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  • Women in patient safety: Interview with Dr Annie Hunningher

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    Dr Annie Hunningher is a Consultant Anaesthetist and a National Safety Standards for Invasive Procedures (NatSSIPs) lead. 

    In this interview, Annie explains why personal experience led her to feel so passionately about patient safety and shares her thoughts on how to engage frontline staff.


    AHunningher headshot (1).jpg

    Questions & Answers

    Can you tell us a little bit about yourself?              

    I’m a consultant anaesthetist at the Royal London Hospital with an interest in safety. I’m also the Barts Health Trust-wide Director and University College London Partners (UCLP) network lead for the National Safety Standards for Invasive Procedures (NatSSIPs).  

    I was a UCLP Improvement Fellow, 2017. That same year, our NatSSIPs team was awarded the Barts Health Hero award for Safety. 

    I’ve developed and delivered educational courses including:

    • trust-wide and UCLP network NatSSIPs 
    • multidisciplinary team (MDT) training
    • Gas Again (a return to work course for anaesthetists awarded the Humphry Davy Award Royal College of Anaesthetists 2017). 

    I’m a co-organiser of a number of safety conferences and safety network meetings (www.periopsafety.net, Patient Safety in Perioperative Practice at the Royal College of Anaesthetists, and the UCLP invasive network learning events). 

    I’m married with two sons and a dog and I was a carer to my mother before she died. I know to be my best self at work and at home, I need to exercise (I like running and swimming) and get lots of sleep. 

    How long have you been in post?

    I’ve been a consultant for 10 years. My trust-wide role has been 3 years and my UCLP role has been 1 year, with the secondment being extended for another year. 

    Can you tell us more about what you do and the purpose of your role?

    My trust-wide role has involved bringing standardisation, harmonisation and education through engagement and collaboration to invasive safety. We try to learn from excellence in addition to learning from our governance. I aim to get ward to board involvement, and as a frontline worker I can see the sharp end, understand the issues and I will highlight risks, work as done and advise on culture change in a meaningful way.

    Talk us through a typical day

    No day is typical! My clinical week is variable as I have a 4-week rolling rota with various specialty commitments, including ear nose and throat, orthopaedics, trauma, emergency, neuro and interventional radiology, along with on-calls. My supporting professional activity is also varied and includes educational supervision, trust meetings, UCLP days, Royal College of Anaesthetists events, delivering training and writing articles, case reports, policies/standards, book chapters, business cases etc. 

    What do you think is the most effective way to engage frontline staff in patient safety?

    • Collaborate and involve them. Listen and be kind.
    • Give team opportunities to develop and learn.
    • Engage hearts and minds with data and stories.
    • Be one of the frontline and show humility and fallibility. 

    How do you engage patients in patient safety?

    • Involve them in the reasons why we follow certain processes.
    • Consult them on their experiences ‘secret safety shoppers’.
    • Show them that actions and change are more important than the report.

    What three words best describe a culture that promotes patient safety?

    Fair. Kind. Responsive.

    What are the main barriers to patient safety for frontline staff?

    • Operational pressures
    • Financial pressures
    • Multiple conflicting tasks and priorities 
    • Lack of training and education, especially in teams.

    What do you think needs to stop, start and continue when it comes to patient safety?

    Stop: Focusing on compliance figures and meaningless measures.
    Start: Focusing on the quality of safety processes.
    Continue: To look at learning from excellence.

    Can you share an example or anecdote about how you or your team have had a positive impact on patient safety?

    The NatSSIPs work at Barts Health has changed the way our invasive teams work and train. In complex work, an understanding of human factors, tools that can help us and a good team culture make a big difference to the safety of care we provide. The processes which we follow have prevented harm. For example, discrepancies at sign in (one of our safety checks) between the consent, the arrow and the list have prevented multiple wrong site surgeries. We learn as much from the near misses as we do from the incidents. 

    What are you passionate about?

    I am passionate about real, sustained, quality safety improvement, rather than dashboards or data that is meaningless.

    If you could jump to 2050, in an ideal world, what would healthcare look like? 

    I am known for my blue sky and Utopian view of healthcare. I would like to see human factors design embedded and prioritised. The technology is there that can help us and we can use it to be safer. Auto-count pads for invasive kit, bar-coding and innovations like Wiresafe. 

    Can you tell us about a woman who has inspired you when it comes to patient safety?

    My mother (who died in 2015 from breast cancer) was an inspiration and my best friend. In 2013, she fractured her hip and had surgery at my hospital. Post-operatively, a very kind healthcare assistant helped her shower and didn’t keep the wound dry. It wasn’t her fault, as she didn’t know this was a basic of post-op nursing care and had received no local induction. My mum ended up with a wound infection, antibiotics and a prolonged hospital stay. This is when my interest in patient safety became a passion. I asked on the ward if this had been reported as an incident and this was met with fear. I wanted to make sure harm incidents like this would be avoided by other patients, through better education and using governance to learn in a just culture.

    What advice do you have for young females who are just starting out in their careers, whether in the healthcare industry or otherwise?

    Be brave, be fierce, find allies, make time to look after yourself and reflect regularly on your aims.




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    I love your emphasis on 'be kind'.  That immediately puts the patient at the centre of their care.  Am writing on behalf of the Campaign Against Painful Hysteroscopy.  Please do you know of any NHS initiatives to enable women to choose safely monitored IV sedation with analgesia for endoscopy of the womb?  It would end an awful lot of suffering.  



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    i like the point of Stop: Focusing on compliance figures and meaningless measures. many women at barts health are having pain scores of 8 9 and 10,s (on the vas scale) in outpatient hysteroscopy theater patients that should be transferred to theater that are not 

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