• Led by a team at Southmead Hospital, North Bristol NHS Trust.
  • Ran from October 2011 for 2 years.
  • Aimed to understand and improve the complex care pathway for patients with end-stage renal failure, particularly those in need of surgery.
  • Designed to generate a positive working environment, improve communication and handover processes, and build a better system of care.

A team at Southmead Hospital, North Bristol NHS Trust, set out to test the Safer Clinical Systems approach to improve systems of care for patients with end-stage renal failure. In particular, the project concentrated on how clinicians share and hand over care when these patients need surgery.

The renal unit at Southmead Hospital serves a population of 1.4 million patients. In 2010, 788 operations were performed on patients cared for by the unit. Of these, 176 were emergencies.

Patients with end-stage renal failure have diverse clinical needs, relating to dialysis, electrolyte and fluid management and appropriate prescribing. As a result they have a complex care pathway.

The existing system at Southmead Hospital required multiple handovers at various stages of patient care and there were numerous human factors that could compromise a patient’s safety. This renal care microsystem provided an excellent opportunity for teams to develop robust pathways and improve the experience of care for patients with end-stage renal failure.

This project aimed to generate a positive working environment, in which health care teams could proactively identify and eliminate potential safety breaches and build a better system of care.

The project aimed to understand and improve the complex care pathway for patients with end-stage renal failure. The team hoped to improve communication and handover processes between all members of the multi-professional team but particularly between senior surgical, medical and anaesthetic doctors. The project team also set out to improve patient experience, team working and organisational efficiency.

Further reading

Research report

Safer Clinical Systems: Evaluation findings

December 2014
Research report

Lessons from the second phase of the Safer Clinical Systems programme.

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