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Human Factors In a maternity service Making it happen. Dr. Harriet Nicholls Consultant Anaesthetist Luton and Dunstable Hospital NHS Foundation Trust. How we’ve done it What we’ve gained. Process Raising awareness Training Introducing and spreading behaviours Developing behaviours - PowerPoint PPT Presentation
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Human Factors In a maternity service
Making it happen
Dr. Harriet NichollsConsultant Anaesthetist
Luton and Dunstable Hospital NHS Foundation Trust
How we’ve done it What we’ve gained
• Process– Raising awareness– Training – Introducing and spreading behaviours– Developing behaviours– Communications
• Achievements
Process – Raising awareness
• Senior management
• Heads of department
• Risk management• Staff groups• Walking down the
corridor
Process – Training
• Critical mass introduced to the concepts
• Monthly team training days
• Multi-disciplinary group on LIPS course
Process – Introducing behaviours
• One behaviour, one area
• One individual, one day
• Multi-disciplinary champions
• Monthly meetings
• Sharing good practice
• Learning from one another
• Asking of each other
Spread of BehavioursArea Briefing Debriefing Closing the
loopSBAR Critical
Language
Ward 32
Ward 33
ANC
Delivery suite
Elective Theatre
Emergency
Theatre
NICU
Community
MLBU
Developing Behaviours
• Realising potential
• Novice to expert
• Requires practice
• Coaching
• Reflection
Developing BehavioursBriefing
Red Amber
NOVICE
Green Silver Gold
EXPERT
Not being used
Done by minority of people
Every one takes part
Done using a structured checklist
Outstanding jobs are allocated to a named individual
Leader invites people to speak up if they perceive a problem with patient care
Developing BehavioursDebriefing
Red Amber
NOVICE
Green Silver Gold
EXPERTNot being used
Done by minority of people
Occurring at target frequency
What did we do well
What could we have done better
What can we learn
Teamwork
Equipment
System change required
Leadership
Task Management
Situation awareness
Communication
Patient’s feedback is fed into the debrief
OR
If a team member has spoken up they are thanked for having done so
Process – Communications
Evaluation
• Clinical Outcomes
• Cultural Survey
• Anecdotal
What have we gained?
• Day starts when it’s supposed to start
• We all know the game plan
• Handover time cut by 20 minutes, Ward 32
• ODPs want to come and work in maternity
• Communication has improved across and
within disciplines
• It feels safer in theatre
Success Factors
• Support at all levels
• Built in-house capability
• An appreciation that we are the culture…