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Showing results for tags 'Speaking up'.
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Content Article
Safety Chats: Part 2 – Safety as measured
Gina Winter-Bates posted an article in Good practice
In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In her first blog, Gina explained what motivated her to introduce Safety Chats into her Trust. In part 2, Gina reflects on how we know we are safe and the safety measures her Trust has put in place. -
Content Article
Safety Chats blog series: Part 1
Gina Winter-Bates posted an article in Good practice
In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In this first blog, Gina explains what motivated her to introduce Safety Chats into her Trust. -
Content ArticleFrom April 2023 the new Health Services Safety Investigations Body will require doctors to be candid about errors that have led to patient harm. But can medics trust that material given in this “safe space” won’t be used against them?
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Content ArticleRepeated culture of safety surveys of the nursing staff at Children’s Hospital of Philadelphia’s main campus demonstrated lagging scores in the domain of nonpunitive responses to error. The hospital had tried for many years to address the problem using a variety of strategies, including small group training sessions on just culture for staff and leaders, but had met with limited success. Finally, in 2015, it committed to trying something genuinely different—even perhaps disruptive—that might actually shift the stagnant metrics. Their novel, multifaceted programme, implemented over a two-year period, yielded a 13% increase in staff rating scores that the hospital has been able to sustain over the subsequent two-year period. The design and rollout of our program was neither simple nor smooth, but valuable lessons were learned about realistic, operational implementation of principles of psychological safety in a large and complex clinical organisation. In this paper, Neiswender et al. describe the programme and the lessons learned in the journey from idea inception to post-implementation.
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Content ArticleIn this blog, Bob Matheson, Head of Advice and Advocacy at the charity Protect, explains the case of Dr Chris Day and how it highlights the vital importance of reforms to UK whistleblowing law. Protect is campaigning for Reform of whistleblowing legislation in the UK. The author highlights loopholes in UK law that Dr Day has faced throughout his long legal battle with Health Education England (HEE). These gaps mean that whistleblowers lack certain important legal rights and protections, and this in turn may prevent individuals from raising concerns.
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Content ArticleEverybody makes mistakes at work but what if you're a doctor and you ruin a patient's life - or even end it? Doctor-turned-writer Jed Mercurio recalls a catalogue of errors from his years as a medical student.
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Content ArticleThis presentation provides an insight into a real life crowdfunded NHS whistleblowing case. This comes from the perspective of both a frontline NHS clinician and crowdfunder. The tactics used against Dr Day, his response to them and the effect that such a public protracted fight has had on NHS culture and ‘confidence in the system’. Potential changes are then discussed Chris is a Locum Emergency Medicine doctor working at the moment in East London. Chris is also a Claimant in a high profile whistleblowing case that has been ongoing for nearly 9 years. The case re-established statutory whistleblowing protection (in the Court of Appeal) for junior doctors in England. The case has had further media attention last month when Chris’ NHS opponents admitted to destroying evidence whilst a 16 day court hearing was in progress.
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Content ArticleIn this blog, consultant on workforce culture Roger Kline looks at the case of Shyam Kumar, an orthopaedic consultant who was seconded as an inspector for the Care Quality Commission (CQC). After raising concerns about patient safety, harm, cover up and bullying of staff with the CQC, his secondment with them was terminated. An Employment Tribunal has found that Mr Kumar's concerns were well-founded and that he was then victimised for raising them by the CQC. The Tribunal accepted his claims that he was removed from his secondment as a CQC inspector as a result of making protected disclosures, accepted his evidence, and at a number of points did not believe the evidence provided by senior CQC staff. The blog raises the question of whether the CQC would fail on its own criteria for being a 'well led' organisation on the basis of this case. It also questions whether the CQC can credibly hold NHS organisations to account on whistleblowing after its response to having concerns raised by Mr Kumar, one of its own inspectors. The author asserts that "the CQC needs to urgently demonstrate it will apply accountability to its own decision making, and lack of support for those raising concerns, and hold its own senior leaders (up to the CEO) to account for decisions which are contrary to its own published standards."
