MoRISS checklist

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The Monitoring Risk and Improving System Safety (MoRISS) checklist for priority safety issues.

Why do we need such a checklist?

Practice processes for checking priority safety issues that can impact on the health and wellbeing of patients AND GP team members are highly variable and can be inconsistently applied which often contributes to why significant events happen.

When combined with everyday workloads and stresses our memory spans and attention to detail are affected.  This means we can often forget to undertake necessary checks of important safety tasks as planned – this can lead to errors being made, sometimes this has no real consequences but on other occasions it impacts negatively on patients, staff and the practice.

Checklists are used routinely in high risk industries such as aviation, nuclear power and many hospitals to help staff remember critical tasks to be undertaken to ensure mistakes are not made and help make patients and the workplace safer.

The purpose of this checklist is to help ensure that tasks that are considered to be important from a safety perspective are actually checked on a routine basis and action is taken where needed to improve overall compliance.  It aims to combine some existing checking processes into a single checking system which is undertaken every four months to ensure that the necessary checks are completed on a timely basis.

About the checklist

The preliminary checklist was developed based on a combination of what we know can go wrong when things that should be checked routinely in practice are not, and the knowledge and expertise of a large group of practice managers, practice nurses and GPs who contributed to its design and content over several workshops and surveys.

It is important to note that it is not mandatory – but is a flexible guide, you will not necessarily agree with all of the content nor may it always be relevant to your practice.  Use your own judgement and apply your own common sense.  In these cases, simply tick Yes for being fully compliant.

As far as possible the development process was informed by human factors/systems thinking and guidance to make the checklist content relevant and understandable and to cover all aspects of the general practice workplace.

If the checklist is not an improvement on existing checking processes then it is unlikely to be used, although bear in mind that some practices do this inconsistently and infrequently compared with others.  The prevailing safety culture within a practice will also influence how seriously the checklist and checking processes are taken i.e. the checklist itself will not make the practice processes safer, like any improvement activity this is always down to the leadership, team-working and commitment of the GP team.

How to use the checklist

Simply work your way through the checklist (it has been sub-divided to make it easier to follow and complete) and use a combination of checking and your own professional judgement to determine whether you are fully compliant with each of the issues outlined.