Care by Design understands the fundamentals of organisational development, service management and leadership for the 21st century public sector organisation and communities.

Introduction to Checklists

Today we find ourselves in possession of stupendous know-how, which we willingly place in the hands of the most highly skilled people. But still avoidable failures are common. The reason is simple: the volume and complexity of our knowledge has exceeded our ability to consistently deliver it correctly, safely or efficiently. There is now, more than ever, a compelling argument for adopting the use of a simple accessible appropriate checklist. In the high tech fast paced service environment a succinct visual ‘checklist’ is proving to be the most promising method available in surmounting failure. Whether you are following a recipe, investing in a company or building a skyscraper, the checklist is an essential tool in virtually every area of our lives, but by breaking down complex, high-pressure tasks into small steps can radically improve everything from airline safety to heart surgery survival rates. The simplest prompt from a relevant appropriate checklist could transform how we operate in almost any field:

Care by Design is a natural home and champion of the drive for simple solutions that empower and facilitate clinicians and practitioners in the field of quality and safety in healthcare. In the course of the practical delivery of its services, Care by Design has engaged with enthusiastic clinicians who have embraced the provision of simple, succinct checklists that work to the benefit of practitioners and patients alike. Care by Design has assisted clinicians to take an idea from concept through design and development to concrete visualisation turning an idea into a real practical support tool to promote and safeguard quality and safety in healthcare. 

Bookmarks for Better Care

The Bookmarks for Better Care are the brainchild of Dr Gordon Caldwell FRCP (London) MD (Oxon), Consultant Physician at Worthing Hospital since 1993 and Clinical Tutor since 2000. Gordon studied at Oxford and King’s and is passionate about ensuring quality and safety at the point of care.

Please download Gordon’s post take ward round checklist — this ward safety visit checklist for Execs and Non-Execs. Other resources to enable better care in ward rounds will be available shortly.

The Alzheimer’s Society is also considering commissioning Bookmarks for Better Care of people with Dementia.

The bookmarks can be viewed and ordered online here (coming soon)

The Sepsis Card

Mr Marius Paraoan
Consultant General and Colorectal Surgeon
Wrightington Wigan and Leigh NHS Foundation Trust

Marius was won over by the concept of using checklists through two different encounters. The first was reading ‘The Checklist Manifesto – How to get things right’ the most influential book by Atul Gawande (a famous American surgeon). The book was recommended to me by Andrew Foster, the Chief Executive of my Trust, who was encouraging me to become involved in the field of quality and safety in healthcare. The second was my encounter with Dr Gordon Caldwell who I met during the Advanced Improvement in Quality and Safety Programme at the NHS Institute for Innovation and Improvement. Gordon’s enthusiasm and brilliant idea about the ‘Ward Round’ Checklist or ‘Bookmark for better care’ won me over to the concept and inspired me to produce the Sepsis Card.

As a surgical head in our steering group, from 2008, I became involved in the ‘Surviving Sepsis' campaign. The work is relentless as we seek to raise awareness about this condition, which is one of the biggest killers in hospital care in the western world. Regular courses are run, posters put up, and intranets set up all providing the information needed to identify septic patients and how to treat them according to best practice. Despite all this, something was missing. What was needed was an easy to carry and access reminder tool. It was then I conceived the idea of collating the information on a screening tool and the first hour duties of care pocket size postcard. The card would be easy to carry around all day, every day by every doctor and nurse. 

Angie Nisbet and her team at Care by Design were extremely professional in helping to take the idea from rough thinking to final product producing the cards and providing the opportunity to test the Sepsis Card in our Trust. The feedback has been instant and so positive so much so that the Sepsis Card will now be provided to every doctor and nurse in the Trust. I am absolutely certain the Sepsis Card will have a major impact on the care of septic patients.

All Trusts should look at the Sepsis Card and consider taking up its use. See it here for yourself now. See how useful the Sepsis Card could be in guiding even a junior healthcare profession ‘do the right thing’ when screening a patient and taking the correct course of action in the vital first hour after diagnosis.

» View images of the Sepsis Card

Free Resources to Download

Published 26th November 2018