Abstract

Surgery, by its very nature, is challenging work. When the experience of adverse surgical events is factored in, surgeons can experience significant negative effects on their psychological wellbeing. In this presentation Helen Bolderston and Kevin Turner will summarise the findings of a UK national survey of surgeons which provided evidence of the impact of adverse events on surgeons, especially when those events are perceived as errors by the surgeons involved. This research led to the Bournemouth University Surgeon Wellbeing Research Team convening a national, multidisciplinary working group tasked with developing good practice guidelines addressing the support of surgeons in the immediate aftermath of adverse events. The guidelines will be outlined, with specific focus on the recommendation for organisations that employ surgeons to develop ‘First Responder’ surgeon support schemes. Recent developments in relation to such First Responder schemes will be discussed.

Part 2. Preparing healthcare professionals for adverse events: Reboot coaching programme

Dr Judith Johnson

Abstract

Adverse events are a common occurrence in healthcare and most healthcare professionals will be involved in a patient safety incident at some point during their career. However, many professionals report feeling unprepared for how to manage and cope with the psychological distress they may experience in response to these events. The Reboot (Recovery-boosting) Coaching Programme was developed to fill this gap. It is the first prophylactic psychological intervention designed to prepare healthcare professionals for the occurrence of adverse events. Reboot has now been evaluated in two completed studies. The first reported on Reboot when delivered via an in-person modality to multidisplinary healthcare professionals prior to the Covid-19 pandemic. The second reported on an evaluation of Reboot delivered via a remote format to Critical Care Nurses during one of the peaks of the Covid-19 pandemic. Studies are currently underway evaluating Reboot in medical students and surgeons. This talk will provide information about Reboot, describing the components of Reboot and evidence regarding its potential value to healthcare providers.

Biographies

Dr Helen Bolderston

Helen Bolderston has over 30 years’ experience as a clinical psychologist and psychotherapist. She was a consultant psychologist in NHS mental health services for many years before moving to an academic post at Bournemouth University. She trains and supervises clinical psychologists and psychotherapists nationally and internationally, specialising in empirically-supported mindfulness and compassion-based psychotherapies such as Acceptance and Commitment Therapy. Her research focusses on three main areas:  1. Evaluating psychotherapeutic interventions, particularly mindfulness and compassion-based therapies.  2. Investigating psychological processes implicated in the development and maintenance of mental health problems. 3. Addressing psychological wellbeing, resilience, and burnout in health and educational settings. She is a member of the Bournemouth University Surgeon Wellbeing Research Team. As part of this work she took the lead for an RCT testing a resilience-enhancing training intervention for trainee surgeons and contributed to the RCS Good Practice Guide “Supporting surgeons after adverse events.”

Professor Kevin Turner

Kevin Turner was appointed as a Consultant Urological Surgeon in Bournemouth in 2007 and is a Visiting Professor at Bournemouth University. He trained in Urology in Oxford, Edinburgh and Melbourne. His clinical interests are in urological cancer, particularly resectional surgery for pelvic cancer and robotic / minimally invasive surgery. He was elected an Hunterian Professor of the Royal College of Surgeons of England whilst still a trainee, was awarded the European Association of Urology Thesis Award for his research in renal cancer, and is co-editor of the Oxford Handbook of Urological Surgery. In 2015 he co-founded the Bournemouth Surgeon Wellbeing Research Team with colleagues in the Department of Psychology at Bournemouth University. The aim of the team is to generate original research data concerning the psychological health of surgeons including in relation to the impact of adverse events on surgeons. The team develop and trial novel interventions designed to ameliorate the impact of adverse events and more generally, to increase surgeon resilience and wellbeing. Results of the team’s national survey have been published in the British Journal of Surgery, an RCT of the effectiveness of a resilience training intervention for surgical trainees has been completed, and in 2020 (in conjunction with RCS England) the team led the multidisciplinary panel that wrote the RCS Good Practice Guide “Supporting surgeons after adverse events.”

Dr Judith Johnson

Judith Johnson is an Associate Professor in Psychology at the University of Leeds and holds adjunct roles at the Bradford Institute for Health Research, UK and the University of New South Wales, Australia. She gained a PhD from the University of Manchester and a ClinPsyD (Practitioner Doctorate) from the University of Birmingham. She is an HCPC registered Clinical Psychologist. Her research interests focus on healthcare staff wellbeing and burnout, patient safety and communication in healthcare settings. She is particularly interested in developing interventions which can support healthcare providers better in order to improve the delivery of patient care. She has published over 60 peer-reviewed articles in high-quality journals including the BMJ, International Journey of Surgery and Academic Medicine. Her work has been covered by The Guardian newspaper and BBC News and has been referred to in policy documents published by the World Health Organization, the British Medical Ultrasound Society and the Society and College of Radiographers.

Webinar link

Abstract

Medication administration errors (MAEs) are prevalent.  The use of double-checking as a strategy to prevent errors and associated harm in hospitals is internationally widespread. However, evidence of the effectiveness of this high-resource process is very limited. We conducted a direct observational study of medication administration to measure the association between double-checking and medication administration error rates.

The study was undertaken over 22 weeks during weekdays and weekends between 07:00 and 22:00 on nine wards at a major Sydney Children’s Hospital.  Hospital policy mandated an extensive list of medications requiring independent double-checking by two nurses. Trained clinical researchers observed 5,140 dose administrations by 298 nurses.

