Aims Parents know their children best and therefore may recognise deterioration before a doctor or a nurse. Our ward is the children’s inpatient ward for a North London teaching hospital with approximately 1000 admissions annually. There are many safety interventions on our ward to identify parental concerns, including ‘parental concerns’ as a point on the Paediatric Early Warning (PEWS) chart, multidisciplinary ‘safety huddles’ and patient safety information pack given out on admission, designed to empower parents to raise concerns. We aimed to improve the safety of our ward through co-design with parents.

Methods Current practice was established by interviewing young people, families and staff from the multidisciplinary team. Audit of PEWS charts revealed that ‘parental concerns’ on the chart was never ticked. A recent serious incident was reviewed and, despite current safety measures, communication of concerns between parents and the multidisciplinary team was a contributing factor. We then used the Model for Improvement approach to look at the safety interventions which identify parental concerns.

Results 64% of parents did not receive the patient safety information admission packs, despite all nurses interviewed saying they gave the packs to all/most parents. However, 43% of nurses interviewed had not read the pack themselves. 37% of parents interviewed had some concern about communication with the medical team.

‘Patient safety menus’ were co-designed with parents to issue every morning to families at the same time as the food menu. These will serve as a daily reminder to young people and their families that raising concerns is a vital part of safe care. A housekeeper was appointed as a ‘Parents’ Champion’ in order to act as a non-medical educator to introduce to parents the importance of their concerns and how they can be escalated. PDSA (Plan Do Study Act) cycles will refine these interventions and further results will be available in May 2017.

Conclusion Recognition of parental concerns is important in good and safe paediatric care. We have identified problems with the current mechanisms on our ward to improve this and therefore ongoing work has been necessary, which may help other paediatric wards address these issues.