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What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

Whittington Health was the pilot site for Project Wingman, an initiative bringing grounded aviation crew into UK hospitals to provide ‘tea and sympathy’ to staff. As relationships between staff and aviation volunteers grew, we identified new opportunities for collaborative human factors education through in-situ simulations.  This is currently being run as an educational research project, with feedback gathered from staff involved in the simulations. The initial feasibility study of 15 sims demonstrated very high levels of engagement amongst participants. The aim is that this initiative will not only improve staff experience of training, leading to behavioural changes at an individual level; but also system wide improvements, for example latent safety threats identified have resulted in practical changes to equipment labelling and checklists. It has also led to better collaboration across departments and between disciplines, with simulation scenarios designed around safety incidents and risks, sharing learning across the trust.

What does your project aim to achieve?

The project seeks to expand the multi-specialty in-situ simulation programme (with aviation observation) wider, including into community services and if successful to trial with a partner Trust.  Evaluating culture change is notoriously difficult and only becomes apparent over a long period of time. However, aviation experience has demonstrated that if human factors are improved within the organisation then safety improvements will follow in time.

It is hoped that over six months, staff confidence in human factors skills will have improved, leading to changes in behaviour.

The programme’s success will be measured by;

Qualitative feedback based on surveys from staff
Targeted human factors learning workshops based on feedback from simulations and triangulated against trust safety intelligence
Number of human factors champions trained to observe simulations and provide feedback (ensuring ongoing sustainability of the project)
Practical changes made in response to latent safety threats identified during simulations

How will the project be delivered?

Rather than a traditional classroom based programme, this model embeds human factors into existing processes, (e.g. simulation and incident investigation), and training is targeted based on intelligence gathered, and delivered through existing educational channels at the trust. This minimises the need for backfill cover and ensures human factor awareness is seen as a core function, not a one-off extra training session.   The funding will almost exclusively be used to purchase the pilots’ time to attend sims and join team meetings for education. Human factors ‘champions’ from other departments are then trained to carry on the pilot role to ensure sustainability.

The objective is that this will promote a greater understanding of human factors through learnt experience, in collaboration with aviation experts. This in turn will empower our staff to change their own behaviours and to work together to develop safer systems and processes across the trust.

How is your project going to share learning?

Human error is a recurring theme in serious incidents in healthcare, highlighted in the National Patient Safety Strategy. Human factors knowledge can help design safe systems and processes that make it easier for staff to do their jobs effectively. The support from Project Wingman during the Covid-19 pandemic has presented a unique opportunity to collaborate on human factors knowledge and develop this multi-disciplinary education model which aligns with the National Patient Safety Syllabus.

The pilots involved know a lot of the staff already, having volunteered in hospitals as part of Project Wingman during the Covid-19 crisis. This creates a hugely positive buy-in to the programme which given the scale of Project Wingman across the UK, could be replicated. Expanding the model to the community and a partner Trust provides an opportunity to directly share learning from incidents through simulation scenarios, and develop collaborative approaches to changing unsafe behaviour identified.

How you can contribute

  • Whittington is an integrated care organisation with community services, we are very keen to role this project out to community simulations. I would love to hear from those with experience of community simulation exercises and ideally collaborate with them.

Plan timeline

19 Oct 2020 Hospital based sims continue
31 Mar 2021 Trial sims in community
30 Apr 2021 Sims at Partner Trust

Comments

  1. Hi Gillian,

    Myself and my colleague Emma Adams (Health Transformation Partnership) are supporting the Health Foundation this year by fostering conversations between Q members and encouraging collaboration. We were Exchange applicants last year, so we’re hoping that our experience will help us to help others, as their ideas take shape.

    I really like the idea of this project. Through the Q visit programme we've run (pre-COVID) we got the chance to visit https://www.hsib.org.uk who use aviation and human factors perspectives when investigating system strengths and weaknesses. I thought they might be a good organisation to reach out to, to provide feedback on your project idea. I'm sure some of the people I'm thinking of will be Q members. Anyway, do let me know if you'd like me to connect you (I'm conscious you may already have links/knowledge of HSIB).

    Best of luck,

    Pete

    1. Thanks Pete, that's a really good idea. Particularly since we were thinking of focusing on maternity - community and hospital. I'll speak to HSIB colleagues and see what they think. Thanks!

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