Situation Awareness for Everyone (S.A.F.E) Programme

Situation Awareness for Everyone logo - a heart in a green circle

The RCPCH led this two year programme in partnership with 28 hospitals to develop and trial a suite of quality improvement techniques. Our Resource helps sites implement the programme's core principles to improve communication, build a safety-based culture and deliver better outcomes for children and young people.

Free online resource 

Including presentations, tools and worked examples so you can introduce and improve situation awareness locally

Access the resource

Background to the S.A.F.E programme

The RCPCH led the programme on behalf of a partnership, with Great Ormond Street HospitalUCLPartners, and the Anna Freud Centre. The Health Foundation’s Closing the Gap in Patient Safety programme funded it.

There are an estimated 2,000 preventable deaths each year compared to the best performing countries in Western Europe. The programme aimed to reduce preventable deaths and error occurring in the UK’s paediatric departments. 

Its aims were to:

  • reduce avoidable error and harm to acutely sick children by 2016
  • improve communication between all healthcare professionals involved in a child’s care as well as families to ensure treatment is consistent and of the same high standard regardless of postcode or class
  • close the disparity in health outcomes for children in UK vs other countries as well as between children’s care and adult care
  • involve parents, children and young people to be better involved in their children’s / own care.

How the 'huddle' technique works

The huddle is a 10-minute, free and frank exchange of information between clinical and non-clinical professionals involved in a patient’s care. It encourages information sharing. And, it equips professionals with skills to spot when a child’s condition is deteriorating and to prevent missed diagnosis.

Here's a video of Dr Peter Lachman, S.A.F.E National Clinical Lead, describes the huddle in this video.

How the programme worked

Paediatric units in 28 hospitals across England each ran a local quality improvement (QI) project aimed at improving outcomes for paediatric patients. While a set of central measures was collected, each participating unit had the freedom to focus their project on a particular measure they want to improve.

The collaborative model allowed participating units to share their knowledge and experience with other partners, demonstrating both their successes and failures. This provided the opportunity for good practice to be spread and adapted within the collaborative, and for this to contribute to the single common aim of the programme: to reduce preventable deaths and error from occurring.

Programme evaluation

The Anna Freud Centre is evaluating the impact of improved situation awareness, and will submit the results to the Health Foundation.

The question is: "Under what circumstances, by what means and in what ways does increasing situation awareness lead to improved safety, experience and other elements of quality for children under inpatient care?"

The evaluation comprises a quantitative element involving all twelve sites, and a qualitative element, which will involve two specialist children’s hospitals and two district and general hospitals.