Innovative approach to improving patient safety in hospital operating theatres

19 February 2020

Shropshire’s two acute hospitals are taking an innovative approach to improving patient safety by closing their theatres every couple of months to implement Human Factors training.

Healthcare professionals are always exploring new ways to make services safer. But it’s complicated, and there is so much more to it than just ensuring that the people with the best skills and knowledge have access to state-of-the-art equipment and technology.

That is why, at The Shrewsbury and Telford Hospital NHS Trust, which runs the Princess Royal Hospital (PRH) in Telford and the Royal Shrewsbury Hospital (RSH), a team of Consultants has introduced Human Factors training to the Theatres Department.

Dr Lorien Branfield, a Consultant Anaesthetist at SaTH, who along with Mr Joe McCloud, Consultant Surgeon is running the course, explains: “Having the right people in the room is of course essential, and having access to the best equipment is obviously very beneficial, but even then there is so much more that needs to be done to ensure our patients are as safe as they can possibly be.

“Human Factors training is about improving people’s leadership and communication skills. It removes perceived hierarchy and gives people the confidence to escalate concerns.

“We have had two full training sessions, with two more planned in March and May, and so far it has been incredible. We have had people from across the organisation taking part, including some of our top doctors, nurses, healthcare assistants and porters. But, regardless of their job title or speciality, they all learn the same thing and get treated identically.”

The Trust’s management are on-board too, and have agreed to close Theatres for half-a-day every other month so staff from all areas of the organisation can undergo simulation training to learn more about themselves and how best to communicate with others in a range of challenging scenarios.

Lorien continues: “This is obviously a brave decision but one we applaud. It has allowed us to carry out simulation training using real-life scenarios.

“We are finding out how people communicate, how they manage interruptions, how people lead and how people deal with changes in leadership. Once we see that we can then go back and look at how things can be done differently to result in better outcomes.”

The training sessions are all themed and are linked to incidents, or near incidents, reported by the Trust’s Patient Safety team. The current focus is on raising concerns.

Bev Roberts, a Healthcare Assistant in the Theatres Department at RSH, has been on one of the training sessions and is now recommending it to all of her colleagues.

She said: “It’s brilliant and gives people the confidence and skills to speak up if they think something isn’t right.

“I have also learned how the use of language is so important. For example, rather than asking someone to fetch a piece of equipment and have three people or, even worse, no-one get it, we are taught to use ‘closed-loop’ communication. This means I would now instruct someone by name to fetch something and ask that they inform me when the task is completed.”

Mark Cheetham, Medical Director for the Scheduled Care group, has praised the approach.

He said: “This will improve team working and communication in order to create the conditions for safety and staff experience to thrive.”