Make PSIRF learning measurable.

Structured patient safety analysis for NHS organisations. CASCADE turns incident data into learning that reaches practice.

PSIRF · Patient Safety · Clinical Governance · NHS & International Experience

The Problem

Incidents are reported.
Learning is not.

Healthcare organisations collect large amounts of safety data. Incidents are logged, investigations completed, reports filed. The learning rarely reaches the people or systems that need it.

Themes repeat. Actions close on paper. Frontline teams remain unaware of the patterns in governance databases.

"The most dangerous gap in patient safety is not the absence of data. It is the absence of a system to learn from it."

PSIRF now requires organisations to demonstrate that they have learned, not just investigated. That requires a structured approach.

67%
of NHS staff say lessons from incidents are not shared effectively
1 in 3
safety actions close without evidence of sustained change
PSIRF
requires evidence of learning, not just reporting activity
Repeat
themes persist across NHS Trusts without structured analysis
Framework

The CASCADE Patient Safety Framework

CASCADE is a structured patient safety methodology developed from direct NHS practice. It takes your incident data and produces governance-ready analysis, recommendations, and evaluation outputs that evidence learning at board level under PSIRF.

Each engagement applies the full framework. Outputs are practical: suitable for patient safety committees, PSIRF reporting, and frontline learning conversations.

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What it works on

Your incident data, near misses, and safety intelligence

What it produces

Governance-ready analysis and strength-rated recommendations

How it measures

Outcome, process, and sustainability evaluation for board reporting

Who it is for

NHS Trusts and ICS organisations implementing PSIRF

Services

Four ways to work with CASCADE

Each service applies CASCADE to your organisation's context. The right starting point depends on where you are with PSIRF and what your governance requires.

Diagnostic

CASCADE Diagnostic Review

A structured analysis of your incident data. We identify patterns, map system factors, and produce a governance-ready report with strength-rated recommendations. Includes a debrief with your patient safety lead.

Embedded Programme

CASCADE Embed Programme

A 3 to 6 month programme that builds CASCADE as a repeatable cycle within your organisation. Includes a diagnostic review, facilitated second cycle, internal training, and a board-level close-out.

Facilitated Learning

CASCADE Learning Workshop

A half-day or full-day facilitated session that takes your team from raw incident themes to a structured learning output and action log. Designed for patient safety leads and governance teams.

Training

CASCADE Practitioner Training

One or two days of training for patient safety and governance staff to apply CASCADE independently. Includes the full operational toolkit. Available in-house or as an open cohort.

All CASCADE engagements begin with a free 30-minute discovery call. Get in touch to start the conversation.

Evidence

What structured analysis can deliver

Figures from an anonymised pilot CASCADE Diagnostic Review applied to a single NHS service. Results from one engagement only.

36%
of incidents reclassified at lower harm following structured review, reducing LFPSE reporting burden
~155 hrs
of meeting time released by reducing unnecessary case review huddles through clearer triage
0
patient harm events in reclassified incidents, confirming reclassification was clinically justified

Published work: Nursing Management (RCNI) · Nursing Times · Patient Safety Learning Hub

About

Aderonke Opawande

Aderonke Opawande is a Registered Nurse, Patient Safety Specialist, and founder of the CASCADE Framework, an approach designed to help healthcare organisations turn incidents into meaningful system learning and measurable improvement.

Dual board-certified in healthcare quality and patient safety, she has experience across NHS acute, community, and mental health services, local authority healthcare, and international healthcare consulting and education.

She is the author of Patient Safety 101: A Practical Guide for Nurses and other patient safety educational resources focused on systems thinking, workforce learning, psychological safety, and safer healthcare delivery.

Her work focuses on helping healthcare professionals and organisations move beyond blame toward practical, sustainable improvement and safer systems of care.

MSc Patient Safety & Healthcare Quality Registered Nurse CPHQ CPPS Clinical Safety Officer
Selected publications
  • Nursing Management · RCNI · December 2025
    Designing Accessible and Usable Clinical Policies to Enhance Patient Safety
  • Nursing Management · RCNI · September 2025
    Supporting Internationally Educated Nurses in Navigating Patient Safety in the UK
  • Patient Safety Learning Hub
    CASCADE Patient Safety Framework

Patient Safety 101

Practical patient safety education for nurses worldwide. Handbook, ebooks, and learning resources, including the CASCADE Workbook.

Visit patientsafety101.com →

LinkedIn

Patient safety insights, CASCADE updates, and published articles.

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Get in Touch

Tell us what you are working on.

We are still developing how CASCADE is delivered and would welcome a conversation about where your organisation is and what you need. There is no fixed menu to select from. Just tell us your context.

We aim to respond within two working days.

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