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Content ArticleOn 2 September 2006, all 14 crew of a UK Royal Air Force (RAF) ‘spy plane’ Nimrod XV230 were lost following a catastrophic mid-air fire. The aircraft was on a routine mission when a leak of aviation fuel, shortly after air-to-air refuelling, came into contact with a source of ignition. The fire was not accessible, not able to be remotely suppressed, and the incident was not survivable. ‘The Nimrod Review’, led by The Hon. Mr Justice Haddon-Cave, is a model investigation, and should be required reading for executives and leaders in all industries. The Review takes the aircraft fire as its starting point, but casts its net far and wide through the organisation, as well as considering relevant events in other industries. This Nimrod XV230 tragedy is so rich in lessons, Martin Anderson, Chartered Human Factors Professional, shares on his website a series of articles about the Nimrod XV230.
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Content ArticleYou may not have heard about them; what they do is rarely in their job description. You may not even be aware of what they do; they tend to act as enablers rather than taking credit or seeking the spotlight. But they are here— working on sustainable change, across challenging silos, in complex social landscapes, amid changing circumstances. We call them systems conveners. For many people, being a systems convener is only something that exists in retrospect. They may never have set out to convene people across a social landscape but have found themselves taking this on as a way to make a difference they care to make. Even if they set out with the intention to use a convening approach to make a difference, they may not have an adequate language to describe what they do. The purpose of this book from Etienne and Beverly Wenger-Trayner is to shine some light on systems convening—to emphasise the importance of this work and provide a language to articulate what it entails. The authors also want to describe the experience of people who do it. Systems convening is not an abstract type of work that can be done with detachment. It takes personal commitment and passion. It involves the heart as well as the head. To bring this to life, they have included portraits and quotes from people they interviewed.
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Content ArticleHealthcare settings are inherently hazardous places, with very unpredictable and complex working environments. These hazards and risks not only result in a range of injuries and ill-health among workers but also jeopardise the safety of patients. The COVID-19 crisis has amplified the importance of ensuring that the healthcare that is provided is safe—for patients and health workers alike. A sufficient, and capable, workforce, is the foundation of resilient systems. Policy makers need to focus now on how to build and support an appropriate workforce to respond to future shocks. This includes health workers beyond the hospital—including those in community, long-term, and primary care. The safety of both patients and health workers should be protected through appropriate mechanisms to ensure the safety of protective equipment and sufficient supplies, appropriate staffing levels, training and support at the workplace. These governance mechanisms are even more relevant when policy makers face trade-offs between health, safety and economic concerns. This is part of series of health working papers from the OECD on the economics of patient safety. The preceding paper, focusing on Long-term care, can be found here.
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In most cases pregnancy and birth are a positive and safe experience for women and their families. This is the outcome that everyone working in maternity services wants every time, for every woman. But when things go wrong, we need to understand what happened, and whether the outcome could have been different. The death or injury of a new baby or mother is devastating and something that everyone working in the health and care system has a responsibility to do all they can to prevent. Following the publication of ‘Getting safer faster’ the Care Quality Commission (CQC) launched a programme of risk-based, focused maternity safety inspections involving a more focused in-depth assessment of relational elements such as teamworking and culture, staff and patient experience. Building on our previous calls for action, the CQC also sought to further explore the barriers that prevent some services from providing consistently good, safe care and to better understand the disparities in outcomes that exist for women and babies from Black and minority ethnic groups. This report presents the key themes from nine of those inspections alongside insight gathered from direct engagement with organisations representing women using maternity services and their families, including Five X More and local Maternity Voices Partnerships. -
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'Whistleblowing': a definition for reflection in Speak Up Month
Steve Turner posted an article in Whistle blowing
