• Led by the Royal College of Paediatrics and Child Health, in partnership with UCL Partners Academic Health Science Network, WellChild, Anna Freud Centre and the Institute of Child Health.
  • Implemented at 28 specialist children’s hospitals and district general hospitals across England.
  • Aimed to improve outcomes for acutely unwell children on paediatric wards, and reduce variation in service delivery quality.
  • Used the clinical huddle method to improve situational awareness and facilitate improved communication.

Outcomes for acutely sick children in paediatric care in the UK are significantly worse than those for children in other countries, and for children in the NHS versus adults in the NHS. This project aimed to improve outcomes for these children, using situational awareness and improved communication.

It involved trialling models of care, including the ‘huddle’ technique: a 10-minute exchange of key information between clinical and non-clinical professionals involved in a patient’s care, using specific tools to ensure its consistence and validity. The huddle encourages information sharing and equips professionals with skills to spot when a child’s condition is deteriorating.

The Situation Awareness For Everyone (S.A.F.E) programme brought together paediatric units from 28 sites. Each ran a quality improvement project, focusing on a particular aspect they wanted to improve.

Evaluation of the project was carried out by the Anna Freud Centre and explored how and to what extent increasing situation awareness can lead to improved safety, experience and quality for children. A mixed methods approach was taken, including interviews with parents, patients and staff, observations of huddles, and analysis of safety indicator data.

The evaluation provided essential learning on the implementation of huddles and their potential impact. While no obvious pattern in outcome measures, such as cardiac arrests and transfers to ICU, could be discerned, there were clear examples of the benefits of implementation, particularly in terms of staff communication, teamwork, organisation and efficiency, and awareness of patient safety and safety issues.

Some sites had challenges with implementation, particularly around lack of involvement of groups of staff, and there was clearly variation in how embedded the huddle methodology was across the sites. Commonly cited barriers included lack of leadership and ownership, and lack of perceived fit between the methodology and the way that the ward works.

There was a clear will to continue to embed and spread S.A.F.E practices following the programme, and many teams were confident that evidence of its benefits were emerging from their locally collected improvement data.

As a result of the S.A.F.E programme, a clearer model for implementation has now emerged for the use of huddles in UK paediatric settings. In many of the S.A.F.E sites, the huddle methodology has become embedded in its ‘business as usual’ and spread to other paediatric wards.

The programme will continue to be overseen by the RCPCH Quality Improvement team, who will keep the online resource pack up to date.

Contact details

For further information about the project, please email Kasia Muszynska, RCPCH.

About this programme

Programme

Closing the Gap in Patient Safety

This programme ran from 2014 to 2017, and offered funding for projects to implement and evaluate tested, evidence-based patie...

Related links

You might also like...

Blog

Artificial intelligence in the NHS: getting the priorities right

The NHS’s new AI lab needs to focus on the needs of patients and the health system, argue Adam Steventon, Sarah Deeny, Josh K...

Newsletter feature

Acting on the evidence to empower young people with asthma

Dr Mosler's project developed a theatre workshop, transforming awareness and attitudes about asthma among young people.

Blog

If young people can’t afford to move to UK cities for work, that’s a health issue

Young people face an impossible choice between either quality housing or good work. Jo Bibby explains the ramifications of th...

Kjell-bubble-diagramArtboard 101 copy - only-wan.info

Get social

OnlyWan

It's putting the patient back in the centre, and saying 'it's your medicine, what shall we do with it?' says…

Kjell-bubble-diagramArtboard 101 - only-wan.info

Work with us

We look for talented and passionate individuals as everyone at the OnlyWan has an important role to play.

View current vacancies
Artboard 101 copy 2 - only-wan.info

The Q Community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more