Mrs Yolande Noble1, Ms Caitlin Duffie1, Ms Bree Walker1
1Patient Safety & Quality, Clinical Excellence Queensland, Department of Health, Queensland Health, South Brisbane, Australia
Abstract:
In response to systemic reviews across various HHSs, Patient Safety Net (PSN) was piloted as an escalation mechanism to provide all staff with a clear and easy to use process for raising patient safety concerns not adequately resolved through other pathways.
A comprehensive literature review and consultation was undertaken, including a staff survey. An expert advisory panel utilised this information to inform the initial approach, including an option to report anonymously. Department of Health and HHS Patient Safety Steward (Steward) roles were created to receive and act on concerns. PSN was iteratively refined based on feedback and contemporary safety science. The program was tested in four HHSs and an evaluation undertaken following the 9-month pilot, using activity metrics and conducting stakeholder interviews.
Reporting rates rose steadily over the pilot period, with most concerns in-scope (92%), and no vexatious complaints. Concern numbers were higher in sites with a dedicated Steward role. Concern sources were mainly from nursing staff (50%), then allied health professionals (13%). User experience ratings were high (8.8/10) and all known reporters received feedback. Staff awareness between the pilot sites was variable. PSN is being introduced in remaining HHSs throughout 2025.
The pilot phase of PSN demonstrated that a staff escalation pathway, facilitated by a Patient Safety Steward, can enhance clinical governance and existing safety systems. Key elements of the program to ensure successful implementation include:
– Visible support by healthcare leaders
– Ensuring Steward attributes like trustworthiness, political astuteness
– Robust governance
– Targeted promotion to raise awareness.