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Building teams for safer careThe Productive Operating Theatre
TM
The challenge of organising national human factors training
Hugh Rogers FRCSConsultant UrologistSenior Associate, NHS Institute
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How The Productive Operating Theatre has been developed
Understand the real issues and challenges.
Identified co-production partners
Observing and enquiring in high risk and lean organisationsTerminal 5, Unipart Other healthcare settings, USA
Generated and tested lots of ideas with the ‘field test sites’
Test the ideas as prototypes with the ‘Associate sites’
Consolidate the learning, consider delivery mechanisms,Publish & launch
Internal & external peer review. Regular learning sets
Ongoing ROI and benefits realisation capture
Launch in Sept 2009, followed by regional start-up events for NHS England
Since April 2010 initiated 10 cohorts of training and implementation support to 90 of 174 acute trusts in NHS England.Delivered Master Training internationally in Wales , Scotland, New Zealand and Northern Ireland. Coming to Australia, Canada and South Africa etc
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We tested different approaches
• Commissioned HF training• On site coaching• Structured observations• Safety attitudes
questionnaires• Key interventions:
• Brief and de-brief• WHO checklist• SBAR
We wrote the guide (‘module’)Then we designed our own training
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Outline workshop agendaLots of interactive elements, multi-media and group work
Psychologist + clinician
• How unsafe is healthcare• frequency of harm• complexity of disaster
• The psychology bit• humans as hazards and heroes• how errors occur• self-awareness exercise
• Implementation• the model for improvement• action planning
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Examples:
Wrong Engine Kegworth Jan 1989
The complexity of disasters
Wrong Kidney LlanelliFeb 2000
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‘The psychology bit’ Eight key human factors
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Situation awareness
Also:• Colour changing card trick• Smoke filled room• The door
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Merrill & Read
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Analyticalformalmeasured + systematicseek accuracy / precisiondislike unpredictability and surprises
Driverbusiness likefast + decisiveseek controldislike inefficiency and indecision
Amiableconformingless rushed + easy going seek appreciationdislike insensitivity and impatience
Expressiveflamboyantfast + spontaneousseek recognitiondislike routine and boredom
Personal styles Controlsemotions
Ask Tell
Showsemotions
See the Improvement Leaders Guide
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Implementation: The Model for Improvement
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