Celebrating when things go well at the BAOMS Annual Scientific Meeting
08 July 2024 (Last updated: 8 Jul 2024 12:26)
Reflections on surgery tend to focus on learning from things that go wrong, While this can lead to positive adaptation and improvements, it is far more often the case that things go right in the operating theatre. At the BAOMS Annual Meeting in Oxford last week Professor Helen Higham reminded participants of what can be learned when we focus on these.
Helen explains: “In theatre, despite the current challenges in healthcare, I see resilience within teams. We work well together, we look after each other, we are respectful, collaborative and we communicate well, and these things mean that safety risks in the environment are acted upon in the moment and don’t slip through leading to patient harm.”
Her talk: “Shifting the paradigm in patient safety: understanding how things go right in healthcare,” included praise for oral and maxillofacial surgeons. As a consultant anaesthetist, Helen has observed a strong sense of collaboration and support in her interactions with oral and maxillofacial surgeons during her career and she now works closely with BAOMS President Daljit Dhariwal’s surgical team in Oxford. She says that the dynamic between consultant anaesthetist and consultant surgeon is important and sets a tone for the rest of the team that keeps the patient safe.
During the presentation, Helen gave an example of the impact of good teamwork with a case that occurred in surgery. A patient reacted badly to anaesthesia and suffered from life-threatening anaphylaxis as she was transferred into theatre for a complex parotidectomy. As the patient’s blood pressure dropped worryingly, Helen stated out loud what was happening informing everyone in the room what was going on. She has run through this frequently in simulation training; she and the whole team understood their roles, and this enabled her to step back and take the lead and together they worked to achieve a positive outcome for the patient.
In day-to-day practice, theatre teams should be empowered to speak out if they see anything they feel concerned about. During the morning briefing Helen and Daljit always ensure that new team members understand that the culture is about collaboration and support and everyone is encouraged to speak up if they have a question or concern.
She says: “Our work environments can be constrained, for example in older buildings theatres are small and lack space for all the equipment we use in modern practice. The way we adapt to the work environment and support each other is part of what keeps patients safe. Good teamwork and communication make a massive difference to patient safety.”
Helen concludes: “Healthcare is widely recognised to be one of or the most complex, dynamic adaptive systems, in which humans work. There are multiple interdependencies, patients are seen by different specialists as they move from pre- to post-operative care. Often the bit between care boundaries is where things can get missed and that is a challenge for healthcare generally. The focus for the future should be on designing healthcare systems which support safe working practices for the humans within them.”
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