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Content ArticlePoor communication among healthcare professionals contributes to widespread barriers to patient safety. The word “communication” means to share or make common. In research literature, two communication paradigms dominate: communication as a transactional process responsible for information exchange communication as a transformational process responsible for causing change. Implementation science has focused on information exchange attributes while largely ignoring transformational attributes of communication. This article in the journal Implementation Science debates the merits of encompassing both approaches.
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Content Article
15 seconds, 30 minutes: Creating joy in work
Patient Safety Learning posted an article in Good practice
15 seconds 30 minutes (or 15s30m for short) aims to help anyone identify how they could spend a few extra seconds on a task now which will save someone else 30 minutes or more later on. In doing so you will reduce frustration and increase joy. Joy in work has been proven to help staff to do their best and deliver safe and effective patient care. Improving joy is the key to retaining the workforce and reducing staff sickness. And who doesn’t want to enjoy coming to work every day! 15s30m is a change platform which individual staff or patients or whole organsiations can use to release the value in every idea. To get started you don’t need a charter or formal plan or programme initiation document: its just individuals being empowered to do what they know is right for staff and patients.- Posted
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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.- Posted
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Content Article
Joy in work: presentation from Julia Wood (22 July 2022)
Patient Safety Learning posted an article in Culture
Presentation from Julia Wood given to the Patient Safety Manager Network (PSMN) on the importance of finding joy and happiness in work and how you can support your staff.- Posted
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Content ArticleHealthcare is traditionally a hierarchical industry. This structure can foster a culture of division amongst staff that is sometimes made worse by significant differences in background and training. However, in order to make sure care is safe and of a high quality, healthcare teams must develop good teamwork and communication. This is only possible if every member of the team feels respected and is free to speak up when they think something is wrong. In this podcast, host David Feldman speaks to Michael Brodman, Professor and Chair Emeritus in the Department of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai in the US. They discuss how mutual respect is essential for any institution developing a culture of safety and how the problems presented by medical hierarchy can be overcome.
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Content ArticleDuring COVID-19, clinical teams faced disruption, having to respond to challenging circumstances and high uncertainty, whilst providing quality care to patients. We know that staff psychological wellbeing affects team effectiveness and patient experience and resilience is fostered by connections between (not just within) individuals. New collaborations between clinical, service improvement and psychology teams recognised the value of introducing the psychologically-informed ‘Start Well>End Well’ team procedure into routine team processes. This evidence-based approach consists of 1) an enhanced safety briefing, 2) peer-to-peer debrief guidance and signposting for trauma-focused support, and 3) team check-out. Initially launched as a general procedure across all wards with variable uptake, a more tailored co-design and coaching approach was then piloted on 2 neurology wards over 3 PDSA cycles. Formative evaluation (focus groups and written feedback) demonstrated staff felt “cared for” whilst achieving “positive impact” through improved ways of working within new teams.
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Content ArticlePsychological safety is a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. More than 20 years of research demonstrates that organisations with higher levels of psychological safety perform better on almost any metric or key performance indicator (KPI) in comparison to organisations that have low psychological safety. However, achieving psychological safety is a challenge in the complex, ever-evolving health and care systems in which we operate. In this guide, Professor Amy C. Edmondson shares insights that emerged from exploring the experience of differing Integrated Care Systems; a range of case studies, and a wealth of tools and resources. This guide is not a 'how to' for how to create psychological safety; it is more of a reflection on the opportunities and challenges in our health and care system, and how you might seek to work with them.
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Content ArticleThe emotion of the team is a sum-total of emotions and feelings that members of the team experience. Left unnoticed, unexpressed, and unattended, these emotions can grow toxic to harm relationships or grossly undermine team’s potential. Leaders have a choice of either noticing those emotions intentionally and intervening constructively when needed or just ignore the emotions to focus only on the outcomes and the process. Tuning into team emotions, fostering productive relationships, building trust, and a conducive environment within the team is the constant work of leadership.
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Content ArticleThis improvement tool is designed to help NHS organisations identify strengths their leadership team and organisation, and any gaps that need work, in seeking to create an environment where people feel safe to speak up with confidence. It should be used alongside Freedom to speak up: A guide for leaders in the NHS and organisations delivering NHS services, which provides full information about the areas addressed in the statements, as well as recommendations for further reading.
