Beyond knowledge: a new approach to behaviour change for patient safety

Interventions designed to improve patient safety such as guidelines, checklists and new technologies, all require healthcare staff to do things differently – in other words – to change their behaviour. It is widely, but wrongly, assumed that if people have the knowledge about what to do, change will follow. This is why strategies to implement change usually focus on increasing knowledge through emails, posters, meetings and training. However, if knowledge were the key to behaviour change, few of us would be overweight or inactive.

The NIHR CLAHRC YH Evidence Based Transformation with the NHS theme have been working with the AHSN Improvement Academy in Yorkshire and Humber to support improvement projects by helping staff across the region to implement change more effectively by using theories of behaviour change to underpin their work.  We developed the Achieve Behaviour Change approach which involves working with teams of health professionals to identify barriers to change and then developing a tailored intervention to specifically address these barriers. To support roll-out we worked with the AHSN to develop a workshop to spread these ideas across the region. Over eight hundred people have now attended one of these ABC Workshops and a toolkit is freely available via the Improvement Academy website to support their change projects. http://www.improvementacademy.org/tools-and-resources/abc-for-patient-safety-toolkit.html

A good example of the ABC approach changing practice was a project to increase the use of pH testing, over x-rays, to determine correct nasogastric (NG) tube placement. X-ray use for this purpose fell from 55% to 24% across four hospital Trusts, saving an estimated £1M across the region in one year alone. The ABC approach has also been used in the region for increasing cancer referrals in general practice, implementing the safer surgery checklist and reducing Acute Kidney Injuries. In the UK, the approach underpins the patient safety work within the Y&H Patient Safety Translational Research Centre YH (UK) more information can be found on the Yorkshire Quality and Safety Research (YQSR) website.

Internationally, this work is being implemented as part of a New South Wales Translational Cancer Research Network project in Australia.

To find out more contact R.Simms-Ellis@leeds.ac.uk