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Content Article
7 Rules for persuasive dissent (22 July 2022)
Patient Safety Learning posted an article in Good practice
Decisions formed from a diversity of opinions usually lead to better long-term outcomes. So, when you believe that your team or organisation is missing something important, moving in the wrong direction, or taking too much risk, you need to speak up. Done effectively, dissent challenges groupthink, reminds those in the majority that there are alternatives paths, and prompts everyone to get creative about solutions. Six decades of scientific research point to strategies those without formal power can use to make sure their dissenting ideas are heard. First, pass the in-group test by showing how you fit in. Then pass the group threat test by showing how you have your team’s best interest at heart. Make sure your message is consistent but creative tailored for different people, lean on objective information, address obstacles and risks, and encourage collaboration. Finally, make sure to get support. Dissent isn’t easy but it can be extremely worthwhile. -
Content Article
In this blog, Nigel Roberts, who is a registered Allied Health Professional theatre lead at the University Hospitals of Derby and Burton (which has in excess of 50 operating theatres and performs over 50,000 procedures annually), considers the current challenges facing all operating theatre staff post pandemic. Nigel looks at how human factors may influence the delivery of the surgical safety checklist, and discusses whether Local Safety Standards for Invasive Procedures (LocSSIPs) are making a difference in terms of the number of intra-operative Never Events being reported.- Posted
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Content Article
Nuffield Trust: Safety culture in the NHS (25 August 2022)
Mark Hughes posted an article in Culture
A good safety culture in healthcare is one that includes value and respect for diversity, strong leadership and teamwork, openness to learning, and staff who feel psychologically safe. In this article the Nuffield Trust use data from the NHS Staff Survey to look at safety culture in the NHS. -
Content ArticleThis webpage highlights press coverage of the Chris Day whistleblowing hearing which took place in June 2022. Dr Day's case originates in 2013, when he initially raised concerns about unsafe staffing levels at Woolwich Hospital ITU, run by Lewisham and Greenwich NHS Trust. Following this, senior management in the Trust made allegations about his conduct, he believes as a result of his whistleblowing action. As a result Health Education England (HEE) deleted Dr Day's training number, meaning he was unable to progress to become a consultant. Dr Day has been campaigning for a public hearing of the case since 2016, and believes HEE, Lewisham and Greenwich NHS Trust and other authorities have spent large amounts of money attempting to 'crush' his case and prevent it from being heard. The tribunal hearing finally took place in June 2022 and featured revelations about Trust staff deliberately deleting emails relevant to the case, partisan briefings made to senior NHS management about Dr Day and inaccurate press statements from the Trust.
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Content ArticleThis is the witness statement submitted by the claimant at an employment tribunal between Dr Chris Day and Lewisham and Greenwich NHS Trust. Dr Day's claim is based on his belief that the actions of the Trust irreparably damaged his medical career and had a significant impact on his job security and other areas of life. The document contains Dr Day's statement about the following events: Misrepresenting the substance of the protected disclosures Misrepresenting formal investigation findings Cost threat detriments Events post-settlement Impact of the case on Dr Day and his family
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Content ArticleRAND Corporation and MedStar researchers examined the intersection of patient safety and racism, focusing on patient safety and health equity from clinician leaders' perspectives. An overarching emphasis of the work concerned the impact of racism and other related factors (i.e., bias) on patient safety events and potential interventions or changes (such as creating a culture of speaking up about racism in care) that can help prevent such events.
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Content Article
The NHS whistleblowing crisis (8 February 2022)
Patient Safety Learning posted an article in Whistle blowing
Tommy Greene and David Hencke report on a number of worrying NHS dismissal cases in this Byline Times article. -
Content ArticleThe National Guardian’s Office has published its latest annual speaking up data, which summarises the themes and learning from the speaking up data shared by Freedom to Speak Up guardians.
