Safety Measures (Evidence-based transformation)

Safety Measures (Evidence-based transformation)

Published Date: 8 Oct 2018

The usual approach to measuring safety is to analyse incidents of past harm, and to incorrectly assume that absence of harm equals safe care. Commissioned by the Health Foundation (HF), the Safety Measurement and Monitoring Framework (MMF; Vincent et al (2013)) was designed to help staff think differently about safety. It is facilitating a cultural shift in the NHS from focusing on the absence of harm to the presence of safety. Yorkshire Quality and Safety Research Group, CLAHRC Yorkshire and Humber Improvement Academy and two test sites (Bradford DCT and BRI) collaborated on a Health Foundation funding application and were awarded a grant to evaluate the MMF, explore how it might be used and submit case studies of how it changed practice. Test site stakeholders took the MMF to frontline teams. The MMF helped test site 1 to understand the conditions triggering patient violence and change staff approaches, which successfully reduced incidences of aggression/violence on their wards: Intelligence from this phase has gone into interactive PDFs and video case studies showing the utility of the MMF (

Spread: Following this successful evaluation work, Health Foundation funding was awarded to YHIA in collaboration with other national improvement bodies (Healthcare Improvement Scotland, AQuA, Haelo), for further spread and continued testing. Currently in progress, this second phase involves four national learning events and regional workshops to train teams of individuals to use the MMF. These individuals apply learning in the field between workshops, and return to share progress and improvements. To date, four workshops have run with six YH teams.    

A planned publication is in development “How does the MMF help people think differently about safety?”

Contribution of CLAHRC Yorkshire and Humber

Preliminary work from CLAHRC went into this project: Rebecca Lawton (EBT Theme Lead, CLAHRC match funding) were part of an expert group convened by the Health Foundation to share *Vincent et al’s (2013) Safety Measuring and Monitoring Framework. Rebecca Lawton suggested testing the framework and brought it back to Yorkshire Quality and Safety Research group, where she and Jane O’Hara (also CLAHRC match funded) wrote the funding bid, in collaboration with the Yorkshire and Humber Improvement Academy.

What happened next

A planned publication is in development “How does the MMF help people think differently about safety?” The team continues to support the national spread of MMF. For example, we hosted a national event in Birmingham (October 2017), and from this meeting, YHIA are now supporting colleagues in Birmingham Community Trust in their facilitation of the MMF. West Midlands AHSN are also becoming involved in the ongoing work locally. CLAHRC YH have supported national webX calls, with IA staff delivering presentations on the mortality programme and human factors. A Regional Improvement Body learning workshop ran January 2018 to collate learning over Phase 2.