Doctor Informed

In the previous episodes of Doctor Informed, we've heard why it's so important to talk about patient safety concerns, and some of the mechanisms that allow hospital staff to raise them, but knowing why and how doesn't always make it easier to speak out. In this episode we're exploring the concept of a voiceable concern – identifying what counts as a concern, and what counts as an occasion for voice by an individual, is not a straightforward matter of applying objective criteria- for example how do you tell if you're witnessing poor practice, or just something that lies outside your area of understanding? Or how do you know if the common practice in this particular ward is actually an outlier when looking at other hospitals? Our guests this week; Mary Dixon-Woods is director of THIS Institute, and a Health Foundation Professor of Healthcare Improvement Studies in the Department of Public Health and Primary Care at the University of Cambridge. Her work is concerned with generating a high quality evidence-base to support the organisation, quality and safety of care delivered to patients. Zoe Fritz is a consultant in acute medicine at Cambridge University Hospitals NHS Foundation Trust, she is also a Wellcome Fellow in society and ethics at THIS Institute, investigating how we communicate and record uncertainty around diagnosis. Reading: https://pubmed.ncbi.nlm.nih.gov/34978470/ www.bmj.com/podcasts/doctorinformed/

https://www.thisinstitute.cam.ac.uk/podcast/

Previous Doctor Informed episodes have discussed how to prevent patient safety issues from occurring, but sometimes situations are beyond anyone's control - like COVID. It can be hard to look back, especially if difficult decisions and compromises were made, including ones we did not completely agree with, or if there could be criticism of the way we responded. We ask how individual doctors, teams, and organisations could respond to and recover from major problems? In this episode, we're joined by Annelieke Driessen, a THIS Institute fellow and medical anthropologist. She is a research fellow at the University of Oxford and honorary assistant professor in medical anthropology at the London School of Hygiene and Tropical Medicine, who has spent hours listening to and understanding patient experiences of ICU during the pandemic. We'll also hear from Dominque Allwood, Chief Medical Officer at UCL Partners, and Director of Population Health at Imperial College Healthcare NHS Trust, who focuses on creating positive change in healthcare.

The research Annelieke Driessen discussed, and the full versions of the patient interviews that are included in the podcast are available at https://healthtalk.org/Experiences-of-Covid-19-and-Intensive-Care/overview

In Doctor Informed, we've been hearing a lot about the problems of healthcare, but we also want to talk about solutions. Whatever we're going to do to fix healthcare, whether that's bullying, or burnout, or patient safety - it's going to require change. And change is hard. In this episode Clara Munro is joined by Graham Martin, director of research at THIS Institute. They discuss the dreaded phrase "But it's always been done this way", and why failing is the path to success, and the true importance of listening. Our guests; Penny Pereira, Q managing director at the Health Foundation. Q helps promote improvement within the health and care system, encouraging and supporting a wide range of people to effectively lead improvement. https://www.health.org.uk/about-the-health-foundation/our-people/q-and-q-labs-team

Moira Durbridge, director of safety and risk at University Hospitals of Leicester NHS Trust. Moira trained as a nurse, and continues to work clinically, as well as her role in leading her Trust's change.

In this episode we’re going to be talking about misogyny in surgery, recent revelations about sexual harassment in the theatre have emerged - but these behaviours have been endemic for a while, even as the profession seemed to ignore them. Joining Clara Munro is Baroness Helena Kenned, the author of a recent report into diversity in medicine, who, as a barrister, has long worked on discrimination cases. The reports mentioned in the episode are from the Royal College of Surgeons;

https://www.rcseng.ac.uk/about-the-rcs/about-our-mission/diversity-review-2021/

Medicine is complex, and as a doctor you won't always do the right thing - but you can prepare yourself for when mistakes happen, both emotionally and logistically. In this episode of Doctor Informed, Clara Munro is joined by Susanna Stamford, a patient who was on the receiving end of a mistake, which catalysed her interest in patient safety. We're also joined by Anthea Martin, from Medical Protection, who dispels some myths about saying sorry. Ayisha Ashmore returns to the pod to digest the lessons from our experts. Futher reading: The video that Susanna mentioned is available to watch on youtube

bitly.com/ManagingAdverseEvents