It's that time again. 'Speak Up Month' in the NHS. In this blog, I discuss the definition of 'whistelblowing' and why this is important. I believe that although the Francis Report has stimulated some positive changes, the only way to successfully move forward on this is to celebrate and promote genuine whistleblowers. This includes using the word 'whistleblowing', not a euphemism. It also needs us to involve everyone, including patients, in the changes. "Whistleblowing isn’t a problem to be solved or managed, it’s an opportunity to learn and improve. The more we move away for labelling and stereotyping the more we will learn. Regardless of our position, role or perceived status, we all need to address this much more openly and explicitly, in a spirit of truth and reconciliation." What is whistleblowing? "In the UK, NHS bodies have been guilty of muddying the waters. Sometimes implying that whistleblowers are people who fail to use the proper channels, or are troublemakers, especially when they go outside their organisation with their concerns. In fact, the Public Interest Disclosure Act makes no distinction between ‘internal’ and ‘external’ whistle-blowers..."- Posted
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Content ArticleVideo series catching up with alumni of the Darzi Fellowship in Clinical Leadership to find out what are they up to, how they got there, and how the Fellowship has influenced their work in the NHS and wider health and care landscape. In this episode, Jamie Stafford, Senior Programme Manager with the Community Mental Health Transformation Programme for East London Foundation Trust (ELFT) talks about how frustration with the system lead him to the Darzi Fellowship, and how his Fellowship Year taught him the value of nurturing cross-boundary relationships to create a better experience of care.
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Understanding Schwartz Rounds (22 January 2018)
Patient Safety Learning posted an article in Good practice
A film about why Schwartz Rounds are needed. -
Content ArticleSurgery can be a highly demanding environment, and in pressurised situations we need to prioritise patient safety. Under these circumstances there is a need for clear leadership, but being assertive can sometimes be challenging without coming across as aggressive or intimidating. Training is also an area in which potential issues could arise. Not every trainee will develop at the required rate, and it is important to be able to address concerns with an individual without fearing being labelled as a bully. The following recommendations from the Royal College of Surgeons of Edinburgh may help with workplace relationships.
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Content ArticleThe NHS is in the process of changing the way it embraces patient safety, moving from a focus on individual incidents and issues to a more comprehensive look at system learning. The changes are set out in NHS England/Improvement’s Patient Safety Strategy, released in July 2019 and updated in February 2021. This was followed by the Patient Safety Investigation Framework in March 2020, due for full implementation by Spring 2022. They are important not just in relation to incident management but also because of the implications they have for strategy and board responsibilities in relation to patient safety. So they need careful attention at all levels of NHS organisations. This article from the Good Governance Institute highlights the safety roles and responsibilities of organisations and moving to a proactive approach to safety management.
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Content ArticleMoira Durbridge, Director of Quality Transformation & Efficiency Improvement for University Hospitals of Leicester NHS Trust, describes her typical day.
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In this video, Helen Hughes, Chief Executive of Patient Safety Learning, speaks to Phil Taylor, Chief Product Officer at RLDatix, about the importance of culture in achieving high reliability in healthcare. They discuss the impact of culture on incident reporting, examples of where safety culture is key to making improvements and consider what is needed to create the right safety culture. -
Content ArticleImproving quality is about making healthcare safe, effective, patient-centred, timely, efficient and equitable. It’s about giving the people closest to problems affecting care quality the time, permission, skills and resources they need to solve them. As we shift from the emergency phase of COVID-19 it is vital that health and care workforces are able and supported to lead radical service change and improvements through re-starting, re-designing or developing new processes, pathways and services.
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Content ArticleHundreds of healthcare organisations around the world are Schwartz Center healthcare members and conduct Schwartz Rounds® to bring doctors, nurses and other caregivers together to discuss the social and emotional side of caring for patients and families. This video explains more.