Specialised data collection software (Precise Observation System for Safe Use of Medicines – POSSUM) allowed observers to accurately collect multiple details of medication preparation and administration reliably. Steps in the double-checking process were defined and classified in terms of ‘primed’, ‘independent’ or ‘incomplete’ double-checking. Observational data of drugs administered were later compared to patients’ medication charts to identify any MAEs, by a researcher blinded to information about whether medications had been double-checked.  This presentation will report the results from this study and discuss implications for future work.

Biography

Professor Johanna Westbrook, PhD, FTSE, FAIDH, FACMI, FIAHSI, is internationally recognised for her research evaluating the effects of information and communication technology (ICT) in health care which has led to significant advances in our understanding of how clinical information systems deliver (or fail to deliver) benefits. She has led extensive studies on the impact of medication technologies in hospitals on medication safety and clinicians’ work. Her highly applied research has supported translation of this evidence into policy, practice, and IT system design changes. Johanna has contributed to theoretical models regarding the design of complex multi-method ICT evaluations. She led the development of the Work Observation Method by Activity Timing (WOMBAT) software to support the conduct of observational workflow studies. WOMBAT has been used in over 15 countries and version 3.0 is available in the Apple Store.

In 2019 she presented research findings to the Royal Commission into Aged Care Quality and Safety regarding the contribution that ICT can make to supporting improvements in monitoring the quality of care and outcomes in the sector.  Her work informed several of the recommendations in the Commission’s final report. She has several current projects in aged care including: the development of a National aged care medication roundtable; and a dashboard of predictive analytics for residential care.

Johanna’s interests centre around designing innovative approaches to delivering robust research evidence to inform translational improvements in the delivery and outcomes of health services. She has recently been working with a large health care provider to evaluate a large-scale organisational culture change intervention designed to reduce unprofessional behaviour between hospital staff.  This work has generated comprehensive new evidence of the scale and type of unprofessional behaviours occurring among over 5000 hospital staff in seven hospitals across three states.  Using an innovative multi-method research approach this project is delivering new information about mechanisms by which elements of the change program are effective, along quantitative data on changes in behaviours and attitudes 2-3 years after intervention implementation.

Johanna has >500 publications and been awarded >$70M in research grants. In 2014 she was named Australian ICT professional of the year. In 2020 she received the NHMRC Elizabeth Blackburn Investigator Award. Johanna has contributed to many policy bodies including being appointed to the inaugural Board of the Australian Digital Health Agency; Chair of the Deeble Institute Advisory Board, Australian Healthcare and Hospitals Association, and is a Co-Director for the Safety, Quality, Informatics and Leadership (SQIL) Program for the Harvard Medical School.

Abstract

Public health policies are used internationally to encourage healthcare professionals to deliver health behaviour change interventions (e.g. being more physically active, reducing alcohol intake) as part of routine healthcare. However, organisations face a number of barriers to implementing public health policy during routine clinical practice. Research suggests inconsistencies in: (a) how health behaviour change interventions are delivered by healthcare professionals, and (b) how patients experience receiving these interventions. Of additional concern are the pressures of the COVID-19 pandemic, which may have led such health policies to be overlooked. Given that COVID-19 has increased health inequalities, supporting people to modify health behaviours is now more important than ever. This webinar will present findings from a programme of research examining the prevalence of health behaviour change interventions during routine NHS healthcare, from both the healthcare professional and patient perspectives. Preliminary findings will also be presented from a new programme of research currently underway, which examines if and how COVID-19 has affected the health communication practices of healthcare professionals, including COVID-19-specific challenges, and the awareness and prevalence of healthcare professionals’ policy-related practice in relation to health communication.

Biography

Chris is a Chartered Psychologist and Lecturer in Psychology at The University of Leeds. Before moving to Leeds in May 2021, Chris obtained his PhD in Health Psychology at The University of Manchester (2015), and has since worked across a number of multidisciplinary research programmes. He is a member of the UK Society for Behavioural Medicine, and the British Psychological Society Division of Health Psychology. Chris has a background in mixed methods research, and his main interests are in applying evidence-based theory to developing behaviour change interventions, and understanding healthcare professional-patient communication.

Webinar Link

Abstract:

Health inequalities are increasing in the UK and the COVID-19 pandemic has provided renewed impetus to find solutions to these unfair and avoidable differences in our population’s health. In addition to addressing the social determinants of health, we must also consider whether elements of healthcare itself systematically disadvantage vulnerable groups of patients. The National Patient Safety Team has set out its strategic objectives to understand whether differences in risk of harm from healthcare are a contributing factor to health inequalities.

Here we presented the findings of a mixed-methods review exploring whether risk of harm from healthcare varies between different groups of patients, what the mechanisms driving these differences are, and what possible solutions may be able to reduce these inequalities. This presents an integration of the patient safety and health inequalities agendas, which offers a novel perspective on the possible role healthcare professionals, organisations and systems could play in both improving patient safety and reducing health inequalities.

Abstract

The seminar will discuss some key aspects of our changing understanding of, and approach to, patient safety in the NHS. Discussion points will include our approach to the role of individuals and systems in patient safety incidents, the importance of culture and the need to ensure our approach to learning from incidents is based on a good understanding of error theory. These issues will be presented in the context of the NHS Patient Safety Strategy and how some of the key components of the Strategy link to our evolving understanding of the topic.

Biography

Matt is currently Deputy Director of Patient Safety (Policy and Strategy) for the national NHS Patient Safety team. Prior to this Matt held a number of roles as a Civil Servant, including as a Private Secretary to the Minister of State for Health. Before joining the Civil Service, Matt was a research scientist and gained his PhD in Developmental Neuroscience at University College London in 2006.

Webinar Link