Learning from the design and development of the NHS Safety Thermometer.
Research indicates that 10% of patients are harmed by healthcare but data that can be used in real time to improve safety are not routinely available.


METHODS
We identified the need for a prospective safety measurement system that healthcare professionals can use to improve safety locally, regionally and nationally.


METHODS
We designed, developed and implemented a national tool, named the NHS Safety Thermometer (NHS ST) with the goal of measuring the prevalence of harm from pressure ulcers, falls, urinary tract infection in patients with catheters and venous thromboembolism on one day each month for all NHS patients.


METHODS
The NHS ST survey instrument was developed in a learning collaborative involving 161 organizations (e.g. hospitals and other delivery organizations) using a Plan, Do, Study, Act method.


RESULTS
Testing of operational definitions, technical capability and use were conducted and feedback systems were established by site coordinators in each participating organization. During the 17-month pilot, site coordinators reported a total of 73,651 patient entries.


CONCLUSIONS
It is feasible to obtain national data through standardized reporting by site coordinators at the point of care. Some caution is required in interpreting data and work is required locally to ensure data collection systems are robust and data collectors were trained. Sampling is an important strategy to optimize efficiency and reduce the burden of measurement.
Haelo, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK.
Maxine
M
Power
Patient Safety Policy and Strategy, NHS Commissioning Board, 4-8 Maple Street, London W1 T 5HD, UK.
Matthew
M
Fogarty
Health and Social Care Information Centre, 1 Trevelyan Square, Boar Lane, Leeds LS1 6EB, UK.
John
J
Madsen
University College London Hospitals, 235 Euston Road, London NW1 2BU, UK.
Katherine
K
Fenton
Clinical Effectiveness & Evaluation Unit, Royal College of Physicians, 11 St Andrews Place, Regent's Park, London NW1 4LE, UK.
Kevin
K
Stewart
Haelo, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK.
Ailsa
A
Brotherton
The Quality Observatory, York House, 18-20 Massetts Road, Horley, Surrey RH6 7DE, UK.
Katherine
K
Cheema
Haelo, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK.
Abigail
A
Harrison
Associates in Process Improvement, Austin TX, USA.
Lloyd
L
Provost
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D003625:Data Collection / Q000379:methods; D005260:Female; D040261:Harm Reduction; D006801:Humans; D008297:Male; D015279:Organizational Culture; D061214:Patient Safety; D003668:Pressure Ulcer / Q000453:epidemiology / Q000517:prevention & control; D016730:Program Development; D015397:Program Evaluation; D011787:Quality of Health Care; D013222:State Medicine / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000517:prevention & control
harm; measurement; testing