A look at improving patient safety: the devil is in the data

In addition to publication of the consultation document Busting bureaucracy: empowering frontline staff by reducing excess bureaucracy in the health and care system in England,¹ the Care Quality Commission (CQC) is taking an in-depth look at how health and care services work together and how they can evolve in order to meet people’s needs and improve outcomes for all concerned. In doing so, patient safety is being pushed firmly to the top of the agenda.

           The identification of opportunities to learn and improve safety is a critical facet of safety processes and is core to successfully implementing three of the five characteristics of high reliability.² Healthcare is a classic example of a potentially high-reliability industry, with its hyper-complexity, tight interdependence between different departments for patient outcomes, multiple levels and hierarchies for decision-making, and the requirement for fast, emergency action often in compressed timescales with critical outcomes that can be a matter of life and death.

           Safety has always been a key concern and there have been numerous investigations and reports after certain incidents. All of these highlight that the focus on opportunities to improve patient safety is often overlooked, a fact acknowledged and something the CQC is looking to address in its latest strategic consultation paper.³ This lack of investment is not, we believe, due to a lack of commitment, but due to the challenge of being able to show that investment in one area will not have a greater detrimental impact on other areas of care. Data are where the answers to this problem will be found.