Methods Using the science and approaches of quality improvement the Health and Social Care Safety Forum have engaged with all paediatric units in Northern Ireland in an on-going quality improvement collaborative.

Results

• A Regional Collaborative has now been in place since August 2013. An advisory group has been established to provide focus and drive, this is chaired by a consultant paediatrician and a senior nurse acts as vice chair. To date there have been five learning sessions held with continuing support and engagement from frontline clinical staff.

• Communication – All paediatric units now hold safety briefings and have a structured handover in place. The collaborative has also coproduced with parent representatives a parent safety poster, video and is working with Parent Action to coproduce a parent checklist.

• The collaborative is building on the initial “what matters to me” approach tested in one Trust using “Daisy” the cow as a mascot. This has received multiple awards and commendations. The roll out is being supported by the “Daisy Chain” graphic, highlighting the NI linkages with local mascots to support ownership.

• Reduction in medication errors – including prescribing and administration errors. Development of a regional drug kardex, currently out for testing.

• Early detection and rescue of the sick child – the collaborative have agreed a set of regional, age bracketed early warning score charts and an agreed escalation protocol. These are currently out for testing and regional audit is underway.

• QI training- fundamentals of QI, human factors, situational awareness and linking with NI paediatric training schedule

Conclusion The value of a regional paediatric quality improvement collaborative is that it brings clinicians, managers and parents together with a set of core aims. The collaborative gets results by engaging frontline teams in identifying the key challenges faced, generating the potential solutions and then by using the methodology, testing these in real time to see what works and importantly what doesn’t work before scaling up change.