As part of our 2015 conference, exploring the theme of creating a culture of openness, safety and compassion, we invited medical students and doctors in training to contribute a poster on a patient safety project they have been involved in.
Arwa Abdel-Aal won the competition and we asked her to blog about the winning initiative. She is a doctor from East Midlands deanery, working at the University Hospitals of Leicester as an academic FY2 leader.
So, why have I started this project? At my hospital there was a gap in the way that learning from serious untoward incidents (SUIs) is shared with frontline staff, a gap that is often replicated in other parts of the NHS. I have always been interested in both patient safety and medical education and I found it frustrating that lessons learnt weren’t always being reflected in practice. When the opportunity arose to combine both patient safety and medical education in one project I was very keen to grab it. However, only when I started my project did I realise the vital role of patient safety education at both the undergraduate and postgraduate levels. To change the way junior doctors think, patient safety has to be embedded in our culture. Learning from mistakes and reflecting on things that go wrong is an excellent way to achieve this.
When SUIs occur in the NHS, hospitals have a responsibility to report and investigate them, and agree on action plans and learning points. The reporting process aims to ensure that recurrences are prevented. Hospitals also have a duty to formulate and disseminate learning points from SUIs to staff on the frontline, including junior doctors. My project aims to bridge the gap in disseminating the learning from SUIs using animated videos.
Why animated videos?
Reaching hundreds of busy junior doctors at different levels and in different specialities at University Hospitals of Leicester is challenging. Alternative methods such as emails, newsletters, group discussions and e-learning packages are time-consuming, costly and are not guaranteed to reach many of the junior doctors. In addition, these methods could increase the workload on junior doctors and may not improve compliance. Animated videos offer a simple, cheap and focused alternative, and convey explicit patient safety messages in an entertaining and memorable way. These are played at various mandatory junior doctor teaching sessions such as FY1/ FY2, core medical and surgical, simulations and induction sessions. The videos are short (1-3 minutes) to allow them to be played with minimal impact on the structure of teaching sessions.
In my hospital, a team of clinicians and managers meet every month/week and discuss SUI reports to see what can be learned. Realistic, but not real, scenarios for the videos are formulated based on these themes. The structure generally includes the story, a reflective part and a final tips part. This encourages learning from errors by reflecting on what went wrong. It also focuses on key “take-home” messages to facilitate retaining information.
To achieve the balance between preserving patients’ confidentiality and having realistic scenarios that junior doctors could relate to, we formulate fictional scenarios that are inspired by true stories. This way, SUIs are kept completely anonymous and confidential while allowing a widespread share of learning points both locally and nationally. Junior doctors are encouraged to share, discuss and learn from SUIs. Social media such as YouTube and Twitter are some of the sharing platforms used. This promotes a cultural shift in the way junior doctors think and act about patient safety. Nevertheless, the main challenge facing this project is balancing a culture of openness and safety using social media whilst maintaining patient confidentiality. My next step in the project is to find a way to achieve both.
Attending the GMC 2015 conference was both inspiring and encouraging. In particular, taking part in the “Promoting patient safety through undergraduate medical education” workshop provided me with deeper awareness of issues pertinent to patient safety education and also inspired me with new ideas. The poster exhibition was thought-provoking, with many diverse projects to learn from.
I entered the poster competition as I was keen to discuss my project with people from different backgrounds and to learn from the perspectives of a wider medical audience. I was thrilled to win the competition, but I was even more pleased to meet many people who are eager to think outside the box and use new innovative technologies to bridge gaps in patient safety medical education.