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Content Article
Human factors and the ad hoc team during the pandemic
Claire Cox posted an article in Blogs
In her latest blog, Claire, a critical care outreach nurse, reflects on how the 'ad hoc' team has to adapt to the new challenges the coronavirus pandemic brings. She offers insights into the challenges she and her team face and gives examples of potential solutions.- Posted
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Content Article
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.- Posted
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Content ArticleDisagreements are an inevitable, normal, and healthy part of relating to other people. There is no such thing as a conflict-free work environment. Amy Gallo explains why disagreements — when managed well — have lots of positive outcomes.
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Content ArticleIn this Institute for Healthcare Improvement blog, Derek Feeley discusses how "joy at work" during times of collective stress can nurture a sense of purpose and community that supports staff well-being and reduces burnout.
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Content Article
How are you feeling today NHS? toolkit (14 January 2019)
Patient Safety Learning posted an article in Staff safety
It’s easier to recognise someone’s physical wellbeing than their emotional wellbeing. We also find it much easier to engage in conversations about physical health, but often find talking about emotional wellbeing to be more of a challenge. The implications of decreased emotional wellbeing are detrimental as it can contribute to mental health and stress concerns, it is important to ensure good staff wellbeing by encouraging conversation in the workplace.- Posted
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News Article
Northern Devon Healthcare NHS Trust: 20 deaths or serious harm cases in maternity
Patient Safety Learning posted a news article in News
At least 20 maternity deaths or serious harm cases have been linked to a Devon hospital since 2008, according to NHS reports obtained by the BBC. A 2017 review which was never released raised "serious questions" about maternity care at North Devon District Hospital. The BBC spent two years trying to obtain the report and won access to it at a tribunal earlier this year. Northern Devon Healthcare NHS Trust (NDHT) said the unit was "completely different" after recommended reforms. A 2013 review by the Royal College of Obstetricians and Gynaecologists (RCOG) investigated 11 serious clinical incidents at the unit, dating back as far as 2008. The report identified failings in the working relationships at the unit, finding some midwives were working autonomously and some senior doctors failed to give guidance to junior colleagues. Despite the identified problems with "morale", the subsequent investigation by RCOG in 2017 expressed concerns with the "decision-making and clinical competency" of senior doctors and their co-operation with midwives. An independent review into midwifery in October 2017 noted "poor communication" between medical staff on the ward for more than a decade. The report identified a "lack of trust and respect" between staff and "anxiety" among senior midwives at the quality of care. Read full story Source: BBC News, 16 March 2020- Posted
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News Article
Harrowing stories of burned out NHS doctors bullied and broken
Patient Safety Learning posted a news article in News
Dedicated to caring for the sick and vulnerable, junior doctors should expect to be supported and valued as they carry out their vital work. However, hundreds have revealed they are subjected to bullying and harassment at overstretched hospitals that have been plunged into a staffing crisis by a decade of savage health cuts. A Mirror investigation uncovered harrowing stories of young medics being denied drinking water during gruelling shifts, working for 15 hours on their feet non-stop and of uncaring managers tearing into them for breaking down in tears over the deaths of patients. One was even accused of “stealing” surgical scrubs she took to wear after suffering a miscarriage at work. The distraught woman finished her shift wearing blood-soaked trousers, instead of going home to rest. Doctors are now quitting in their droves, leaving those left struggling to cope with a growing workload. The Mirror investigation reveals the reality of working for an NHS which has been subject to a record funding squeeze and is 8,000 medics short. Health chiefs vowed to investigate the Mirror’s evidence from 602 testimonials submitted to the lobbying group Doctors Association UK. Chairman Dr Rinesh Parmar said: “These heartbreaking stories from across the country show the extent of bullying and harassment that frontline doctors face whilst working to care for patients". Read full story Source: The Mirror, 12 February 2020- Posted
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This is how to not fail at failing – blog by Roi Ben-Yehuda
Patient Safety Learning posted an article in Culture
In this blog, Roi Ben-Yehuda, a trainer at LifeLabs Learning, discusses why learning from failure is so rare and difficult and gives his top tips on what we need to do to stop failing at failing.- Posted
