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Realistic evaluation of Situation Awareness for Everyone (SAFE) on paediatric wards: study protocol
J Deighton1, J Edbrooke-Childs1, E Stapley1
1Evidence Based Practice Unit, University College London and the Anna Freud National Centre for Children and families, London, UK.
Insights
The Situation Awareness For Everyone (SAFE) intervention, using huddles, aims to improve UK child hospital safety by addressing preventable deaths. This study evaluates its implementation and effectiveness in paediatric wards.
Area of Science:
- Pediatric healthcare quality improvement
- Patient safety research
- Clinical intervention evaluation
Background:
- UK hospitalized children face poorer outcomes than European counterparts, with ~1500 annual preventable deaths.
- Unanticipated deterioration, potentially treatable with early intervention (e.g., sepsis), contributes to these deaths.
- The 'clinical gaze' needs broadening to include prospective risk indicators for timely intervention.
Purpose of the Study:
- To evaluate the Situation Awareness For Everyone (SAFE) intervention in UK pediatric wards.
- To understand the mechanisms of change and impact of SAFE on social processes.
- To provide initial evidence on the effectiveness of SAFE and huddles in improving pediatric patient safety.
Main Methods:
- Utilizing a realistic evaluation framework.
- Employing multiple methods and data sources for comprehensive understanding.
- Focusing on how the intervention triggers change mechanisms and influences existing social processes.
Main Results:
- The study is evaluating the SAFE program using a realistic evaluation framework.
- Multiple data sources are used to understand intervention mechanisms and impact.
- Findings will elucidate key elements of SAFE and huddles, their effectiveness, and initial outcome effects.
Conclusions:
- This research provides the first evidence of SAFE and huddle implementation in UK pediatric wards.
- Understanding SAFE's elements and processes is crucial for improving child hospital safety.
- The study aims to inform future interventions to reduce preventable deaths in hospitalized children.
Introduction:
Evidence suggests that health outcomes for hospitalised children in the UK are worse than other countries in Europe, with an estimated 1500 preventable deaths in hospital each year. It is presumed that some of these deaths are due to unanticipated deterioration, which could have been prevented by earlier intervention, for example, sepsis. The Situation Awareness For Everyone (SAFE) intervention aims to redirect the 'clinical gaze' to encompass a range of prospective indicators of risk or deterioration, including clinical indicators and staff concerns, so that professionals can review relevant information for any given situation. Implementing the routine use of huddles is central to increasing situation awareness in SAFE.
Methods And Analysis:
In this article, we describe the realistic evaluation framework within which we are evaluating the SAFE programme. Multiple methods and data sources are used to help provide a comprehensive understanding of what mechanisms for change are triggered by an intervention and how they have an impact on the existing social processes sustaining the behaviour or circumstances that are being targeted for change.
Ethics And Dissemination:
Ethics approval was obtained from London-Dulwich Research Ethics Committee (14/LO/0875). It is anticipated that the findings will enable us to understand what the important elements of SAFE and the huddle are, the processes by which they might be effective and-given the short timeframes of the project-initial effects of the intervention on outcomes. The present research will add to the extant literature by providing the first evidence of implementation of SAFE and huddles in paediatric wards in the UK.
