Getting to Safe

Denys Court

Description

For patient safety to flourish, those who provide care must also be flourishing. That is what this book is about. It is people working in mutually supportive professional relationships and who are supported by safe systems who are best enabled to provide safe care. The goal of this book is to enable reflection on how to achieve that shared concept of safety. Some suggest that health should be more like the aviation industry, which is properly considered safe because its accident rate is so very low. But if an aircraft is 'understaffed', it simply does not fly. An understaffed hospital ward is never told it can't fly; its staff is more likely to be asked to do more with less. For this and many other reasons, there is a limit to the extent that systems can provide safe environments in the health sector. There is so much unpredictability that it is frequently not the rules and guidelines that determine safety but the actions of individuals and the teams in which they work, and their ability to work around the unexpected that determine it. For that to be possible and effective, these teams and individuals need to be supported, safe and resilient also. This book examines how healthcare professionals can get to a safer place in their workplace and, by doing so, keep their patients safer.

Sujets

• Sociologie, société et politique
• Human security

Informations

• Publié par: Austin Macauley Publishers
• Date de parution: 08 janvier 2021
• Nombre de lectures: 0
• EAN13: 9781528993609
• Langue: English
• Poids de l'ouvrage: 14 Mo

Extrait

G etting to S afe
Resilience Strategies for Healthcare Teams
Denys Court
Austin Macauley Publishers
2021-01-08
Getting to Safe About the Author Dedication Copyright Information© Acknowledgement Introduction: Why This Book? Chapter 1: Setting the Scene for Safety A Comprehensive Understanding of Safety Aspiring to Resilience in Healthcare Safety for Clinicians Bringing Resilience Principles to Healthcare Chapter 2: Mind the Gap Assessing Resilience in Healthcare Personalities in Healthcare and Aviation Learning Safety Strategies from Aviation Chapter 3: Managing the Gap The Good and Bad of Workarounds Chapter 4: It’s Just Culture Organisational Culture Necessary for Teams Inadvertence, Recklessness and Reality A Just Culture Accountability Standard of Care Revisited Chapter 5: Sharing Leadership Chapter 6: Effective Teams Introducing the Challenge Creating Effective Team Functioning Trust and Psychological Safety; the Essence of Effective Teamwork A Shared Mental Model; the Framework of Effective Teamwork Distributed Cognition Effective Teams Can Learn Together Little-C Coaching and the Art of Feedback Professionalism Chapter 7: Why Things Go Wrong Expecting Perfection, but Getting Less Defining the Problem Why Things Go Wrong – In Health Organisations, All Cheese is Swiss Caught Between Slices of Cheese Supporting a Learning Environment When Learning Fails Chapter 8: Supporting Open Communication The Relationship Between Adverse Events and Litigation Open Communication After Adverse Events The First AE Meeting with the Patient Chapter 9: When Things Have Gone Wrong Managing the Effects of Adverse Events on Staff Critical Incident Debriefing: lessons for Healthcare Schwartz Rounds Chapter 10: Making Things Go Right Speaking Up for Safety The Deteriorating Patient Handover/Handoff Checklists Briefings Debrief Chapter 11: Conflict Competence Values, Identity, Interests, Needs and Triggers 5 Communication During Conflict Developing Conflict Competence The Challenges in Conflict Resolution Emotions and Rationality The Conflict Management Process Chapter 12: Challenging Conversations Preparing for Challenging Conversations Suggestions for Starting Challenging Conversations with Those Superior to You in the Organisation Suggestions for Starting Challenging Conversations with Peers Where There Is No or Moderate Power Differential Suggestions for Starting Challenging Conversations with Staff Where You Have the Greater Power Chapter 13: Career Positivity Stress and Burnout Satisfaction and Happiness Positivity (Positive Psychology) Gratitude, Savouring and Flow Mindfulness Chapter 14: The Resilience Habit Explanatory Styles; Optimism, Realism, Pessimism Willpower and Habits Your Resilience Toolbox Epilogue: Planning Your Strategies 360° Resilience Notes and References Chapter 1: Setting the Scene for Safety Chapter 2: Minding the Gap Chapter 3: Managing the Gap Chapter 4: It’s Just Culture Chapter 5: Shared Leadership Chapter 6: Effective Teams Chapter 7: Why Things Go Wrong Chapter 8: Supporting Open Communication Chapter 9: When Things Have Gone Wrong Chapter 10: Making Things Go Right Chapter 11: Conflict Competence Chapter 12: Challenging Conversations Chapter 13: Career Positivity Chapter 14: The Resilience Habit
About the Author
Denys Court is an obstetrician-gynaecologist who has worked in New Zealand, Canada and the United States. His experience includes many years in health leadership. He is also qualified in law and has extensive experience as an advisor in a medical indemnity organisation, as well as a facilitator of communication skills workshops for health professionals. He chairs a clinical ethics advisory group for a District Health Board and is a credentialed mediator and conflict management coach.
Dedication
To the many excellent teams that I have been so lucky to work with and the team members within them who have seeded my passion and inspiration.
Copyright Information©
Copyright © Denys Court (2021)
The right of Denys Court to be identified as author of this work has been asserted by the author in accordance with section 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publishers.
Any person who commits any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.
A CIP catalogue record for this title is available from the British Library.
ISBN 9781528993593 (Paperback)
ISBN 9781528993609 (ePub e-book)
www.austinmacauley.com
First Published (2021)
Austin Macauley Publishers Ltd
25 Canada Square
Canary Wharf
London
E14 5LQ
Acknowledgement
I always start any book I read with the acknowledgments section to understand the context in which it has been written. I’ve been impressed that so many authors have a plethora of colleagues and friends who seem to write much of the book for them; I’d love to understand how they have harnessed such contribution. Although I don’t have that particular kind of collegial plethora, I have certainly benefited from the many friends and colleagues who have encouraged me along the way, especially those who have read a chapter or two and given me constructive feedback.
I’d like to thank Sue Fleming who, after my first shot at writing a chapter, said something along the lines of “there is probably a book within you, but this isn’t it.” Or at least, that is how I heard it. And indeed, Sue did not recognise this book but did indirectly set me on the right track. The other friend and colleague who provided me with the wherewithal to write was Neil Pattison, who agreed to job-share to allow me to free up big aliquots of uninterrupted time for this project.
That uninterrupted time meant that my family were at times short-changed. My wonderful and tolerant partner, Shirley, my delightful four children, both humorous and humouring, and my delicious seven grandchildren who show me more respect than I deserve and relish the time I do manage to find for them. I’ll make up for that now.
Having sketched out the idea of the book, it was Joy Marriott who did the research for me, to free me from that irksome responsibility and to ensure that my thoughts and ideas were evidence-based. At times, my enthusiasm meant that I put Joy under pressure to deliver in unreasonably short timeframes but she always did so uncomplainingly.
I’d like to thank the Hawaii sunsets. Much of my most productive writing was done in the hours that followed them.
And now for two very special people. A big thank you to my daughter, Bridget, who allowed me to use a part of her personal story in the book. You are one of the bravest and most resilient people I have ever known. The second is Mike Roberts, who mentored me through this whole adventure. Mike is surely the most constructive yet self-effacing mentor one could ever be lucky enough to benefit from. There were a number of times when I wondered whether this project was too big a bite. It was at those times that Mike provided me with the thoughts and comments that rebuilt my writing resilience. He believed this book needed to be written; so, Mike, it has been.
Introduction

