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Luke Brown

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Posts posted by Luke Brown

  1. During the COVID pandemic, it was clear that Emergency Departments across the UK needed to adapt and quickly, with my trust not exempt from this. We have increased capacity, increased our nursing and doctors on the shop floor, obviously with nurse in charge being responsible for all areas. We have different admission wards in terms of symptoms that the patient has, but also have a different type of flow, which i am getting my head around to be able to share

    I have seen departments split into 2 and various other ideas coming out from various trusts. Which got me thinking about patient safety and how well this is managed.


    So....

    How is your department responding to the pandemic?

    Do you have any patient safety initiatives as a result of the response?

    Is there a long term plan?

     

    The reason why i am asking this, is so we can share practice and identify individual trust responses.

  2. During the COVID pandemic, it was clear that Emergency Departments across the UK needed to adapt and quickly, with my trust not exempt from this. We have increased capacity, increased our nursing and doctors on the shop floor, obviously with nurse in charge being responsible for all areas.

    I have seen departments split into 2 and various other ideas coming out from various trusts. Which got me thinking about patient safety and how well this is managed.


    So....

    How is your department responding to the pandemic?

    Do you have any patient safety initiatives as a result of the response?

    Is there a long term plan?

     

    The reason why i am asking this, is so we can share practice and identify individual trust responses.

  3. I think there is a couple of strands here, 

    There is one element as identified above about not receiving feedback from the incident reported. I know from personal experience, there is an option for this now when the DATIX is closed which is brilliant. But in an age of computers and technology, sometimes the feedback is not as desired, so would recommend a face to face meeting (obviously social distanced). 

    Also I do think there is a culture of fear from completing DATIX's. Even now, I worry when I see a incident report regarding a patient I have looked after. Firstly thinking about the patient and then moving on to, what is going to happen to me? These are natural feelings and I think this can be a barrier to incident reporting. 

    I know there is lots of messages from trusts about being open and honest which we should all strive to be, but in the context of DATIX, I think we need to really home down on the message of DATIX is for learning and areas to improve. 

    I work for a trust that does take this seriously, and we often have team meetings, discuss and learn from these incidents, but doesn't stop the mind doing over time. I think the messaging and a showing of learning practices due to DATIX would actually go a long way! 

  4. Hi All, 

    I think your video identifies key areas that would allow us to feel safe at work. What I have found is the lack of clear information being a massive issue, more so during Pandemic times. This is not likely due to the individual trusts, but the change of messages in government on a national basis and the individual trusts adapting as necessary. Although this topic appears very clinical, I feel that members of staff need some certainty in these very uncertain times. Staff are adapting, changing and being flexible with their practices which can be stressful and put a strain on a team & systems. I appreciate that in health care, we constantly change our practices, but this topic is much more personal than previous. This pandemic is indiscriminate, and has the potential to affect staff, staff families, friends, colleagues and so on. When so many health and social care workers have been affected and have died due to this pandemic, the change in practices on top of this, is a lot for people to take in. 

    The problem I fear we have now, is that a lot of staff are "bracing for impact" and I don't know how much reserve particularly the nursing profession has with regards to this. I fear from an economic standpoint, that lockdowns and similar measures would not a be a viable option, therefore approaching Flu season, there is much apprehension regarding Flu vs COVID  which is becoming a topic in the back of our minds. 

    Staff Well-Being has definitely been bought forward in recent months, with offers of psychological help and Self Care ideas from larger and local businesses/ apps which has been fantastic. But these are not going to last forever, and if/ when COVID is over, I worry about the aftermath particularly those health and social care practitioners, who may have been in lockdown 2-3 times in certain areas of the UK.

    I whole-heartedly agree with the 3 you have chosen, but I think there is more. I think having just 3 is a band aid on a gushing wound. I fear we may need a bandage. 

     

  5. I think it’s difficult sometimes to get the balance right, I don’t think it’s a ‘see saw’ I think it’s a balance act of ‘multi-elements’ 

    One one hand the patient who should be our main priority and making sure that Candour and communication of the incident happens. 

    Another side of this would be the investigation itself, which I think people tend to follow the pathway to the letter, however in these pathways, there is no documentation about ‘support for individual’ I have done training linking with this in the past, but there was never a mention of supporting individual, only focusing on the process etc. 
     

    Then you have your individual who has completed the error, and whether they are suspended/ continuing to work, they are going through an awful time with over analysing the situation, and feeling pressure on the shoulders. 
     

    So I think it’s much more complex than what many may perceive.... I am sure I’m not the only one to say I have made an error, and I am proud of the nurse who posted the original post! Thank you 

  6. On ‎08‎/‎11‎/‎2019 at 14:27, Evelyn Prodger said:

    It is really tricky in organisations of different sizes and with different geography.

    Small organisations have fewer people to draw on and often fewer incidents so identifying trends or forming a working group with a new perspective can be a challenge but you can have great conversations because everyone is based together.

    Community Trusts have different challenges. They are likely to have more disparate teams on stand alone sites across large geography making coming together difficult. They may work in different systems i.e. Community Hospitals may be linked to different acutes for microbiology so different reporting systems and different antibiotic prescribing protocols. The meeting structure can be very hierarchical as a way of managing workloads but this can make the decision making remote form the frontline. They do however, by their nature, have a more diverse workforce which opens up more lateral problem solving if harnessed correctly.

    I am not convinced it is more or less difficult in any area, the challenges (but also the options to be creative) are just different.

    I think there is something about honest conversations and reducing organisational fear about looking outward. Make it okay for me to talk to a Community Trust in the North about where I am with falls and share solutions. Use technology sensibly to enable conversation (video conferencing not conference calling). Above all the people with the greatest insights into what we could do better are our frontline staff, patients and carers and they are right there where the care is being delivered.

    I joined a webinar today about clinician burnout and one of the discussions resonated for patient safety. They talked about "silly rules" and how they govern behaviour. If clinicians in whatever setting could have the courage to say this rule is negatively impacting on patient safety (e.g. say pedal bins with lids are required in toilets but patients are falling over trying to balance to open them) then there can be a open debate about the greater risk.

     

    Not sure any of this helps @Claire Cox but happy to discuss further.

     

    Wonderful insight, thank you @Evelyn Prodger, its very easy to get "trapped in a bubble" and not sure about how ither trusts work, particularly as i have expeirence in both, but really flourished in a smaller hospital. As i stated prior, i was very junior in my previous trust and lacked experience. 

    Thank you 

  7. I have worked in a large trust in London, but was very junior and didn’t appreciate the enormity of the trust from a management and patient safety perspective. Incredibly, there are further complications for trusts with Community Teams. Very complicated processes, be great if anyone has got any insight into this? 

  8. I have been thinking recently about the challenges which is posed towards larger trusts with regards to patient safety. Particularly with getting information disseminated to all staff and being reliant on endless emails. I have recently done some work with our Action Card App which has posed its own challenges particularly with physically getting around the Departments, spreading the word, and assisting people on the app itself. What really helped us iare screen savers, twitter and having those key conversations with stakeholders within the trust. I was wondering what everyone elses perspectives were?

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