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News ArticleOne in three trainee doctors in Australia have experienced or witnessed bullying, harassment or discrimination in the past 12 months, but just a third have reported it. That's according to a national survey of almost 10,000 trainee doctors released today by the Australian Health Practitioner Regulation Agency (AHPRA). The results of the survey, co-developed by the Medical Board of Australia (MBA), send a "loud message" about bullying and harassment to those in the medical profession, said MBA chair Anne Tonkin. "It is incumbent on all of us to heed it," Dr Tonkin said. "We must do this if we are serious about improving the culture of medicine." "Bullying, harassment and discrimination are not good for patient safety, constructive learning or the culture of medicine," Dr Tonkin continued. "We must all redouble our efforts to strengthen professional behaviour and deal effectively with unacceptable behaviour." Read full story Source: ABC News, 10 February 2020
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Content ArticleCathe Gaskell, from The Results Company, presented at the recent Bevan Brittan Patient Safety Seminar on incivility in healthcare and the impact this has on patient safety. Attached are her presentation slides
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News ArticleThe former police chief who investigated mental health services in a crisis-hit health board was “shocked” by the poor working relationships and “blame shifting” he uncovered. David Strang, who led the independent inquiry into the issues in NHS Tayside, said staff felt isolated and unsupported and people complained about each other’s practices without coming together to sort the issues out. He described asking staff questions based on information he had received and being met with the response: “Who told you?” He added: “A lot of staff felt there was a real blame culture and that risk and blame fell to the front line.” Read full story (paywalled) Source: 6 February 2020, The Times
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Content ArticleIn this article in the APSF newsletter, Jeffrey Cooper discusses the importance of the anaesthetist and surgeon relationship and why a healthy collaborative relationship is vital for patient safety. He suggests a number of practical relationship building principles. "I’m not promising you a rosy world if you work at this. But I think it’s worth your time for your patients’ safety to try as much as you can. Doing nothing will mean nothing will change. If your efforts succeed, you’ll have made a huge advance for patient safety, and you’re likely to find more joy and meaning in your professional daily life."
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Content ArticleHow people are treated following their involvement in a workplace accident can have far reaching implications for both the individual and the organisation. This paper, published by Science Direct, examines the impact the use of retributive justice mechanisms within the accident analysis process have on both the individual and the organisation. It analyses the perceptions of those involved in five accidents where retributive justice mechanisms were used. The study of these cases shows retributive justice mechanisms used as part of the accident analysis process negatively impacts three key areas; (1) the mental health of the individual; (2) organisational learning and; (3) organisational performance. The study also illustrates that the language used as part of the accident analysis has a significant impact upon the perception of the process and the willingness to participate.
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Content ArticleThe Comprehensive Unit-based Safety Program (CUSP) aims to improve the culture of safety while providing frontline caregivers with the tools and support that they need to identify and tackle the hazards that threaten their patients at the unit or clinic level. Developed by Johns Hopkins safety and quality researchers, the five-step programme has been used to target a wide range of hazards, including patient falls, hospital-acquired infections, medication administration errors, specimen labeling errors and teamwork and communication breakdowns. Notably, CUSP has been used in national and international quality improvement projects that have drastically reduced hospital-acquired infections. Whether your hospital has participated in such projects or is seeking to adopt CUSP, the Armstrong Institute provides resources to help you run a successful programme.
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Community PostRestorative justice brings those harmed by crime or conflict and those responsible for the harm into communication, enabling everyone affected by a particular incident to play a part in repairing the harm and finding a positive way forward. This is part of a wider field called restorative practice. Restorative practice can be used anywhere to prevent conflict, build relationships and repair harm by enabling people to communicate effectively and positively. This approach is increasingly being used in schools, children’s services, workplaces, hospitals, communities and the criminal justice system. What are your thoughts on how this approach would work in a healthcare setting? Does anyone have any experience of using restorative practice?
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Content ArticleA problem solving tool that captures everything you need on one piece of paper. Now that sounds pretty useful. In her latest blog, Sally Howard, Topic Lead for the hub, summarises 'A3', a problem solving tool that does exactly that. She draws on her own experience of using the tool to improve patient outcomes and provides both rich insight and practical examples to help others maximise it's potential.
