A HSE National Patient Safety Alert (HSE NPSA) is a high-priority communication in relation to patient safety issues, which requires HSE services and HSE-funded agencies to take specific action(s) within an identified timeframe, in order to reduce the risk of occurrence or recurrence of patient safety incidents that have the potential to cause serious harm or death.
HSE NPSAs are issued by the HSE in conjunction with relevant stakeholders (subject matter experts, patient representatives, clinical & academic experts)
Identification and development
HSE National Patient Safety Alerts introductory video
This animated video is an informational guide on how HSE National Patient Safety Alerts are identified and developed.
View the HSE National Patient Safety Alerts infographic
Purpose
- To support staff to make their services safer by having identified existing safety risks and providing them with implementable actions
- To support patients and service users by keeping them up to date with the latest alerts issued to the HSE and HSE-funded services
- To reassure anyone involved in a patient safety incident that the HSE are continually identifying crucial patient safety information and sharing learning to help prevent occurrence or recurrence of similar incidents
HSE National Patient Safety Alert Committee
The HSE NPSA committee is a multiagency, multidisciplinary committee under the governance of the Chief Clinical Officer and chaired by Dr Darren McLoughlin (Consultant in Emergency Medicine). Its purpose is to oversee the identification, development, publishing, dissemination and evaluation of critical safety information to support and improve patient safety within the HSE and its funded services by reducing patient safety incidents and preventing patient harm.
The Objectives of the HSE NPSA Committee are:
- To apply system learning to improve patient safety by developing HSE NPSAs and HSE patient safety supplements.
- To determine criteria for developing HSE NPSAs and PSSs
- To oversee a national system for identifying, developing, communicating and evaluating learning following patient safety incidents through HSE NPSAs for information that requires immediate action and through PSSs dealing with a range of specific patient safety topics.
- To apply a RAG rating system for categorisation of HSE NPSAs
- To incorporate a design thinking approach to identifying problems and solutions
- To work collaboratively with other organisations to inform potential safety alerts/safety supplement content
- HSE NPSA Committee Terms of Reference
How will National Patient Safety Alerts support improvement?
Alerts support learning, sharing and improving for patient safety.
- Learning: Patient Safety Learning is generated through analysis of all available data sets including incident report data using the National Incident Management System (NIMS), audit reports, complaints data, other published national and international safety alerts and research. This analysis is carried out by a multidisciplinary multiagency HSE NPSA Committee
- Sharing: Patient Safety Alerts are designed and distributed to those who need to take action(s). HSE NPSAs are sent to HSE NPSA Officers across our health services through a HSE eAlert system and are also posted on Patient Safety Together: learning, sharing and improving
- HSE eAlert System – HSE NPSAs are sent via a dedicated channel on the existing HSE eAlerts system. The eAlerts system is a closed loop system whereby NPSA Officers for each service will receive the NPSA, review and see the actions required, determine if and how the NPSA applies to the service they work in NPSA officers will forward the alert to the responsible staff in their service that the alert applies to. The responsible staff completes any applicable actions and informs the NPSA officer when completed. The NPSA Officer then updates the eAlert system to record completion of actions required
- Patient Safety Together – HSE NPSAs will also be freely available through Patient Safety Together, this online resource where a searchable repository of the issued alerts will be freely available to all. Users can view a high level summary, opt to view a more detailed document and download as needed.
- Imroving: HSE NPSAs contain time-bound actions to be taken that are designed to reduce the risk of occurrence or recurrence of incidents. These actions are taken by staff identified in the HSE NPSA (this varies depending on the subject of the alert)
More information
If you require further information on a specific HSE NPSA, supplementary information is included with each NPSA.
Managing HSE National Patient Safety Alerts in your service (PDF, 28 pages, 1.2MB)
You can also contact us at patientsafetytogether@hse.ie for further information on HSE NPSAs