Hello, I'm Helen Silver McMahon, and I'm looking forward to taking you through my top tips for safer surgery. The first top tip I have for you is how to plan a good day, by pre-briefing and by using Halt. In this session, we will explore two of the key ingredients for ensuring a successful day in veterinary practise, briefings and breaks.
Briefings have been shown to reduce risk of adverse events occurring and improve efficiency and collaboration within teams. As part of the briefing, teams should be encouraged to plan ahead for short breaks and prioritise those breaks when they come. We know that communication is responsible for a large percentage of error within practise.
The Joint Commission on the Accreditation of Health organisations describes communication error as the cause of 60 to 70% of preventable hospital deaths. So it's really important that we start each and every day by proactively considering our communication methods. At the start of each day, we should begin with a patient safety briefing.
We should take this opportunity to ask ourselves and our team what is different about today? And consider each and every patient individually, and what are the moments where a single error from a single person could lead to harm, and what steps can we put in place to make sure that that doesn't happen. By doing this, we enter a threat and management cycle where we take proactive steps to ensure that our patients are kept as safe as they can be.
One of the anticipated pushbacks in practise would be lack of time. However, it has been found that surgical teams perceived that briefing and debriefing improved efficiency with more operations starting on time and less taking an unexpectedly long time. It was found that the pre-op briefing took less than 4 minutes to conduct.
And we know that patient safety briefings improve patient safety and collaboration within teams in the hospital setting. So, when we're looking at a patient safety briefing structure, we have to remember our key aims are to agree a plan for the day, discuss and allocate rules, and highlight our patients specific concerns and special considerations. We want to make sure that we're prompt in how this goes ahead.
We want to make sure that we discuss and allocate roles because we know that research from Google in Project Aristotle has told us that by making sure people are aware of their roles and responsibilities, they perform better as a team. We want to make sure that we use a structure for our patient safety briefing, and I'll come on to that in a moment. We need to be aware of the fact that these are different from surgical checklists.
We're going to be proactively considering the challenges we might find throughout the day, making sure that we're inclusive to each and every member of the team, and adaptable in how we approach our our challenges. So we use the acronym TeamPO. And as we work through it, we, we acknowledge that we use this acronym because under the pressure, under the pressure, it's easy to become distracted and it can be hard to think of what to say if we don't have a mental structure.
Also within a team of structure such as this can be a useful common language to develop to develop and trigger and at the end of the day, normalise patient safety briefings. So we want to consider for each of these elements, what could catch us out, what assumptions might we might we have made, and what particular challenges might we face. So we want to consider the team as a whole.
Who is on our team? What are their roles and responsibilities? Is there anyone missing today?
And what do we need to do to cover their role and responsibilities? Are there any challenges within the environment? Can we use all the areas that we wanted to, or are there certain areas that are not available today?
Have we got all the equipment we need today? Is there anything that we need to, to ask for, especially, are there going to be any challenges in turning it around, sterilising it, making sure that we have everything for every operation that we're doing on the list? Medications.
Are there any medications that we don't have available today, or that our patients are allergic to? We need to consider each of our patients as individuals. Think about what challenges they may present.
Is it a small patient that needs pre-warming and lots of warming devices in theatre? Or are there a large patient who might be quite tricky to get onto the operating table and keep there? Then we need to consider the procedure itself, have a, a mental rundown of what equipment we need and how the room needs to be set up and make sure we're prepared for that.
Then post procedure. We need to consider how our patient will recover best. Do they need to go into the incubator, or are they best going back to their own kennel with a designated nurse to look after them?
And perhaps if they're fractious or, large or bury a nurse, this could be better for them. And then we need to consider anything else that might present a challenge on that day. We debrief the team as a whole, even if it's rapid and short.
Check that we've got the same mental model, check that we've all got the same understanding, and don't make any assumptions about shared insight or knowledge. If you're leading the briefing, lead it by being open and inclusive. Ask questions first and lead second.
And encourage your team to speak up. It's really important that we have a good deal of psychological safety and a low authority gradient so that everybody in the team feels that they can add their thoughts or concerns. Within the veterinary profession, we spend a huge amount of time looking after our patients and doing our very best for them.
We sometimes go so all out for our patients that we forget ourselves and what we need to feel and function at our best. We develop what we call a superhero mentality. Doctor Mike Farquhar at St.
Guys and Thomas's Hospital has done lots of research into fatigue and sleep, and he states that unless critically ill patients require immediate attention, our patients are always served better by clinicians who have had appropriate rest breaks during their shifts. And that's why we talk about Holt. The Holt campaign was launched within the NHS by Mark Mike Farquhar, to make sure we plan our breaks, we work as a team, and create a take a bake culture.
After the NHS was found to have difficulties with fatigue. We know that this means that we're healthier, our patients are safer, and it's better for everyone. So when we look at home, we need to consider preventing our teams becoming hungry or thirsty, anxious or angry, late or lonely, or tired.
And we need to plan, prioritise, and then pause when that time for our break comes to make sure that we're looking after each other and our team as best we can. If you'd like any more information about the whole campaign, please head over to VetTE's website. There's lots of freely downloadable resources there.
Thank you.
