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Pete Smith

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When John and I introduced Below Ten Thousand to our audience, we relied heavily on creating the image of a plane skimming the treetops  

The image formed a Cognitive link to an action which invoked a behavioural team response which then optimised the performance environment.

Creating the image contributed to our success.

To help clinicians (wanting to improve patient and staff safety using ideas born of their own reflective practice) be brave in the face of hierarchal opposition, I’ve recently settled on the image of the ‘sword in the stone’. 

Your thought, please!


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Just ordered your 'The Below Ten Thousand' book. And then the amzing @Claire Cox has shared her copy with me. Great stuff! Can't wait to read.

Creating the image. That's a really intesting concept and soemthing we should think about too @Sophie Caswell

Really awful that clinicians need to be brave. Think @Claire Cox is developing a blog on courage. Won't it be wonderful when all staff and patients are actively encouraged to identify areas for improvement and new ideas are celebrated , actioned and shared?

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I feel strongly that having courage to come to work to do your job and improve care for patients is a symptom of a failed system.  Giving safe care or innovating ways to give safe care should be a 'thing we all do' not a 'thing other people do' .

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Would really like a coffee and a Round Table right now! 

Feel free to suggest a better image, because the sword in the stone has certain mythological connotations which may or may not be helpful. 

For me it bears the image of a will to advocate in the face of a need for change ?

All swords work best when emotional intelligence and intellectual humility reign receptive over the change environment to such effect that the sword need never be used. 

Inference born of my own wishful thinking?

For me, the principles of graded escalation would be inscribed along the blade. 

Interesting thought.

Maybe better to ditch the sword and just have the stone lol  

in the end I thought I would start with an easy topic just to practice with this incredible forum.

Can’t wait to read Claire’s blog on courage!

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Claire, I agree!

Being a clinician is such an incredible job. Every patient is a potential test of the sum total of all your knowledge and skill. 

Looking into the profession from the outside, as I now can, what we manage each day is incredible and just being there takes guts. 

I’m sure you find the same, but walking into work each day, I used to love that I could achieve small miracles with nothing more than my brain and my hands, but it took all I had to give, plus more, which is where the courage comes in. 

Layer over that a positive Safety culture that embraces opportunities to learn and improve no matter where the inspiration comes from and the future will be....wow!

That is why what you are doing with Patient Safety Learning is so important. In the end you will be the architects of changing how we change ?

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I’m a slow thinker.

It takes a while, but the symbol is finally complete:

it is the Staff of Asclepius that is stuck in the stone. 

I’m going with that as my go-to image. 

Change? It’s worth a try!

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