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National Patient Safety Agency (NPSA)
UK
The NPSA case-study proves ...
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Projects can last between a few weeks to two years. T...
The majority of patient safety incidents reported by community pharmacy involve selection
errors (selecting the wrong dose...
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Case Study: The NHS National Patient Safety Agency (NPSA)

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Case study written by Darragh Murphy.

Suggested citation:
Murphy, D. (2007). DME Case Study: National Patient Safety Agency (NSPA). DME Library.

Originally uploaded at http://www.designmanagementexcellence.com/wp-content/uploads/2013/08/NPSA.pdf

Publicada em: Design
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Case Study: The NHS National Patient Safety Agency (NPSA)

  1. 1. dme_design management europe design management europe National Patient Safety Agency (NPSA) UK The NPSA case-study proves that design management is not restricted to design disciplines but is a creative management process to deliver problem solving activities. The NPSA was established in 2001 to co-ordinate the reporting of patient safety incidents and to learn from them and act in order to improve patient safety in the NHS. Around 60,000 incidents are reported every month covering a wide range of issues from the administration of the wrong medicines to the spread of healthcare associated infections. DME AWard2008 SELECTION Winner NGO/ NPO category Learning from patient safety reports includes developing solutions that are practical and deliverable. To be effective they need to address the root causes of incidents and reflect the complexities of healthcare delivery and its environment. Dr Helen Glenister, Deputy Chief Executive of the NPSA, has championed the benefits of good design in the NHS and identified a seven step approach to developing safer practice solutions in the NHS. The stages in this problem solving process are identical to those in the design process, which is essentially a problem solving activity. The names of the stages are different but they work on the same principles to a designer interpretation: identifying the problem, generating ideas, assessing solutions, testing them and evaluation. The final deliverable is a reduction of the type of patient safety incident(s) being addressed.Members of the NPSA project team, clockwise; Professor David Cousins, Emma Boakes, Patricia
  2. 2. dme_design management europe dme_design management europe page 2 | 3 Projects can last between a few weeks to two years. The NPSA would typically run 15 to 20 large projects at one time; large projects would often involve a greater number of stakeholders outside of the NPSA. No two problems are the same, and the make up of the team and its solution can have a heavy bias to a design outcome or not, depending on the nature of the problem and the solution approved. Work to date has included the cleanyourhands campaign to combat the spread of MRSA through promoting greater awareness amongst NHS staff of the importance of hand hygiene. Steps Activity 1 Understand the problem 2 Identify potential solutions 3 Risk assess solutions 4 Pilot and learn 5 Implementation 6 Evaluation 7 Closing the loop This is not about a team of trained designers working on a wide range of projects but the solution design process being used by a diverse range of disciplines working on a range of problems. The teams at the NPSA who work on each solution are multi- disciplinary and design is one of the recognised professions represented. All relevant stakeholders are involved, including nurses, surgeons, manufacturers, purchasers and universities. There is an large range of different disciplines within the Stages in the patient safety solution development process Design guidelines have been produced to advise suppliers on how the NHS wishes their products to be specified. Again the guidelines are set by a multi-disciplinary team of relevant stakeholders considering the problems caused by the products or equipment and recommending solutions that are risk assessed and approved by them. The NPSA has worked with partners such as The Helen Hamlyn Trust of the Royal College of Art (RCA) to produce guidelines on medical devices, equipment and packaging. The Medical Futures award-winning resuscitation trolley, in partnership with the RCA, was the result of a design study exercise addressing a number of problems associated with this life saving equipment. A team of two designers from the RCA, a surgeon, an anaesthetist, nurses, a human factors engineer and the NPSA produced a three dimensional physical design prototype. The clinical team played an important part at the start of the process by understanding the nature of the problem and analysing the work flow and processes of emergency resuscitation. The design skills came in towards the end of the process.
  3. 3. The majority of patient safety incidents reported by community pharmacy involve selection errors (selecting the wrong dose or wrong drug during dispensing), which may be related to pack design. The NPSA, working with a large team of stakeholders, researched the issue and published guidelines for the design of medication packaging. dme_design management europe dme_design management europe page 3 | 3 Challenging Regulations A characteristic of all innovative businesses and organisations is their need to challenge the regulations and standards that govern their industry. The NPSA is a pioneer in a new approach to work with the pharmaceutical industry and regulators to push for improvements in medication packaging. Until recently the pharmaceutical pack design was primarily influenced by regulatory requirements, rather than ease of use or patient safety. The guidelines provide more detailed direction on the design of packaging to improve ease of use and safety, in addition to that required by the regulations. In order to implement these guidelines they promoted the government agenda of ‘purchasing for safety’, rather than the slow and expensive regulatory route. Some of the pharmaceutical companies welcomed these changes, realising they could compete on specification as well as price and embraced the changes, realising that the regulator is not the customer. “The gap between what we want and what the regulations want is filled with design solutions.” - Professor David Cousins, NPSA Manufacturers have realised there is more to design than meeting regulatory requirements. Although design is not the sole activity of the NPSA, they employ the design process to a high level that many professional designers and manufacturers will never achieve. They will put together the best team of stakeholders to research a problem thoroughly with evidence-based research; analyse possible solutions through risk assessment; carefully test and evaluate user interaction; measure the affect of the solutions and review them.

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