Safer Clinical Systems: Nottingham University Hospitals NHS Trust

Nottingham University Hospitals NHS Trust is one of the largest acute trusts in the UK and manages around 110 unscheduled medical admissions per day. The wards are under pressure and reliable, safe systems of prescribing are essential.

Medication safety is an important priority at the trust. The medicine safety group proactively identifies and manages risks. The group has been working with the acute medicine service and for this project decided to focus on a number of key safety areas:

• reliable processes: medication histories and prescriptions must be complete and free from errors
• awareness: staff understand risks and report incidences of harm
• communication: prescribing errors are most at risk of occurring at admission, during ward transfer and at discharge.

An improvement team tested the Safer Clinical Systems approach to make prescribing safer on an acute medical ward. They focused on the patient’s ‘prescribing journey’, beginning with an unscheduled admission through to transfer home or onto one of the hospital’s medical wards.

The project aimed to improve understanding of the hazards in this high-risk clinical environment. It set out to raise staff awareness of the dangers inherent in prescribing and to develop systematic procedures to implement safer prescribing processes.

Successful techniques learned from this programme will be shared and promoted to the wider NHS.