The Digital Clinical Safety Strategy
IMS MAXIMS Clinical Solutions Manager, Rick Benson on the joint publication between NHSX, NHS Digital and NHS England and NHS Improvement
Background
The NHS Long Term Plan was published in 2019 and is the central document that sets out the priorities for UK healthcare over the next 10 years. Later that year, it was accompanied by the release of The NHS Patient Safety Strategy which focuses on making continuous improvements to patient safety by building on aims to develop a safer culture and safer systems in the NHS.
The Digital Clinical Safety Strategy was published a couple of years later in September 2021 and is considered an addendum to The NHS Patient Safety Strategy. It takes a closer look at the role of digital systems in safeguarding patient safety in the NHS with its key aims being to:
Improve the safety of digital technologies in health and care, now and in the future.
Identify, and promote the use of, digital technologies as solutions to patient safety challenges.
Evidence and the Case for Change
Patient safety is known to be a key indicator associated with providing high-quality healthcare and addressing this in the right way can derive substantial savings, both in terms of patient lives saved and associated care costs. The escalating role of digital technologies in supporting clinical care delivery means that the design, commissioning and use of these systems must be carefully scrutinised as a system-wide priority. This is particularly relevant following the COVID-19 pandemic which has accelerated the use of digital systems in healthcare such as online consultation systems and digital prescriptions.
The term “Digital Clinical Safety” is explicitly called out in the strategy and refers to the avoidance of harm to patients and staff as a result of technologies manufactured, implemented and used in the health service. Whilst there is clear evidence that digital technologies can improve care in multiple areas such as reducing errors in patient identification, reducing medication errors and improving the detection of early signs of patient deterioration, new risks can emerge during the implementation of such technologies and even during transitions to newer versions of these digital solutions.
Strategic Actions
The Digital Clinical Safety Strategy commits to enhanced training across the workforce, with a focus on patient safety specialists, chief clinical information officers (CCIOs), chief information officers (CIOs), chief nursing information officers (CNIOs) and wider frontline teams.
The priority actions of The Digital Clinical Safety Strategy are aligned to those under the NHS Patient Safety Strategy and are laid out under the same areas of Insight, Involvement and Improvement.
Insight
Collect information about digital clinical safety, including developments in the Learn From Patient Safety Events (LFPSE) service and use it to improve system-wide learning.
Involvement
Develop new digital clinical safety training materials and expand access to training across the health and care workforce.
Create a centralised source of digital clinical safety information, including optimised standards, guidelines and best practice blueprints.
Improvement
Accelerate the adoption of digital technologies to record and track implanted medical devices through the Medical Devices Safety Programme.
Generate evidence for how digital technologies can be best applied to patient safety challenges.
The MAXIMS Approach
Digital Clinical Safety has always been a priority for IMS MAXIMS having complied with the National Clinical Safety Standards long before the publication of the Digital Clinical Safety Strategy. Under the new proposals, more information on digital clinical safety will be collected through systems like the LFPSE Service and access to digital safety training for healthcare staff will be expanded.
Whilst it is understandable that the importance of comprehensive and centralised patient safety event recording has been highlighted as one of the first key actions to be addressed (under this developing LFPSE service), it is also important to emphasise that Digital Clinical Safety is not just about recording harm in a reactive manner, but also proactively preventing it. This is why the Clinical Safety Officer (CSO) role is deeply embedded into the IMS MAXIMS team, with the DCB0129 standard strictly adhered to and integrated across our processes from development to post-deployment, including such activities as:
Maintaining the key appropriate safety documentation (Clinical Risk Management Plan, Hazard Log and Clinical Safety Case Report)
Ensuring any incidents are prioritised, managed and captured in a timely manner
Assisting deploying organisations with their supporting DCB0160 documentation
Whilst the expansion and enhanced clinical safety training of the NHS workforce will clearly help streamline the awareness and handover of potential clinical risks associated with technology from manufacturers to healthcare institutions (in line with the handshake expected between the two National Clinical Safety Standards) and optimise the implementation of digital technology in a safe manner, the quality of the initial DCB0129 documentation provided by the manufacturer in the first place can greatly reduce the level of activity and resource required by the institutions themselves.
The experience that IMS MAXIMS has gained from working across multiple diverse customer sites has already resulted in the compilation of digital clinical safety information, guidelines and best practice blueprints that can be leveraged by future customers to enhance the implementation of solutions at their own sites. As well as this being a serious responsibility when it comes to enhancing patient safety, IMS MAXIMS considers this a valuable contribution towards reducing the workload of healthcare providers, particularly when there are so many other demands competing for their time.
“MAXIMS Clinical Safety process is managed by a strong team of Clinical experts which evolves during the lifecycle of the MAXIMS EPR and ensures that it continues to provide sufficient confidence in the safety of our MAXIMS EPR solution. MAXIMS follows the NHS Digital standard DCB0129 to promote and ensure that effective clinical risk management is carried out and maintained for the development and deployment of MAXIMS EPR solution. We pride in working closely with our customer Clinical Safety Leads/CSO which contributes to the delivery of a Clinically Safe MAXIMS EPR solution to all our customers.”