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Content Article
PACE communication tool
Patient_Safety_Learning posted an article in Staff safety
Supporting staff to speak up is essential to patient safety. The PACE communication tool is designed to help anyone in a team challenge an action or behaviour they feel is inappropriate. You can read more about PACE (probe, alert, challenge, emergency) and other communication tools on the Victorian Trauma System website via the link below. -
Content ArticleThis article in Computer Weekly outlines the tribunal proceedings and judgement in high-profile case brought by whistleblower Chris Day. Dr Day claimed that Lewisham and Greenwich NHS Foundation Trust had concealed evidence when a director deleted up to 90,000 emails before he was due to testify at an earlier tribunal, concerning allegedly false and detrimental public statements about Dr Day made by the Trust. Dr Day’s lengthy legal battle first began when he was a junior doctor working at Queen Elizabeth Hospital Woolwich’s intensive care unit in 2013, where he spoke up about under-staffing at the ICU.
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Content Article
GMC: Racism in the workplace hub
Patient Safety Learning posted an article in General Medical Council (GMC)
Everyone has the right to come to work without fear of racism. This resource from the General Medical Council (GMC) provides advice on how our guidance principles on non-discrimination apply when tackling racism. Where racist behaviour occurs among colleagues and patients, we recognise the fear that many doctors have of reporting these incidents. It signposts a range of support channels and highlights the duties we expect of doctors in senior positions in tackling and rooting out discrimination where it arises. It includes case studies from doctors and others on their experiences, advice and best practice. -
Content ArticleThis framework produced by the Royal College of Paediatrics and Child Health (RCPCH) aims to improve how healthcare organisations recognise and respond to children at risk of deterioration. A safer system can work in partnership with families and patients, develop a patient safety culture and support ongoing learning. The framework covers: Patient safety culture Partnership with families Recognising deterioration Responding to deterioriation Open and consistent learning Education and training
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Content ArticleThis webpage provides information about patient rights and responsibilities while under the care of John Hopkin's Children's Center. It includes the following resources and guides: Patient and family handbook Preparation Pain management Your child’s care team Rooms Meals Visitation Patient safety Parent and family journal
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Content ArticleThe aim of this study in Australian Critical Care was to develop an evidence-based paediatric early warning system for infants and children, that takes into consideration a variety of paediatric healthcare contexts and addresses barriers to escalation of care. The development process resulted in an agreed uniform ESCALATION system incorporating a whole-system approach to promote critical thinking, situational awareness for the early recognition of paediatric clinical deterioration as well as timely and effective escalation of care. Incorporating family involvement was an important and new component of the system.
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Content ArticleThis study in Health Expectations aimed to identify barriers and facilitators to implementing a parent escalation of care process: Calling for Help (C4H). Guided by the Theoretical Domains Framework, the authors carried out audits, semi-structured interviews and focus groups in an Australian paediatric hospital where a parent escalation of care process was introduced in the previous six months. The authors found that although there was a low level of awareness about C4H in practice, there was in-principle support for the concept. Initial strategies had primarily targeted policy change without taking into account the need for practice and organisational behaviour changes.
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Content ArticleThis Australian study in Health Expectations aimed to evaluate the implementation of 'Calling for Help'(C4H), an intervention for parents to escalate care if they are concerned about their child's clinical condition. The study used a convenience sample of 75 parents from inpatient areas during the audit, and the authors held interviews with ten parents who had expressed concern about their child's clinical condition and five focus groups with 35 ward nurses. The authors found that there was an improvement in the level of parent awareness of C4H, which was viewed positively by both parents and nurses. To achieve a high level of parent awareness in a sustainable way, a multifaceted approach is required and further strategies will be required for parents to feel confident enough to use C4H and to address communication barriers.
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Content ArticleThis document outlines the standard operating procedure (SOP) adopted by University Hospitals Bristol NHS Foundation Trust, relating to parental involvement in escalation of clinical care for acutely ill children. It aims to clarify the process of empowering parents to escalate concerns if they are worried about the clinical condition and care being delivered to their child, or themselves if they are a patient. It also aims to ensure accurate and appropriate information is provided to parents on admission (elective and acute) regarding how they should escalate concerns about the care their child is receiving.
