Learning from medication errors to minimise future risk
We offer a Skype-based service where by our lead trainer (John Greene) will personally instruct/coach you on how to carry out root cause investigation of actual medication errors that you send to us.
The service starts with a data-gathering period by which you send us copies of medicines charts, medicines containers and initial incident forms. We then carry out a preliminary investigation. Afterwards, we schedule a 1-2 hour Skype screen share with you, in order to investigate the error(s).
The aim is to establish root causes, contributing factors, and lessons learnt, and then cascade improvements across the service to reduce medication errors. By doing this together, you will learn how to investigate and report errors and near misses in a way that ensures lessons are learnt (rather than completing incident forms and sending staff for retraining as an exercise in damage limitation).
John will personally talk you through the reporting requirements from CQC and Safeguarding (which is often a misunderstood area). He will show you how to use an objective tool to differentiate culpable human error, from non-culpable human error and systems failings.
This service will equip you, as a manager, to carry out your own root cause investigations, ensuring that lessons are learnt and cascaded throughout your organisation to ensure the risk of reoccurrence is minimised and ultimately errors are reduced.