To celebrate World Patient Safety Day’s 2025 theme “Safe care for every child and for every newborn” we have invited a group of exceptional clinicians and researchers in the field to talk about their research and broader topics relevant to this year’s theme.

In this blog we are talking to Dr. Calandra Feather, Clinical Safety Officer at Dosium, and an honorary Clinical Research Fellow with the NIHR North West London Patient Safety Research Collaboration.

Can you tell us a bit about your background and what led you to work in this area?

I trained and worked as a children’s nurse, spending many years caring for children and families in hospital. Paediatric medication is uniquely complex: doses may be calculated from weight, age, or body surface area, and both prescribers and nurses often need to work through manual calculations. I was aware of errors that occasionally came to light, but it was only when I moved into research that I began to understand the hidden scale of medication-related harm, now recognised as the leading cause of preventable harm in healthcare worldwide. What was supposed to be a short secondment soon turned into a PhD, and then into a career focused on evaluating and implementing decision support systems to make prescribing safer.

Some of your recent work has highlighted the benefits that may arise from the use of clinical decision support software for paediatric prescribing. Can you tell us a bit more about this and anything you are particularly proud of as part of this work?

One of the most exciting aspects of my recent work has been the evaluation of Touchdose, a new clinical decision support tool developed by Dosium. Touchdose is a patient-specific, indication-based prescribing system that uses the BNF for Children (BNFc) as its underlying formulary, embedded within the existing electronic health record. It is now live across West London Children’s Healthcare, and our research at Imperial College Healthcare NHS Trust found that Touchdose reduced the odds of a prescribing error by more than 80% compared to standard practice. I am especially proud of how positively frontline prescribers and nurses have responded. They describe it as intuitive, supportive, and time-saving, which is exactly the type of impact we hoped for. It is also a great example of collaboration between academia, the NHS, and industry to deliver innovation that makes a tangible difference.

In your opinion, what are the biggest challenges that prevent the delivery of safe care in newborns and children?

One of the biggest challenges is that new innovations, guidelines, and services are almost always designed first for adult populations and only later adapted for children, often with limited oversight or consideration of paediatric needs. But children are not just “small adults.” In medication prescribing alone, there are meaningfully different considerations around drug metabolism and excretion, the much narrower margin for error, the need for frequent dose adjustments as children grow, and the practicalities of administration. Current systems often do not discern between whether the patient is a neonate, a child, or an adult. As a result, an adult dose suggestion may appear alongside one for a newborn baby, meaning that a single mis-selection can result in a significant dosing error. There is no “one size fits all” approach. The outcome is that paediatric services are frequently left working with systems or evidence bases that do not truly fit, contributing to variability in care and creating unnecessary risks. Addressing this requires more paediatric-specific evidence, tools designed with children in mind from the outset, and sustained attention to the unique requirements of safe care for this population.

What do you think is going to make the biggest difference in the field in the next 10 years?

As we move towards a more technology-enabled future, systems should be able to take into account a patient’s age, weight, condition, and other key factors to provide truly personalised care. Once we have mastered these basic but fundamental requirements, then we can begin to build in more advanced layers such as genomics and precision medicine. At the same time, a groundswell has been catalysed in how we define what good looks like. We should expect, and demand, the same level of digital maturity, standardisation, and safety infrastructure across all patient groups,  from neonates and paediatrics to adult and elderly care. Raising expectations in this way will help ensure that safe, evidence-based, and patient-specific systems are seen not as optional extras but as core requirements of high-quality care.

In one sentence, what message would you like readers of the blog to take away?

Safe care for every child and newborn requires us to raise the bar – good enough is not enough – and to commit to systems that deliver the safest and best possible care.