ABC for Patient Safety Toolkit

The Achieving Behaviour Change Toolkit was designed and developed by Dr Natalie Taylor in 2013 as part of a research programme funded by the Yorkshire and Humber Health Innovation and Education Cluster. The toolkit has been based on learning from this successful programme which used behaviour change theory to support the implementation of patient safety guidelines.

The toolkit comprises an instruction manual and resources to support each of the six steps. We recommend that users read the instruction manual and each step of the toolkit before starting their own project.

Instruction Manual

The instruction manual for the toolkit is available here

Step 1: Forming Implementation Teams

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Step 2: Identify the Target Behaviours

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Step 3: Understanding Barriers to Performing the Target Behaviour

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Step 4: Devising Intervention Strategies to Address Identified Barriers

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Step 5: Intervention Implementation

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Step 6: Evaluation

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Further support

Further support is available to participants who attend our one-day ABC training workshop. For details of the next workshop check our upcoming training and events.

What is behaviour change?

This video outlines the challenges of achieving behaviour change and introduces the methodology behind the ABC toolkit.

Some examples

The best way of demonstrating the feasibility and effectiveness of this approach is through example:

1. Natalie Taylor and colleagues from Bradford engaged in a series of patient safety projects adopting this approach. One example used this process to reduce the risk of feeding into misplaced nasogastric tubes. With the involvement of stakeholders, the barriers and levers to ideal practice were assessed using the TDF. Theoretically based practical interventions designed by local clinicians with support from behaviour change experts resulted in more frequent adoption of the desirable clinical behaviours.
2. TRiaDs (Translation of evidence into practice in dental settings programme) involves a number of projects whereby Scottish Dental Guidelines are implemented into dental practice. Questionnaires and interviews (based on the TDF) are used to identify barriers and levers to these key recommendations. Data are routinely collected to measure compliance with the guidance. Interventions are designed according to elicited barriers and levers and are theoretically based. Trials evaluating the effectiveness of this approach are underway.
3. Dr Judith Dyson compared the use of a theoretical approach (the TDF) in the assessment of barriers and levers to hand hygiene with a non-theoretical approach. Although there was considerable overlap in the barriers and levers identified in these two approaches there were also significant differences. The use of theory identified more barriers and levers, some of which, people do not ordinarily report but which may have an important impact on behaviour (e.g. emotion). An instrument was developed and used by the authors to assess barriers and levers to hand hygiene in a group of junior doctors in an NHS trust in the North of England. Interventions were designed by the researchers and the doctors according to the TDF and hand hygiene improved following implementation of these.