Women in patient safety: Interview with Helen Higham

Summary

Helen is a Consultant Anaesthetist at the Oxford University Hospitals NHS Foundation Trust (OUHFT) and a Senior Clinical Research Fellow in the Nuffield Department of Clinical Neurosciences, University of Oxford.

Here, Helen highlights the importance of support and training and gives an example of how the OxSTaR team are transforming staff teamworking skills and improving patient safety.

Content

Questions & Answers

Can you tell us a little bit about yourself? 

In addition to my clinical responsibilities as a consultant anaesthetist, I have many roles in education and research both in the OUHFT and the University of Oxford. 

As Director of the University of Oxford’s Simulation Centre, I lead a team which provides simulation-based education for students and healthcare professionals in the OUHFT, Thames Valley and wider regions.

I am co-director of the Patient Safety Academy providing training and support to healthcare professionals in the application of human factors to improve quality and safety across the Thames Valley region.

As an executive member and immediate Past President of the Association for Simulated Practice in Healthcare, I am closely involved in promoting and developing simulation in healthcare education in the UK and Ireland and in advancing relationships with similar organisations worldwide.

How long have you been in post?

I have been a consultant since 2001.

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

I lead the simulation and human factors training programme for the OUHT and head a research team studying many aspects of patient safety in primary and secondary care settings.

Talk us through a typical day

No day is typical which is part of the fun! I have clinical responsibilities usually on a Monday and Tuesday working with two fantastic teams: one in orthopaedics and one in maxillofacial surgery. My on-call work covers theatres in the main John Radcliffe site where we cover major trauma and general surgical emergencies. Working in clinical teams, often under conditions of stress and high pressure, reminds me how incredibly resilient and innovative healthcare professionals can be.

My other roles in patient safety allow me to teach and conduct research in simulated and real clinical settings in the hospital and in primary care settings such as GP practices and with paramedics. My weeks are never the same – one day I’ll be teaching a human factors course, the next engaging in QI work and the next designing a research protocol or writing a paper. The variety keeps my work life very exciting!

What do you think are the most effective ways to engage staff in patient safety?

Make it real for them – bring them together, give them some guidance and allow them the time to think about issues in their clinical areas. As soon as staff start talking about a safety problem they have seen, you can’t stop them coming up with potential solutions and plans to fix it. They simply need the time and support to get on with it.

How should patient safety leaders be engaging with patients? 

The simple answer is to include patients in everything. Having spent several years getting our annual simulation conference accredited as “Patients Involved” I know that it’s challenging to do this properly but when you do get it right it’s amazingly powerful.

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

Trust. Compassion. Honesty.

What are the three main barriers to patient safety?

• Time, time and time!
• Support for staff to engage in improving safety consistently and sustainably.
• Encouraging senior management in hospitals to empower their staff to embed safety practices.

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

• We need to stop ticking boxes and use proper metrics to assess safety.
• We need to start trusting our staff to implement changes to improve safety – it seems remarkable to me that in organisations which label themselves 'trusts', that is the one quality that is so often lacking.
• We need to continue to put the patient at the heart of our decision making processes.

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

I have several examples from our feedback where staff have used one of the communication tools we have taught and it has prevented an error, but I’ll give you the one that a colleague submitted when he nominated us for a Trust safety award:

“The OxSTaR team have been promoting effective teamwork with the OUHT for many years. In the last year, I have seen several examples of teams working more effectively in life-or-death situations (such as failed intubation and unexpected massive bleeding) than has been the case in years gone by. Skills in team working under extreme pressure bolster the confidence of individual members of staff. By no means do all life-threatening events have a good outcome and it is absolutely key for staff to know that they have done their best. The OxSTaR team are transforming staff teamworking skill and thereby improving patient safety in the OUHT.

I have used the technique 'ten seconds for ten minutes' three times in the last year when attending emergencies in theatre, PACU and ICU. This technique is a formal way of 'steering' a team in a potentially chaotic situation. Although I had heard of this technique being used in military medicine, I first practised using the technique in OxSTaR. This gave me confidence to use it in real life. In addition to experiential learning, it is important for a proportion of staff involved in emergency scenarios to be familiar with the human factors approach promoted within the OUHT by OxSTaR. For the last year, when I arrive at emergencies, it is clear that the staff now draw on the 'toolbox' of techniques promoted by the OxSTaR team. Teamwork in emergency situations is now calmer, controlled and more effective.”

What are you passionate about?

Improving patient safety.

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

It would be run more efficiently, partly through acceptance that improved resource is required to provide word-class healthcare but also because staff would receive training that is fit for purpose and be given time to undertake improvement work. Safety, quality and efficiency are inextricably interlinked.

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

My medical director, Dr Clare Dollery, is a passionate proponent of patient safety and an enormous support in the work I do. She is tireless in her pursuit of a blame-free safety culture but does it all without any attempt at self-aggrandisement and always highlights the exceptional work her teams do.

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

Never believe that something can’t be done – there is always a way.

Twitter

@HelenEHigham

@OxSTaRCentre