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Content ArticleThis guide provides ideas for how an organisation can adhere to the NHS principles for leaders and managers in seeking to create an environment where people feel safe to speak up with confidence. This guide is designed to be used by any senior team, owner or board in any organisation that delivers NHS commissioned services. This includes all aspects of primary care; secondary care; and independent providers.
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Content ArticleThis editorial in BMJ Quality & Safety looks at the risks to patient safety posed by negative interpersonal interactions between healthcare professionals. The authors review a recent study on the subject by Linda Guo et al that revealed how and when these negative behaviours from staff may have an impact on patient outcomes and clinical performance. They highlight the huge scale of the impact of unacceptable behaviours, arguing that it is even greater than evidenced in Guo et al's research. They also highlight that there are other, largely unexplored impacts on healthcare workers, patients and their families when they are exposed to unacceptable interactions.
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Content ArticleThe Safety culture programme group (SCPG) was a virtual task and finish group established in July 2021 for six sessions to provide recommendations to support and enable organisations to improve their safety culture through embedding a continuous cycle of understanding the issue, developing a plan, delivering the plan and evaluating the outcome with an underpinning foundation of inequalities reduction. This report contains an overview of the discussions undertaken by the Safety culture programme group (SCPG) in 2021. It also includes their recommendations so that safety culture continues to be developed as one of the foundations that underpins the NHS patient safety strategy.
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Content ArticleJunior doctors can struggle with decision-making in emergency departments because they worry about “looking silly” in front of senior colleagues, a study has found. A team from the Healthcare Safety Investigation Branch (HSIB) looked at missed or delayed diagnosis of conditions in A&E. They specifically examined cases of pulmonary embolism and focused on diagnostic decision-making using applied cognitive task analysis. Interviews with medical staff found a number of factors which were common among expert level doctors. These included being aware of life-threatening conditions and seeking to rule them out, being comfortable in expressing doubt and seeking out peers to challenge their diagnosis. Junior staff on the other hand often tried to fit symptoms to specific conditions and had a fear of making wrong a diagnosis. Some said they were afraid of “looking silly in front of a senior”. The study, presented at an online session at the Ergonomics & Human Factors 2022 conference, suggested looking at how younger staff can be supported in improving their decision-making. HSIB investigator Nick Woodier, who presented the study, said: “Decision-making is a skill, commonly developed in healthcare through experience without formal training or opportunities to practise it.” You can view the presentation from the link below.
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Content Article
Human factors - Safer surgery checklist (June 2022)
Patient-Safety-Learning posted an article in Surgery
This literature review in The Operating Theatre Journal looks at 'How industry has helped healthcare better understand human factors'. The author, Nigel Roberts, Theatre Lead at the University Hospitals of Derby and Burton, looks at this question in relation to teamwork, leadership, situational awareness, communication and culture.- Posted
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Content ArticleBullying, discrimination and harassment between healthcare workers can have an impact on how well individuals do their job, and may therefore lead to an increase in medical errors, adverse events and medical complications. This systematic review in BMJ Quality & Safety aimed to summarise current evidence about the impact on clinical performance and patient outcomes of unacceptable behaviour between healthcare workers.
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Content ArticleEvery place has its unwritten rules, whether a community or a workplace. But how do we know the culture of a place? It's pretty much impossible until we experience it for ourselves. Jennifer L. Lycette shares her own experience of organisational culture during her medical training.
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Event
A practical guide to psychological safety in healthcare teams
Sam posted an event in Community Calendar
This conference focuses on developing psychological safety in your clinical team or healthcare organisation. This conference will enable you to: Network with colleagues who are working to deliver and enhance psychological safety. Understand the concept of psychological safety and how it can improve staff wellbeing and patient safety. Learn from outstanding practice in local, national and international psychological safety programmes. Implement practices and steps that improve psychological safety. Develop your skills in compassionate leadership. Take part in an interactive session led by the Parliamentary Health Service Ombudsman about techniques for embedding cultures of psychological safety and learning from investigations where lack of psychological safety was a factor. Understand how you can implement a framework for psychological safety in healthcare teams. Identify key strategies for embedding psychological safety into freedom to speak up. Explore the inter relationship between Human Factors, Psychological Safety & Kindness/Civility in Teams. Self assess and reflect on your own practice Supports CPD professional development and acts as revalidation evidence. This course provides 5 Hrs training for CPD subject to peer group approval for revalidation purposes For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/psychological-safety or email kate@hc-uk.org.uk hub members receive a 20% discount. Email: info@pslhub.org Follow this conference on Twitter @HCUK_Clare #PsychologicalSafetyNHS- Posted
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Content ArticleThrough her work on a range of different elements of the Midlands leadership learning offer, Emma Coller has had great success in facilitating the development of the leadership skills and behaviours needed for positive change. Here she shares her insights on the appreciative inquiry process and how it works.
