
Walgett Health Service
Mudgee Health Service
Western Sydney Local Health DistrictWestmead Hospital
Auburn Hospital and Community Health Services

Evaluation

To monitor the effect of In Safe Hands, there are 3 areas of evaluation. These are:

  • Process measures (Length of Stay, Ward Separations, Day of Discharge, Ward Mortality, Transfers to ICU/HDU, Readmissions within 28 days)
  • Patient and Staff Satisfaction
  • Patient Safety 

Related Initiatives

Read more about Orange Health Service's implementation of In Safe Hands on the Innovation Exchange.

Further Details

Contact

Wilson Yeung
Program Lead, In Safe Hands, CEC
wilson.yeung@health.nsw.gov.au
02 9269 5571

Dr Peter Kennedy
Deputy CEO, CEC
peter.kennedy@health.nsw.gov.au
02 9269 5506

Page Top | Added: 6 November 2013 | Last modified: 12 January 2015

CEC
Status:
Contact:
Wilson Yeung
Program Lead, In Safe Hands, CEC
Email
02 9269 5571
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