Reucing Harm, Improving Healthcare

 <---- Photos from yesterday at the 'Reducing Harm, Improving Healthcare' conference at the Suttie Centre in Aberdeen.

The day involved a combination of lectures and small group workshops on different aspects of improving patient safety. It was good to see a whole range of people there, not just medical students. Our Tayside cohort did however dominate the poster presentation at lunch time with over half of the posters on show being from Dundee University! The first workshop I attended was on 'Speaking Up' and we were given a scenario which really happened where a final year medical student noticed an error when watching a patient having a major operation. We discussed the differences between 'mitigating speech' ie. the hint and hope method, as opposed to direct messages ie. Stop now. Also we talked about how as a trainee, a query can be raised as a question, ie. Can I just check that this is what you want to do. Or why are we not doing it this way. I think this is something I'll probably try and do alot as a foundation doctor with the exception of being emergency situations where I hope to think that if I see something being done wrong I would be able to say STOP or WAIT etc if I thought it was incorrect. We talked about critical language approaches, such as the 'probe, concern, alert' method and 'I'm concerned, I'm uncomfortable, I'm scared'.

The second workshop was on antimicrobial prescribing. We were given scenarios where antibiotics had been given and asked questions such as 'What are the risks to the patient', 'What are the information gaps' and 'What are the issues/risks for staff?'. I now know that Tazocin and Co-Amoxiclav contain penicillin and are contraindicated in patients with penicillin allergy. There are some antibiotics such as Ceftriaxone which can be given to penicillin allergic patients but only in an emergency situation. The '4Cs' of C.Diff i.e. the antibiotics which are most likely to cause C.Diff are Co-Amoxiclav, Ciprofloxacin, Ceftriaxone and Clindamycin. There is also some evidence that Tazocin also leads to increased rates of C.Diff although this is yet to be confirmed.

Take home message of the day, in the words of Tommy who is an FY1 at the moment in Ninewells is to make friends with your ward pharmacist when you start work because when it comes to prescribing they are the fountain of all knowledge.

Some useful websites for more information:
www.abdn.ac.uk/iprc - Industrial Psychology Research Centre
www.chfg.org - Clinical Human Factors Group
www.who.int/patientsafety - World Health Organisation