The recent Kennedys annual patient safety forum provided the opportunity to explore principles of better patient safety, and in particular Martha’s Rule.
This new initiative provides a route for patients and their families to obtain an urgent review when a patient’s condition is deteriorating. Phased implementation of the Rule by NHS trusts in England commenced in April 2024.
Dr Henrietta Hughes, the first Patient Safety Commissioner (PSC) for England, highlighted that Martha’s Rule is a cultural intervention, not a process. She explained there needs to be a systemic approach to listening, with a 24/7 escalation route to the critical care outreach team, and patients need to have access to this same escalation route, just as staff currently have.
Dr Hughes observed that the application of Martha’s Rule is about early intervention not a second opinion, the latter usually being a slower response.
Aiding both patients and healthcare professionals, the aim is to foster restorative practice and remove the need to litigate. The PSC added that there is a desire for everyone to use the same language to advocate for patient safety.
There can, at times, be fear amongst the workforce, which can create barriers for patients. Healthcare professionals worry about mistakes being made, which is entirely natural. However, they also worry that, if an error is made, whether there may be legal or regulatory consequences.
These fears, combined with the pressures of a busy healthcare system and mounting administrative burdens, mean that time with patients or interactions with patients and their families becomes more limited.
If a patient or family member does not know what is happening with their management this can understandably cause concern and so good communication is critical.
An organisation that is open about patient safety, with a leadership team interested in the views of both staff and patients, will be an organisation that delivers better outcomes for its patients. It is possible to undertake a culture survey of staff to check, so when mistakes are made, whether staff would feel safe about coming forward.
The organisation needs to be culturally ready to implement systems that ensure listening at all levels. By this we mean, leadership is effective in ensuring both patient and staff trust is maintained, care is provided in a sensitive manner at all times, appreciating the diverse backgrounds of patients and having listened, care is delivered in an equitable manner.
In time, the aim is for Martha’s Rule to be applied in healthcare community settings. This should enhance patient safety by addressing issues at an earlier stage prior to hospital, and secure patient safety in the long-term.
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Healthcare
United Kingdom