A Human factors approach to care and compassion? Peter Jaye SaIL centres KHP

Introduction What are human factors? How are care and compassion related to human factors Can they be used to re-engage staff with care and compassion

Introduction – my personal journey My trainingMy consultant careerNow

Traditional Patient safety approach Human Factors Care and compassion My patient safety journey

Human Factors Patient safety Simulation Inter-professional Education

Traditional Patient safety approach Human Factors Care and compassion My patient safety journey Simulation IPE Patient perspective

Traditional Patient safety approach

Healthcare approach to Patient safety Elimination of error Top down control Guidelines Targets Root cause analysis 100% hand washing 7 x MRSA Never events

Healthcare education Loss of the “therapeutic self” Logical, analytical diagnosticians Focus on technical skills acquisition “Individual” blame

Human Factors Human factors

What are Human Factors? The study of the interrelationships between humans, the tools they use, and the environment in which in which they live and work. 11

Common Human Factors Mental workload Distractions The physical environment Physical Demands Device / product design Teamwork Process design 12

Non-technical Skills Cognitive or mental skills: – Decision making – Planning – Situation awareness – Triage/prioritization – Efficient management of multiple patients Social skills: – Team-working – Leadership – Communication – Effective coping with disruptions/distractions 13

My mum and dad

Care and compassion

Is there a problem with care and compassion in healthcare?

Care and Compassion? - The findings of my investigations reveal an attitude – both personal and institutional – which fails to recognise the humanity and individuality of the people concerned and to respond to them with sensitivity, compassion and professionalism. Report of the Health Service Ombudsman on Ten Investigations into NHS Care of Older People

What are care and compassion? Compassion a feeling of distress and pity for the suffering or misfortune of another, often including the desire to alleviate it. Care to provide physical needs, help, or comfort to be troubled or concerned; be affected emotionally. to have regard, affection, or consideration (for)

What are we trying to achieve?

< 7 MRSA cases Reduction in morbidity and mortality with a HF contributory factor A better healthcare experience What are we trying to achieve? Page 20

“Don’t value the activity more than the value proposition” Ian Curran “Its not the activity itself its why we do it” Healthcare Outcomes Page 21

The Francis report Robert Francis QC If there is one lesson to be learnt, I suggest it is that people must always come before numbers. It is the individual experiences that lie behind statistics and benchmarks and action plans that really matter, and that is what must never be forgotten when policies are being made and implemented.

Traditional Patient safety approach Human Factors Care and compassion Human factors in Healthcare

Traditional Patient safety approach Human Factors Care and compassion My patient safety journey Health “care”

Compassionate attributes Sensitivity Sympathy Empathy Care for well being / motivation Non judgmental Distress tolerance

Teaching Care and Compassion Understand where compassion comes from Understanding of the blocks/barriers Competative psychology vs Collaborative psychology Threat focused vs compassion focused

Competing and striving Social pressures and comparisions Learning how to fail Understanding the blocks and barriers

Experiential learning modalities Harnessing the patient voice within education Modeling behaviour Can simulation re-engage learners with care and compassion?

An opportunity to improve the delivery of healthcare Integrate care and compassion into Human factors Improving Patient Safety AND Patient Experience “Human factors in Healthcare” Page 29

Our destination Page 30 Simulation and Interactive Learning Centres (SaIL) King’s Health Partners AHSC Health care Harm free care

“Healthcare delivered without compassion isn’t healthcare at all” Conclusions Page 31 Simulation and Interactive Learning Centres (SaIL) King’s Health Partners AHSC

32 Conclusion- the patient’s perspective