Sharing learning on WalkRounds – August 2010

Patient Safety WalkRounds are now routine practice in NHS organisations across Wales. In some cases, they have been used for over 4 years, since being introduced as part of the Safer Patients’ Initiative; but in most organisations they were first tested and used from 2008 as part of the 1000 Lives Campaign.

The points below draw on learning about the process to date that was shared during a WebEx session on 19th August 2010.

Board training and development on WR implementation.

  • Need to maintain a focus on patient safety in framing the questions and opening statements – WR’s should not be allowed to become ‘all things to all people’.
  • WR visitors can use ward—based display boards of improvement progress to trigger questions about successes and concerns.
  • If an area has not experienced WR’s before, then visitors should not be surprised if staff raise many long-standing and well-known ‘difficult’ issues, but the aim is to prioritise, practical safety issues for resolution.

WalkRound planning.

  • Need to give ‘just enough’ advance notice – planning too far advance may lead to frustration is sessions need to be re-scheduled.
  • GP practices and other contractor services are likely to need more advance notice and timing should be discussed and agreed with the Practice Manager.
  • Short notice offers of a WR visit may be welcomed by staff, particularly once staff become familiar and comfortable with the process.
  • Asking teams to communicate about WR’s in the context of safety briefings can be a good way to get staff thinking about issues to raise in advance.

Action tracking and reporting.

  • Wherever possible, make sure front line teams are given authority to take the actions at the end of the WR. This will help reduce the risk of large numbers of actions needing to be tracked centrally.
  • For actions that the team cannot address directly, authority and accountability for actions should be delegated to Divisions/Clinical Programme Groups wherever possible. Tracking of progress can then be included in routine reviews.
  • Mapping actions against the Standards for Health Services could be a useful way to categorise actions.
  • Make sure a record of previous actions is available when areas are being re-visited, so that WR visitors can confirm that actions have been closed.

Testing WR's in new settings.

  • A ‘virtual WalkRound’ has been tested with a community pharmacy, where the practice premises were too small to accommodate a visit.
  • WR’s should be tested at Divisional and locality level to build capacity and maximise the opportunities for all teams to participate.