Sharing learning on WalkRounds – August 2010
Patient Safety WalkRounds are now routine practice in NHS organisations
across Wales. In some cases, they have been used for over 4 years, since
being introduced as part of the Safer Patients’ Initiative; but in most
organisations they were first tested and used from 2008 as part of the 1000
Lives Campaign.
The points below draw on learning about the process to date that was
shared during a WebEx session on 19th August 2010.
Board training and development on WR implementation.
 Need to maintain a focus on patient safety in framing the questions
and opening statements – WR’s should not be allowed to become ‘all
things to all people’.
 WR visitors can use ward—based display boards of improvement
progress to trigger questions about successes and concerns.
 If an area has not experienced WR’s before, then visitors should not
be surprised if staff raise many long-standing and well-known
‘difficult’ issues, but the aim is to prioritise, practical safety issues
for resolution.
WalkRound planning.
 Need to give ‘just enough’ advance notice – planning too far advance
may lead to frustration is sessions need to be re-scheduled.
 GP practices and other contractor services are likely to need more
advance notice and timing should be discussed and agreed with the
Practice Manager.
 Short notice offers of a WR visit may be welcomed by staff,
particularly once staff become familiar and comfortable with the
process.
 Asking teams to communicate about WR’s in the context of safety
briefings can be a good way to get staff thinking about issues to raise
in advance.
Action tracking and reporting.
 Wherever possible, make sure front line teams are given authority to
take the actions at the end of the WR. This will help reduce the risk
of large numbers of actions needing to be tracked centrally.
 For actions that the team cannot address directly, authority and
accountability for actions should be delegated to Divisions/Clinical
Programme Groups wherever possible. Tracking of progress can then
be included in routine reviews.
 Mapping actions against the Standards for Health Services could be a
useful way to categorise actions.

Make sure a record of previous actions is available when areas are
being re-visited, so that WR visitors can confirm that actions have
been closed.
Testing WR's in new settings.
 A ‘virtual WalkRound’ has been tested with a community pharmacy,
where the practice premises were too small to accommodate a visit.
 WR’s should be tested at Divisional and locality level to build
capacity and maximise the opportunities for all teams to participate.