Patient safety 1 - How can we build a culture of safety in paediatric healthcare?
01/10/24 • 60 min
Healthcare is inherently risky and so as child health professionals we need to make patient safety a priority in all our actions. We need to think about safety all the time.
In episode 1 of our series on paediatric patient safety, we speak with Dr Peter Lachman, who develops and delivers programmes for clinical leaders in quality improvement at the Royal College of Physicians in Dublin.
As Peter explains on the podcast, we healthcare professionals need to know patient safety theory - but, more importantly, we need to know how to apply it, drive improvement and create a workplace culture that fosters safe working practices.
Everyone - from the most junior member of the team to the most senior paediatric clinical leader - needs to think about patient safety all day every day. A safe culture takes time to build. Shared activities such as handover, huddles and debrief can model good behaviour and benefit performance. Repeating behaviours that represent a safe culture can create a virtuous cycle which can change deeply held attitudes and beliefs, then ultimately the safe culture overall.
Thank you for listening.
Dr Natalie Wyatt, RCPCH Clinical Fellow and Jonathan Bamber RCPCH Head of Quality Improvement
Produced by 18Sixty
Please be advised that this series contains stories relating to child death and harm. All views, thoughts and opinions expressed in this podcast series belong to the guests and not necessarily to their employer, linked organisations or RCPCH.
About the Patient safety podcast series
As doctors we ‘first, do no harm’. However, the systems in which we work are rife with safety issues and resultant harm. In thinking about how to improve this, we have brought together leaders in the field to discuss challenging and thought-provoking issues around keeping our children safe in healthcare settings. We hope you will be entertained, educated, and energised to make strides in improving the safety of the children that you care for.
There are lots of resources that expand on this on the RCPCH Patient Safety Portal, including the theory of patient safety culture and examples of how people across the UK are doing this well. Visit at https://safety.rcpch.ac.uk.
More about Dr Peter Lachman
Dr Peter Lachman develops and delivers programmes to develop clinical leaders in quality improvement at the Royal College of Physicians in Dublin. He works with HSE Global in Africa, and he was Chief Executive Officer of the International Society for Quality in Healthcare (ISQua) from 1 May 2016 to 30 April 2021. Peter was a Health Foundation Quality Improvement Fellow at IHI in 2005-2006 and then went on to be the Deputy Medical Director with the lead for Patient Safety at Great Ormond Street Hospital 2006-2016. Peter was also a Consultant Paediatrician at the Royal Free Hospital in London specialising in the challenge of long-term conditions for children.
Peter is the lead editor of the OUP Handbook on Patient Safety published in April 2022; Co-Editor of the OUP Handbook on Medical Leadership and Management published in December 2022; and Editor of the OUP Handbook on Quality Improvement to be published in 2024.
Topics/organisations/papers referenced in this podcast
- ISQUA (International Society for Quality in Healthcare)
- Oxford Professional Practice: Handbook Of Patient Safety
- IHI (Institute for Health Improvement)
- Human factors - on RCPCH Patient Safety Portal
- S.A.F.E. Collaborative - on RCPCH Patient Safety Portal
- Cincinnati Childrens Hospital patient safety
- Paediatric Early Warning System (NHS England)
- BMJ Quality & Safety journal
- Lachman, P., Linkson, L., Evans, T., Clausen, H., & Hothi, D. (2015). Developing person-centred analysis of harm in a paediatric hospital: a quality improvement report. BMJ quality & safety, 24(5), 337–344
- Health Foundation
- A framework for measuring quality, with Professor Charles Vincent et al
Healthcare is inherently risky and so as child health professionals we need to make patient safety a priority in all our actions. We need to think about safety all the time.
In episode 1 of our series on paediatric patient safety, we speak with Dr Peter Lachman, who develops and delivers programmes for clinical leaders in quality improvement at the Royal College of Physicians in Dublin.
As Peter explains on the podcast, we healthcare professionals need to know patient safety theory - but, more importantly, we need to know how to apply it, drive improvement and create a workplace culture that fosters safe working practices.
Everyone - from the most junior member of the team to the most senior paediatric clinical leader - needs to think about patient safety all day every day. A safe culture takes time to build. Shared activities such as handover, huddles and debrief can model good behaviour and benefit performance. Repeating behaviours that represent a safe culture can create a virtuous cycle which can change deeply held attitudes and beliefs, then ultimately the safe culture overall.
Thank you for listening.
Dr Natalie Wyatt, RCPCH Clinical Fellow and Jonathan Bamber RCPCH Head of Quality Improvement
Produced by 18Sixty
Please be advised that this series contains stories relating to child death and harm. All views, thoughts and opinions expressed in this podcast series belong to the guests and not necessarily to their employer, linked organisations or RCPCH.
About the Patient safety podcast series
As doctors we ‘first, do no harm’. However, the systems in which we work are rife with safety issues and resultant harm. In thinking about how to improve this, we have brought together leaders in the field to discuss challenging and thought-provoking issues around keeping our children safe in healthcare settings. We hope you will be entertained, educated, and energised to make strides in improving the safety of the children that you care for.
There are lots of resources that expand on this on the RCPCH Patient Safety Portal, including the theory of patient safety culture and examples of how people across the UK are doing this well. Visit at https://safety.rcpch.ac.uk.
