Situation Awareness for Everyone (SAFE) collaborative

Doctor checking beeper.

Join SAFE and improve safety in your hospital: fully-funded collaborative starts Sept 2021

Based on the success of earlier programmes, the Office of Nursing and Midwifery Services Director has agreed to fund a new cohort of the Situation Awareness for Everyone (S.A.F.E) collaborative. We are inviting clinical teams to join this new SAFE collaborative programme designed to improve communication, build a safety culture and enhance outcomes for patients in Irish hospitals. The collaborative will start in September 2021 and is an excellent opportunity for multidiciplinary frontline clinical teams to further develop quality improvement (QI) and patient safety skills to tackle a specific problem area in an early warning system of their choice. As well as QI theory, the SAFE programme includes situation awareness methodology and the planning or improving of safety huddles on the wards.

To date, three cohorts of SAFE have run successfully in Ireland, initially with two groups of paediatric and neonatal teams, with 13 adult and maternity teams graduating in June 2021. The new cohort is open to any multidiciplinary team working with any early warning system, from adult, maternity, neonatal, paediatric or emergency care settings.

SAFE: Designed to complement the Irish National Early Warning System (INEWS)

An updated version of the Irish National Early Warning System (INEWS) was published 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 caution' for use by staff, that is, a series of prompts for staff to use in conjunction with clinical judgement to determine if a patient is at risk of clinical deterioration.

The updated INEWS guidelines advocate the use of safety huddles and other communication tools to enhance patient safety. Hospital teams seeking to improve the management of the deteriorating patient will benefit from applying QI approaches such as those contained in the SAFE programme.

Limited funded places available for teams focused on any EWS 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 13 teams (worth €4,000 per team).

As we move towards an anticipatory approach to the management of clinically deteriorating patients, hospital teams seeking to implement the updated INEWS guideline 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

Watch a video which explains how the Rotunda Hospital integrated SAFE into their processes

The importance of creating an environment of psychological safety where healthcare professionals feel comfortable seeking help and advice from one another and from senior colleagues cannot be underestimated and is a key feature of the SAFE programme. In the current climate, facing both a global pandemic and a HSE cyber-attack, the importance of effective communication and the need for an environment of psychological safety for staff has come to the fore and has to be a priority for us all.

Dr Geraldine Shaw

Nursing & Midwifery Services Director, Office of the Nursing and Midwifery Services Director

Why do SAFE?

When you join the SAFE Collaborative, you will work within your teams 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.

SAFE takes the perspective of everyone involved in a patient's healthcare in 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 SAFE 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

We already have huddles – what’s different about the SAFE huddle?

Many teams will already be familiar with the concept of huddles or safety initiatives such as the HSE Safety Pause. This is encouraging but there is often room for improvement in an existing huddle or an opportunity for development of a bespoke SAFE huddle to target specific patient safety concerns. Previous SAFE teams have done both with great success.

Here is some of what our recent graduates had to say:

  • 'It facilitated closed loop communication among the different specialities within the hospital'
  • 'Reduced the ward hierarchy and allows any member of the team to advocate for patients and their safety'
  • 'The SAFE programme gave us a platform to identify and escalate issues daily and then find strategies to manage issues that arise'
  • 'We do a huddle in the mornings with managers and obstetric team, helps communication and anticipating patients we are worried about'.

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, in this case, early warning systems.

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.

What can we expect from SAFE training 

SAFE is a multidisciplinary team-based learning programme. Learning sessions will be delivered virtuallyin 2021 with the possibility of an in-person graduation day in 2022 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 September 2021, followed by five short, afternoon learning sessions from October 2021 to February 2022. These sessions will involve lectures, case studies, interactive group activities and project-based learning.

During the times  between learning sessions,  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 can apply?

Your SAFE team should include four members, representing senior clinical decision makers and key care providers to suit your setting. 

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

SAFE teams should expect to meet briefly at least weekly for the duration of the collaborative. During the COVID pandemic, team meetings were facilitated by virtual platforms which made meetings shorter and easier!

What is expected of me as a team member?

As a member of your SAFE team, you will be expected to: 

  • actively attend all scheduled learning sessions
  • actively meet your team on a regular basis
  • be actively involved in the design and implementation of quality improvement in your workplace.

Dates for 2021/2022 SAFE learning sessions

Learning session date delivery time
Learning Session 1 Tuesday 21 September 2021 Virtual 9.30 - 16:30
Learning Session 2 Wednesday 13 October 2021 Virtual 13.00 - 16.30
Learning Session 3 Wednesday 10 November 2021 Virtual 13.00 – 16.30
Learning Session 4 Tuesday 14 December 2021 Virtual 13.00 – 16.30
Learning Session 5 Wednesday 19 January 2022 Virtual 13.00 – 16.30
Learning Session 6 Tuesday 15 February 2022 TBC 13.00 – 16.30

Register your interest in joining SAFE

To register your interest in joining SAFE in September 2021, 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 SAFE before applying please contact the RCPI Quality Improvement Department at

Claire Davenport

Programme Coordinator, Postgraduate Medical Education Centre

Tel: +353 1 863 9752