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P22 Implementing GREATix: learning from excellence in paediatric services
  1. Emma Barbour,
  2. Maeve Murray
  1. Northern Health and Social Care Trust


Aim The paediatric service is extremely good at reporting incidents through Datix system. These incidents are reviewed, learning is identified and then information disseminated, or even a change in practice takes place, all with the aim to improve things and prevent errors happening. A regular bulletin is prepared for the multidisciplinary paediatric team with the paediatric pharmacist involved in the medication section of this bulletin. There is no system within the Trust for reporting all the good things that are happening and it was felt that the department were missing out on learning from these. Learning from Excellence1 is not new and numerous areas, both locally and nationally have introduced it in some form.

The aim of this project is to identify and learn from everyday excellence as we currently learn from error via Datix, and to also improve staff morale. We wanted to have an anonymised way to let a colleague know they have done a great job. The ultimate goal would be to also interrogate and report findings.

Method A paediatric multidisciplinary oversight group was set up by the paediatric pharmacist and paediatric practice educator. A questionnaire was issued to paediatric staff, examining morale. Resources were developed to support reporting, data collection and nominee feedback. Following some meetings and discussions with the Trust IQI team, a GREATix reporting system was introduced into paediatrics. A pilot was initially carried out in one small area of paediatrics, a few changes were made and it was then introduced throughout the trust in paediatrics.

Nominees are issued with a certificate and a letter from head of service and clinical director.

Results Over the past 20 months there have been a total of 130 nominations to date. 20 themes have been coded including evidence of good teamwork and communication, putting the child and family at the centre of care and staff acting to positively affect patient safety or preserve further harm when an incident had occurred. There has been some feedback from nominees saying how delighted they were receiving the award, how it had made their day, and how grateful they are.

Conclusion For those staff who have received a nomination there has been some evidence of an increase in morale. There have been areas within paediatrics who have embraced this new system more than other areas. As an oversight group we need to highlight the process more. The plan would be to generate a bi-annual report for the paediatric service and present the learning Trust wide. We have supported other areas in the Trust to implement GREATix, including introducing it into the clinical pharmacy team. Our IQI team in the Trust are meeting with the small number of areas within the Trust who have implemented this and plan to look at the way forward as to how we can collaborate to introduce this further within the Trust.


  1. Kelly N, Blake S, Plunkett A. Learning from excellence in healthcare: a new approach in incident reporting. Arch of Dis Child 2016;101:788–791.

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