More about Dr Peter Lachman
Dr Peter Lachman develops and delivers programmes to develop clinical leaders in quality improvement at the Royal College of Physicians in Dublin. He works with HSE Global in Africa, and he was Chief Executive Officer of the International Society for Quality in Healthcare (ISQua) from 1 May 2016 to 30 April 2021. Peter was a Health Foundation Quality Improvement Fellow at IHI in 2005-2006 and then went on to be the Deputy Medical Director with the lead for Patient Safety at Great Ormond Street Hospital 2006-2016. Peter was also a Consultant Paediatrician at the Royal Free Hospital in London specialising in the challenge of long-term conditions for children.
Peter is the lead editor of the OUP Handbook on Patient Safety published in April 2022; Co-Editor of the OUP Handbook on Medical Leadership and Management published in December 2022; and Editor of the OUP Handbook on Quality Improvement to be published in 2024.
Topics/organisations/papers referenced in this podcast
- ISQUA (International Society for Quality in Healthcare)
- Oxford Professional Practice: Handbook Of Patient Safety
- IHI (Institute for Health Improvement)
- Human factors - on RCPCH Patient Safety Portal
- S.A.F.E. Collaborative - on RCPCH Patient Safety Portal
- Cincinnati Childrens Hospital patient safety
- Paediatric Early Warning System (NHS England)
- BMJ Quality & Safety journal
- Lachman, P., Linkson, L., Evans, T., Clausen, H., & Hothi, D. (2015). Developing person-centred analysis of harm in a paediatric hospital: a quality improvement report. BMJ quality & safety, 24(5), 337–344
- Health Foundation
- A framework for measuring quality, with Professor Charles Vincent et al
Previous Episode
The state of digital child health today - an interview with Professor Sam Shah
Richard Burley, Executive Director of Digital talks with Professor Shah about how digital technology can support child health, and how paediatricians can embrace it - with a dose of healthy scepticism.
Professor Sam Shah is Chief Medical Strategy Officer at men's health company, Numan, and Honorary Lecturer at University College London's Global Business School for Health. He spoke at RCPCH Conference 2023 with a session titled, 'Could healthcare technology address the challenges in child health? Richard Burley here at the College was fortunate to be in the audience and invited Sam to discuss further.
As Sam notes on the podcast, there is no shortage of technology from mobile apps to wearables. But, he says there's a challenge, especially as we look to reduce anxieties:
"...how we try and make the environment of child health - really, the treatment end - more accessible to children, young people and their families. And also less imposing, less scary. Especially that moment when families will be scared about accessing treatment, when children will be in unfamiliar environments."
Sam and Richard talk about examples where digital technologies, particularly augmented and virtual reality, are making a real difference. They consider the unique experiences of children and young people as patients, and the differing needs of communities around language, culture and digital maturity. They step into the thorny issues on privacy, security and safety - and how digital tech intersects with real-life clinical care.
Sam finishes with practical advice on how paediatricians can identify, evaluate and use digital technology in their practice.
Next Episode
Patient safety 2 - If we are psychologically safe, children are safer in our care
Psychological safety in healthcare settings is the condition in which you feel included, safe to learn, safe to contribute and safe to challenge the status quo - without fear of being embarrassed, marginalised or punished. And it's an essential foundation in building a safety culture.
Individually, feeling psychologically safe improves performance and innovation, while feeling unsafe reduces productivity and harms retention. In a highly productive team, it is about feeling safe to take risks, to learn from each other and to feel resilient and able to tackle the difficult and varying challenges of healthcare with a healthy mindset.
This is the second episode in our patient safety series and features Dr Dal Hothi and Dr Jess Morgan. Learn how you can reflect on your own behaviour, champion effective communication and create a psychologically safe space within your team.
Hosts: Dr Natalie Wyatt, RCPCH Clinical Fellow and Jonathan Bamber, RCPCH Head of Quality Improvement
Produced by 18Sixty
Please be advised that this podcast series contains stories relating to child death and harm. All views, thoughts and opinions expressed belong to the guests and not necessarily to their employer, linked organisations or RCPCH.
If you are a healthcare professional and you are worried that you are suffering with burnout please speak to your team, your GP or Practitioner Health.
About the speakers
Dr Dal Hothi is a paediatric nephrologist at Great Ormond Street Hospital. She's also a Director of Leadership Development at the Faculty of Medical Leadership and Management, as well as being an Officer for Lifelong Careers at the RCPCH.
Dr Jess Morgan is a paediatric doctor and Dinwoodie RCPCH Fellow who leads on the RCPCH Thrive Paediatrics Project along with Dal.
About the patient safety podcast series
As doctors we ‘first, do no harm’. However, the systems in which we work are rife with safety issues and resultant harm. In thinking about how to improve this, we have brought together leaders in the field to discuss challenging and thought-provoking issues around keeping our children safe in healthcare settings.
We hope you will be entertained, educated, and energised to make strides in improving the safety of the children that you care for.
To learn more, visit the RCPCH Patient Safety Portal and begin your journey in improving your own psychological safety and that of those you work with.
Links for topics/organisations/papers referenced in this episode
- Dinwoodie
- Thrive Paediatrics at RCPCH
- Amy Edmondson and psychological safety
- Tim Clark’s four stage model of psychological safety
- Freedom to Speak Up (The National Guardian)
- Charles Vincent ("Safety is not defined by the absence of negative outcomes") - The Health Foundation: The measurement and monitoring of safety
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