What is First, Do No Harm?
First, Do No Harm is a campaign to minimise preventable harm to patients during clinical care. It is estimated that around 13 per cent of patients suffer ‘adverse events’ during care. The First, Do No Harm campaign aims to improve that rate and has set specific targets for reducing patient falls, pressure injuries and central line infections (CLAB). (See About First, Do No Harm for target details.) It aims to develop a regional patient safety culture underpinning the safest healthcare system in Australasia.
How does it work?
The Northern Region’s four district health boards have committed to work with primary care and age-related residential care to deliver a new, system-wide focus on patient safety. The first step is agreeing on how to measure existing patient harm rates and developing regionally-consistent methodologies for collecting data. The implementation phase is now underway. First, Do No Harm creates an opportunity to share information on successes and challenges across the Northern Region with the aim of improving patient safety by working and learning our way into improvement.
Why are you doing this … what are the key benefits?
The campaign is driven by a clinically-led desire to reduce avoidable harm to patients. There is a recognition that patient harm levels need to be minimised to provide the best possible care. There is clear evidence that certain interventions, if systematically applied, will save lives, prevent harm to patients, save money, free-up capacity and improve productivity. This is best achieved by working together as a region rather than having inconsistent approaches.
Who is involved in the project?
First, Do No Harm is one of the primary goals of the Northern Region Health Plan. The four Northern Region district health boards (Northland, Waitemata, Auckland and Counties Manukau) have committed to the plan, alongside the National Maori PHO Coalition, Alliance Health+ and Greater Auckland Integrated Health Network. The roles of the primary care sector and the age-related residential care sector are considered critical; the campaign is not just about hospital care. Implementation of the health plan is being supported by the Northern District Health Board Support Agency, (NSDA) a shared services agency owned by the Auckland metropolitan DHBs. NDSA has formalised a Memorandum of Understanding with the Health Quality and Safety Commission on the First, Do No Harm campaign.
Is this driven by the need to cut costs?
No. The motivating principle behind First, Do No Harm is delivering improved safety for our patients. Another critical consideration is reducing waste and duplication by working across the region and learning from each other. Money saved is as a result of shorter hospital stays for patients and this, in turn, ensures more patients can receive treatment from the public health budget.
Why hasn’t there been a coordinated patient safety campaign here before?
The strong desire to provide the best possible care for patients has always existed. What has been lacking until now is the commitment to work together across normal DHB boundaries – and across sector boundaries with primary care and age-related residential care – to achieve this. Recognition that maximum benefits could be achieved by working together under the Northern Region Health Plan provided the impetus to launch the region’s first coordinated patient safety campaign.
When will we see improvements?
International evidence suggests there is a lead-time before improvements can be quantified. The process must begin with measuring harm and agreeing on consistent measures to understand the scale of the problem. Only then can solutions be implemented – and these take time to become embedded in normal practice.
Why is it important?
First, Do No Harm matters because it is about providing the best care to those people requiring healthcare services, regardless of the setting. A regional focus on patient safety will ensure patients are spared injury, pain and suffering and that they can get back to their normal lives sooner. This will also have benefits for supporting family members and patients themselves in terms of their mobility, confidence and independence. In extreme cases, the campaign has the potential to save lives.
What’s in it for clinical staff?
The campaign is clinically-led and reflects the strongly-held view within the health workforce that the patient must always come first. First, Do No Harm creates a coordinated framework for clinical staff to learn from each other’s experiences and ultimately achieve their goal of providing the best and safest patient care possible.