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Content Article
Creating a just culture
Claire Cox posted an article in Techniques
In this article, Prof Chris Frerk, Consultant Anaesthetist at Northampton General Hospital and trustee of the Clinical Human Factors Group explains what to do when things don’t go according to plan and we can learn from airway events.- Posted
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Content ArticleAs I mentioned in my previous blog (part 3), the number of staff using the SISOS calm zone as a safe space to take time out was surprising because of the sheer volume and also the average time it was used for (15 minutes). Certain factors contribute to the success of a safe space: management buy-in, location and, to a degree, ambiance. At Chase Farm Hospital, we have been fully supported locally and at a trust level. However, in any organisation there will always be people who are averse to change. In this blog I will share with you some of the negative experiences I encountered, because anyone thinking of setting up a similar initiative needs to be aware that it is not always plain sailing and unfortunately not everyone sees the need to support staff. I will also share with you how SISOS is evolving to meet our staff's needs.
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Miles Sibley: Changing the culture of learning from deaths
Patient Safety Learning posted an article in Culture
In this BMJ Opinion article, Miles Sibley, Director for the Patient Experience Library, reflects on why there is still a failure to listen to patients and bereaved families when things go wrong. Instead we find that over and over again, when patients die avoidable deaths, their shocked and grieving relatives are locked out of investigations, refused access to information, and denied justice.- Posted
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News Article
Warning over warring Great Ormond Street surgeons
Patient Safety Learning posted a news article in News
Warring between two surgeons at Great Ormond Street Hospital could put patients at risk, a review suggests. A board paper released by the leading children's hospital said a "fractured" relationship between two consultants in the paediatric surgical urology team was affecting the service last year. The London hospital said steps were being taken to resolve the problems. This has included mediation, mentoring and away days. The board paper from a meeting in November set out the findings of a two-day inspection by the Royal College of Surgeons last May. The college was invited in by the trust itself after reports of problems. The summary of the report said there were "significant difficulties" between two surgeons in the team. It described a "lack of trust and respect" which meant they did not work collaboratively and led to significant competition for work. If this continued it would have the "potential to affect patient care and safety" as well as longer waits for surgery, it said. The "dysfunction" between the two senior doctors caused problems for the wider team with evidence support staff had also been treated inappropriately. Great Ormond Street said it took the issue "extremely seriously" and good progress was being made. Read full story Source: BBC News, 15 January 2020- Posted
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Content ArticleCommunication and care delivery is enhanced when teams work together well. TeamSTEPPS® is a US government set of teamwork tactics and tools designed to help health care professionals work together safely and effectively.
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Airway alert card and difficult airway database
Claire Cox posted an article in Process improvement
The Difficult Airway Society (DAS) has produced a difficult airway card for patients to carry in their wallet. This is to alert the anaesthetist that this patient has a 'difficult airway' before they find out the hard way. This website also holds the database for patients with difficult airways. This is for clinicians to use to help assess risk in patients undergoing sedation or general anaesthetic.- Posted
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Content ArticleWorkplace bullying (WPB) is a physical or emotional harm that may negatively affect healthcare services. The aim of this study, published in Human Resources for Health, was to determine to what extent healthcare practitioners in Saudi Arabia worry about WPB and whether it affects the quality of care and patient safety from their perception.
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Content Article
The SPA experience: NHS Wales Award winner 2016
Claire Cox posted an article in Learning disabilities
Having surgery can be a daunting experience for most people. Staff at the Princess of Wales Hospital in Bridgend, Wales, have recognised this, especially in their patients with complex needs. The reasonable adjustments that they have put in place to ensure their patients receive a bespoke, calming, safe experience won them an NHS Wales Award in 2016 in the Citizens at the Centre of Service Redesign and Delivery category.- Posted
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Content ArticleAmandip Sidhu is a Learn Not Blame member and pharmacist. Tragically, Amandip lost his brother, a respected Consultant Cardiologist, to suicide. In this heartbreaking and powerful guest blog for Doctors Association UK (DAUK) and the Compassionate Culture campaign, Amandip reflects on the “just get on with it” attitude of the NHS, and how we must move to kinder NHS that treats it’s staff with much needed compassion.
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