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Content ArticlePeople like being treated well. A civil approach to relationships in the healthcare workplace – any workplace – has merit, but there are many questions to explore. While most doctors interact with others in a civil manner most of the time, anyone can experience lapses occasionally. When the many dimensions of civility are considered more closely, it appears that there is much that can be learned about the causes of incivility and the strategies that can be adopted to foster civil behaviour, even at times of risk. Physician Health Programme offers a series of articles below as Five Fundamentals of Civility for Physicians.
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Content ArticleThe CQC inspection framework now includes multidisciplinary teams (MDTs) for end of life care, tumours and weekly MDTs for people with complex needs. However lack of time and staff availability for this is a real problem. MDTs are under increasing pressure and are already seeing an erosion of their power to assure safe and appropriate care. Anecdotally, non-attendance by key MDT members is a significant quality issue for many hospitals. This is not a problem of engagement — all MDT members and are willing to provide input — but staffing pressures and the complexity of rostering makes holding these MDT meetings near-impossible. So how do we stop this degradation? How can hospitals better manage the burgeoning requirement for MDTs? One possible answer is to change the emphasis from a single meeting to a managed series of recorded opinions and decisions. If properly supported by the right workflow technology, we can move away from the ‘single-point’ MDT meeting (MDTM) to a ‘multi-point’ MDT process (MDTP) which could allow better and more auditable decisions to be made. Where significant differences of opinion exist, then a meeting can be called – but the MDT members could act independently and in parallel using a suitable recording and monitoring system. In this article, Dr D J Hamblin-Brown explains how this might work.
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Content Article
4th Learning from Excellence Conference videos (8 October 2021)
Sam posted an article in Improving patient safety
The theme for the 4th Learning from Excellence Community Event was “Being better, together”, reflecting LfE's aspiration to grow as individuals, and as part of a community, through focussing on what works. For this event, LfE partnered with the Civility Saves Lives (CSL) team, who promote the importance of kindness and civility at work and seek to help us to address the times this is lacking in a thoughtful and compassionate way, through their Calling it out with Compassion programme.- Posted
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Content ArticleThis is the first of a short series of blogs in which we take a look back at our work in five areas of patient safety during 2021. This blog explores how the hub has encouraged collaboration, connection and the sharing of patient safety solutions. Through our work, Patient Safety Learning seeks to harness the knowledge, insights, enthusiasm and commitment of health and social care organisations, professionals and patients for system-wide change and the reduction of avoidable harm. We believe patient safety is not just another priority; it is a core purpose of health and social care. Patient safety should not be negotiable.
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EventuntilThis face-to-face event by The Royal College of Emergency Medicine will look at research around burnout and other psychological impacts of working in the emergency department. It will feature talks from clinicians promoting staff wellbeing and explore opportunities to work with the Sustainable Working Practice Committee. View the event programme Book this event. Reduced fees are available for RCEM members and student members LMIC clinicians and students.
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Content Article
Blog: At the edge of inside (24 June 2016)
Patient-Safety-Learning posted an article in Culture
In this opinion piece for The New York Times, David Brooks looks at the value of being 'at the edge of the inside'. He argues that being within an organisation, but not so close to the centre that you are subsumed by the 'group think', puts an individual in a good position to positively influence the organisation's culture and practice.- Posted
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Content ArticleDevelop your understanding of how to lead with compassion and kindness within the health and social care sectors in this free King's Fund course. This introductory three-week course is for anyone working in or interested in health and social care in its broadest sense, regardless of experience or role. It’s designed to introduce you to some of the foundations of leadership, kindness, and compassion. You’ll explore why these qualities matter now more than ever, and how to develop your personal practice of kind and compassionate leadership. As well as deepening your understanding and knowledge of leadership in health and care, this course will help you develop your own practice of kind and compassionate leadership. You’ll hear from leaders and experts from across the health and care system and explore some practical ways that you can develop a compassionate mindset and cultivate kindness and compassion in your relationships with others.
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