Why This Book?
This is a book about people. It is a book which looks at the ways in which people involved in healthcare can keep people they are caring for, and thereby themselves, safe. For patient safety to flourish, those who provide safe care must also be flourishing. It is people, working in mutually supportive professional relationships, and who are supported by safe systems, who are best enabled to provide safe care. My goal is to enable reflection on how you may achieve that shared safety.
If I were to ask you right now about safety in your healthcare workplace, what would immediately spring to your mind? It would probably depend on your most recent experiences. It could be that you had a colleague who stepped in and supported you when you were overworked and made you feel safe and cared about – that you felt safe. Or was it that you spoke up when you were concerned that a patient allergy was about to be overlooked and thus kept a patient safe? And of course, in the process of doing so, kept a colleague safe too. That interwoven view of safety is what this book is about. It is an inclusive look at how to do things right more often, as individuals, and in the context of team-based relationships. As much as anything else, it is about self-care, staying safe ourselves, because if we do not, we are less able to care safely for our patients.
***
For healthcare to be safe for our patients and ourselves, the organisations in which we work must be safe and resilient. In my first two chapters, I will assess in which areas of healthcare we can largely rely on our organisations’ systems to provide a reliable backbone to safety; and in contrast, where does safety depend more on the mindfulness and actions of clinicians simply because our systems are not resilient enough? I refer to this as ‘identifying the gap’. I use the term clinician throughout the book to include all professionals involved in providing clinical care: nurses, doctors, midwives and allied health professionals. Identifying the gap is about clinicians being mindful of where the systems under which we work are least able to keep us and our patients safe and therefore where, as clinicians, like it or not we carry the greatest safety burden. By doing so, I hope to develop insight into the possibilities for, and limits of, safety in our organisations.
To develop that tension, I will explore in Chapter 3 the reality that where our organisation’s systems provide us with the most fragile safety framework is where the work our leaders and system-designers envisage we will do – ‘work as intended’ (WAI) – is