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

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Join S.A.F.E and improve safety in your hospital

Deadline extended for expressions of interest

We are looking for clinical teams to join a new Situation Awareness for Everyone (S.A.F.E) collaborative programme designed to improve communication, build a safety culture and enhance outcomes for adult patients in Irish hospitals.

The deadline for receipt of expressions of interest in joining this collaborative has been extended until September 21, 2020. 

The S.A.F.E collaborative will start in October 2020 and is an excellent opportunity for frontline clinical teams to learn Quality Improvement and patient safety skills. Teams use this training to tackle a specific problem area of their choice. As well as Quality Improvement theory, the S.A.F.E programme includes situation awareness methodology and the planning of safety huddles on the wards.

Originally developed by the Royal College of Paediatrics and Child Health to improve safety in paediatrics, S.A.F.E has been an extremely successful and effective safety initiative completed by 50 teams across the UK and 20 frontline paediatric and neonatal teams in Ireland.

S.A.F.E: Designed to complement the Irish National Early Warning System 

An updated version of the Irish National Early Warning System (INEWS; Acute Medicine programme) is due for publication in 2020.

The updated guidelines see a move towards an anticipatory approach to the management of clinically deteriorating patients. An anticipatory approach to care acknowledges the vulnerability of patients with 'no' or 'low' INEWS scores. It involves the earlier recognition of the potential for deterioration through the use of clinical judgement, situation awareness and an appropriate tiered response model.

The INEWS Escalation and Response Protocol incorporates 'cues for concern' for use by staff, that is, a series of prompts for staff to use in conjunction with clinical judgement. The updated INEWS guidelines advocate the use of safety pauses and communication tools to enhance patient safety. Hospital teams seeking to improve the management of the deteriorating patient will benefit from applying Quality Improvement approaches such as those contained in the S.A.F.E programme.

Funding available for teams focused on INEWS or IMEWS projects

The HSE National Deteriorating Patient Improvement Programme, supported by the Office of Nursing and Midwifery Services, will fund the S.A.F.E course fee for up to 10 teams (worth €4,000 per team). To be eligible for this funding your team must focus on implementing INEWS or IMEWS improvement projects.

As we move towards an anticipatory approach to the management of clinically deteriorating patients, hospital teams seeking to implement the updated INEWS guidelines will benefit from applying Quality Improvement approaches such as those contained in the SAFE programme.

Avilene Casey

National Director of Nursing & Midwifery, Executive Lead HSE National Deteriorating Patient Recognition & Response Improvement Programme

What your team will learn when you join S.A.F.E

When you join the S.A.F.E Collaborative, you will work within your teams and with expert faculty to achieve the following aims:

  • Reduce avoidable error and harm to acutely unwell patients
  • Improve communication between individuals involved in patient care
  • Improve the working culture for healthcare staff providing patient care in your setting
  • Increase the involvement of patients and families in their care

Your team will be taught how to implement an innovative improvement bundle. The bundle improves safety through interventions such as the Irish National Early Warning System (INEWS), effective communication, and short, tailored 5 – 10 minute huddles.

S.A.F.E takes the perspective of everyone involved in a patient's healthcare at hospital - doctors, nurses, porters, families and patients themselves - so that the clinical team can make the best decisions.

This course will take complex theories on patient safety and translate them into practical methods that clinical teams can apply in their day to day practice. Instead of undertakingsafety projects, safety becomes a way of life for the clinical team. You will learn about real-time management of risk to providers and receivers of care, anticipation of threats and hazards and the actions you can take to ensure safety. The S.A.F.E programme will reflect on how we responded during the COVID-19 pandemic; what we would do differently and what we would do the same.

Dr Peter Lachman

Lead Quality Improvement Faculty at RCPI

What is a Quality Improvement (QI) Collaborative?

A QI collaborative is a short-term learning system that brings together teams from different hospital sites to seek improvement in a specific subject area.

Frontline teams work together with improvement experts, using quality improvement methodology, to implement changes at the frontline of healthcare. Teams will adapt the concepts to suit their local setting, resources and identified safety needs.

How SAFE training is delivered - What to expect

SAFE is a team-based learning programme. Learning sessions will be delivered virtually, alongside 1:1 virtual team coaching, with the possibility of face-face sessions in 2021, dependent on current NPHET guidelines. The dedicated SAFE faculty will facilitate your team’s SAFE journey using the methodology and will support you in working through your SAFE project in your own setting.

Your team must attend six learning sessions: a virtual learning session in October 2020, followed by five short, afternoon learning sessions from November 2020 to May 2021. These sessions will involve lectures, case studies, interactive group activities and project-based learning.

The time between these sessions will be designated as action periods, during which your team will use QI methodology to test improvement ideas in your hospital. Your team will need to meet regularly for short team briefings to work through the project. Teams that meet more often have shorter meetings!

Who to include on your project team

Your project team should include three to four members, representing senior clinical decision makers and key care providers during the adult inpatient journey.

Each member of the team must be able to exert organisational change within their institution. At least one consultant, one senior nurse and an NCHD should participate.

Project teams should expect to meet briefly at least weekly for the duration of the collaborative.

Dates for 2020/2021 SAFE learning sessions

Learning session date delivery time
Learning Session 1 Wednesday 21 October 2020 Virtual 10.30 – 16.30
Learning Session 2 Friday 27 November 2020 Virtual 13.00 – 16.30
Learning Session 3 Friday 11 December 2020 Virtual 13.00 – 16.30
Learning Session 4 Friday 22 January 2021 TBC 13.00 – 16.30
Learning Session 5 Tuesday 23 February 2021 TBC 13.00 – 16.30
Learning Session 6 Tuesday 4 May 2021 TBC 13.00 – 16.30

The SAFE collaboration for us at Mayo University Hospital has placed safety at the centre of patient care. All team members now know that voicing their concerns and offering solutions that enhance safety is the expected behaviour. The huddle supports and reinforces this culture.

Dr Michael O'Neill

Consultant Paediatrician, Mayo University Hospital

Register your interest in joining S.A.F.E

To register your interest in joining S.A.F.E in October 2020, please complete the application form below (Word document) and email it to

We will follow up with you. One person should complete the form on behalf of the team.

If you would like to speak to someone about S.A.F.E before applying please contact the RCPI Quality Improvement Department at

The closing date for registering your interest is Friday, September 21, 2020. 

Claire Davenport

Programme Coordinator, Postgraduate Medical Education Centre

Tel: +353 1 863 9752