Have your say on stopping rules and procedures that do no good

Senior research fellow Gillian Janes reports on work under way to identify ineffective practices

National Institute for Health Research senior research fellow Gillian Janes reports on work under way to identify ineffective practices

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Achieving safer care poses significant challenges, not least while working in the context of unprecedented demands on healthcare services and increasingly limited resources at our disposal.

It's unsurprising then that we need to ensure we make the best possible use of staff skills, time and other resources to have any chance of making care safer.

Work is under way to actively discourage the use of ineffective, unnecessary or harmful clinical treatments and practices. We need, though, to do likewise with non-clinical practices, rules and procedures if we are to build a safer healthcare system, improve the process of care for patients and staff, and reduce costs (Norton et al 2017).

There is a tendency in the NHS to add more and more processes and practices to make care safer. Although these are not always evidence based, place additional burden on already busy staff and may be unnecessary, some become integrated in a complex healthcare system, and embedded in the culture of an institution.

'Mindful forgetting'

On the premise that front-line staff are likely to know best which safety practices are unfit for purpose or result in no safety benefits, researchers in the National Institute for Healthcare Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre are working with healthcare staff to identify which rules, processes and practices they would like to stop if they could.

Where the evidence supports this, we will then work with staff and patients to develop interventions to support the stopping or ‘mindful forgetting’ (Coiera 2017) of these in practice.

We’ve already had many valuable suggestions but there is still time for you and members of your networks and teams to have your say too.

For more information on this approach to improving healthcare safety, go to yhpstrc.org, and to submit suggestions, go to surveymonkey.co.uk


  • Coiera E (2017) The forgetting health system. Learning Health Systems. 1, e10023. doi.org/10.1002/lrh2.10023
  • Norton WE, Kennedy AE, Chambers DA (2017) Studying de-implementation in health: an analysis of funded research grants. Implementation Science. 4, 12(1), 144.

About the author

Gillian Janes is a senior research fellow at the National Institute for Health Research Yorkshire and Humber Patient and Safety Translational Research Centre

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