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Schwartz Rounds publications
Patient Safety Learning posted an article in Research papers
Attached is a list of research papers on Schwartz rounds that you might find useful. -
Content ArticleProviding high quality healthcare has an emotional impact on staff. Often they experience high levels of psychological distress, face increasing levels of scrutiny, regulation and demand, and have increasingly limited resources. Schwartz Center Rounds® (Rounds) were developed to support healthcare staff deliver compassionate care by providing a safe space where staff could openly share and reflect on the emotional, social and ethical challenges of their work. Rounds are a monthly staff forum (not attended by patients) where three to four employees (panellists) present short accounts of their experiences of delivering patient care. This organisational guide is based upon the findings from an evaluation of Rounds in the UK, undertaken between 2014 and 2016. The evaluation was commissioned by the National Institute for Health Research and led by Professor Jill Maben at King’s College London (now at the University of Surrey). The evaluation aimed to distil the findings and learning for practical application by organisations seeking to implement and/or sustain Rounds in their organisations.
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Content ArticleAmy Edmondson, the Novartis Professor of Leadership and Management at Harvard Business School, talks about building a psychological safe workplace for staff in this TEDx talk.
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Research: Why managers ignore employees’ ideas (8 April 2019)
Patient Safety Learning posted an article in Culture
When employees share novel ideas and bring up concerns or problems, organisations innovate and perform better. But managers do not always promote employees’ ideas. In fact, they can even actively disregard employee concerns and act in ways that discourage employees from speaking up at all. While much current research suggests that managers are frequently stuck in their own ways of working and identify so strongly with the status quo that they are fearful of listening to contrary input from below, new research offers an alternative perspective: managers fail to create speak-up cultures not because they are self-focused or egotistical, but because their organisations put them in impossible positions. They face two distinct hurdles: they are not empowered to act on input from below, and they feel compelled to adopt a short-term outlook to work. -
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In his latest blog, Ehi Iden, hub topic lead for Occupational Health and Safety, OSHAfrica, discusses the importance of documenting and learning from patient safety incidences. Using a fictional story to draw parallels from, Ehi highlights how accountability, leadership and reporting incidences will help us keep staff and patients safe. -
Content ArticleIn healthcare, leadership is decisive in influencing the quality of care and the performance of hospitals. How staff are treated significantly influences care provision and organisational performance so understanding how leaders can help ensure staff are cared for, valued, supported and respected is important. Research suggests ‘inclusion’ is a critical part of the answer, as Roger Kline explains further in this BMJ Opinion article.
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Content ArticleCOVID-19 presents many challenges to healthcare systems internationally, none more so than the significant reporting among healthcare workers (HCWs) of occupational fatigue and burnout or Long COVID related symptoms. Consensus on the extent of HCW fatigue during the pandemic remains largely unknown, as levels of Long COVID related fatigue in HCWs appears to be on the rise. What is known is that, among current levels, impacts of fatigue on HCW well-being and performance is likely. Developing strategies to mitigate fatigue are the responsibilities of all healthcare system stakeholders. Leadership that goes beyond organisational efforts of mitigating fatigue through mandated working hour limits alone are needed.
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Content ArticleThe Essentials of Safe Care is a practical package of evidence-based guidance and support that enables Scotland’s health and social care system to deliver safe care.
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Content ArticlePresentation from Terry Wilcutt Chief, Safety and Mission Assurance, and Hal Bell Deputy Chief, Safety and Mission Assurance at NASA.
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Content ArticleAlthough midwifery-led continuity of care is associated with superior outcomes for mothers and babies, it is not available to all women. Issues with implementation and sustainability might be addressed by improving how it is led and managed – yet little is known about what constitutes the optimal leadership and management of midwifery-led continuity models. Hewitt et al. carried out a scoping review on leadership and management in midwifery-led continuity of care models.
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Content ArticleWhile the benefits of psychological safety are well established, a new survey suggests how leaders, by developing specific skills, can create a safer and higher-performance work environment.
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We have probably all suffered from imposter syndrome at some point during our career. Doubted our self and our abilities. However, if we aren't confident in ourselves and how we do our jobs it could impact on the patients we look after. Here are my tips on how to get to grips with your imposter syndrome.- Posted
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