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Previous seminars

Undertaking risk and relational work to manage vulnerability: Acute medical patients’ involvement in patient safety in the NHS, Dr Elizabeth Sutton, Research Associate, SAPPHIRE group, Dept. of Health Sciences, University of Leicester – Thursday 20 October 2022

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Abstract

Over the last decade a wealth of studies have explored the way that patients are involved in patient safety internationally.  Most begin from the premise that patients can and should take on the role of identifying and reporting safety concerns.  Most give little attention, however, to the impact of the patient’s health status and vulnerability on their ability to participate in their safety. Drawing on qualitative interviews with 28 acute medical patients, this article aims to demonstrate how patients’ contributions to their safety in the acute medical context are less about involvement as a deliberate intervention, and more about how patients manage their own vulnerability in their interactions with staff. Our analysis is underpinned by theories of vulnerability and risk.  This enables us to provide a deeper understanding of the ways vulnerability shapes patients’ involvement in their safety.   Acute medical patients engage in reassurance-seeking, relational and vigilance work to manage their vulnerability.  Patients undertake reassurance seeking to obtain evidence that they can trust the organisation and the professionals who work in it and relational and vigilance work to manage the vulnerability associated with dependence on others and the unpredictability of their status as acute medical patients.  We argue that patients are involved in the process of creating patient safety at the point of care.  Foregrounding the theory of vulnerability and its relationship to risk offers new insights into the potentials and limits of patient involvement in patient safety in the acute care context.

Biography

Dr Liz Sutton is a Research Associate in the Social Science Applied to Healthcare Improvement Research (SAPPHIRE) Group, Department of Health Sciences, University of Leicester.  She has considerable expertise in qualitative research including: qualitative interviewing, focus group facilitation and ethnography.  Her ethnographic projects have been conducted in different settings including hospital acute care and in care homes, where she has explored such issues as the quality and safety of care and how context affects antibiotic prescribing.  Her PhD research explored how vulnerability affects patient involvement in patient safety.  Her other interests include dementia care, healthcare quality improvement and health inequalities.

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Human Factors in Healthcare Safety Investigation Branch (HSIB) and beyond, Suzy Broadbent; National Investigator (HSIB) – Tuesday 19 July 2022

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Abstract

Learning from adverse events is a well-known approach to managing safety. Lessons learnt from aviation and other industries lead to the formation of the Healthcare Safety Investigation Branch in 2017. They’ve since published numerous investigations, across both National and maternity teams, that do not apportion blame or liability and are instead focused on the wider learning for the system.  In this talk we will discuss the rationale and methods of carrying out these investigations, but also look wider as to how the discipline of Human Factors can be used more proactively in healthcare to help reduce adverse events by sharing learning from other industries in their approaches to this too.

Biography

Suzy Broadbent is a Fellow of the Chartered Institute of Ergonomics and Human Factors with twenty years experience working in Human Factors across defence, rail and healthcare domains. Suzy started her human factors career at CIRAS, the confidential reporting system for the railways, before a secondment to work on the London Underground modernisation programme. From there she moved to BAE Systems Air where she worked on fast jets such as Tornado, Eurofighter Typhoon, F35 and Tempest and became Engineering Manager of the Human Factors team and a Licensed Technologist in Human Performance Enhancement.

In 2021 Suzy moved into the Healthcare sector and is now a National Investigator with the Healthcare Safety Investigations Branch, who improve patient safety through effective and independent investigations that don’t apportion blame or liability.

Suzy is a keen communicator in the field of Human Factors, and has featured on numerous webinars, international panels and podcasts, alongside being interviewed for tv, press and engineering publications.

Webinar Link

Improving support for healthcare professionals experiencing adverse events: responsive and prophylactic interventions, Dr Helen Bolderston, Professor Kevin Turner and Dr Judith Johnson – Thursday 29 September 2022

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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

Is double-checking associated with lower medication error rates in paediatrics? Prof Johanna Westbrook, Director of the Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia – Thursday 18 August 2022 (held at the University of Leeds)

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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.

Health behaviour change interventions in routine healthcare: Healthcare professional and patient perspectives, Dr Chris Keyworth – Thursday 28 April 2022

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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