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What is the “Scottish Patient Safety Programme”?

The Scottish Patient Safety Programme (SPSP) is a government-sponsored programme to improve the safety of patients in the Scottish healthcare system. The objective of the ground-breaking Programme is to steadily improve the safety of hospital care right across the country. This will be achieved by using evidence-based tools and techniques to improve the reliability and safety of everyday health care systems and processes. Further information on the paediatric strand of the Programme can be found here:


Why do we need it?

Patient safety in Scotland is good by international standards, however too many people
experience care that could be safer. Research shows that 1 in 10 patients in Scotland
may experience an adverse event (such as contracting an infection) in hospital. Half of
these adverse events are believed to be avoidable. By implementing evidence-based
interventions that become routine, patient safety can be significantly improved.

The Scottish Patient Safety Programme builds on impressive work that is already taking
place in Scotland. A similar safety initiative in 3,000 American hospitals resulted in the
prevention of more than 122,000 avoidable deaths.

The Programme recognises the complexities involved in delivering modern healthcare,
and so it has been designed to standardise approaches to care. There is good research to
show which interventions make a difference when it comes to protecting patient safety,
and these will be implemented uniformly in acute hospitals across the country.

What are its aims?

The overall aims are a 30% reduction in adverse events and a 15% reduction in mortality
over the five-year period of the Programme. Over the five-year period, steps will be taken
 Improve the organisation and leadership on safety
 Reduce healthcare associated infections
 Reduce adverse surgical incidents
 Reduce adverse drug events
 Improve critical care outcomes
 Ensure early interventions for deteriorating patients

How does it work?

Good people working hard will not be able to overcome the complexities of today’s
systems of care to prevent errors. Those systems need to be redesigned to help people
do the right thing. Redesign needs to be based on the best evidence, presented in a way
that allows its widespread adoption.

For the SPSP, a number of Change Packages have been devised; for critical care, the
general ward, to promote leadership, for medicines management and for perioperative
care. Contained within these Packages are tools for improving care. For example, there
are bundles that enable optimum management of peripheral vascular lines and central
lines, preventing infection.

Bundles are a collection of fairly simple protocols known to have the most impact in
improving a particular aspect of care. Using the Central Line bundle, one intensive care
unit in Scotland has not had a central line infection for over 500 days. Previously infection
of central lines was thought to be an inevitable risk of a stay in intensive care. The change
has not been achieved easily, and not just by transplanting a tool devised in one area
directly into another area. Evidence, an available tool and goodwill are all essential but
are not enough on their own. Each practice area needs to find out for itself how to
integrate changes into practice, and adapt the available tools as necessary. Some
practice areas develop their own tools, and pass these on in turn, to help others develop.

At the heart of making these changes is the Model for Improvement (MFI):

SPSP Model for Improvement