1. Building teams for safer care The Productive Operating Theatre TM The challenge of organising national human factors training Hugh Rogers FRCS Consultant Urologist Senior Associate, NHS Institute

2. How The Productive Operating Theatre has been developed Understand the real issues and challenges. Identified co- production partners Observing and enquiring in high risk and lean organisations Terminal 5, Unipart Other healthcare settings, USA Generated and tested lots of ideas with the ‘field test sites’ Test the ideas as prototypes with the ‘Associate sites’ Consolidate the learning, consider delivery mechanisms, Publish & launch Internal & external peer review. Regular learning sets Ongoing ROI and benefits realisation capture Launch in Sept 2009, followed by regional start- up events for NHS England Since April 2010 initiated 10 cohorts of training and implementation support to 90 of 174 acute trusts in NHS England. Delivered Master Training internationally in Wales, Scotland, New Zealand and Northern Ireland. Coming to Australia, Canada and South Africa etc

3. We tested different approaches Commissioned HF training On site coaching Structured observations Safety attitudes questionnaires Key interventions: Brief and de-brief WHO checklist SBAR We wrote the guide (‘module’) Then we designed our own training

4. Outline workshop agenda Lots of interactive elements, multi-media and group work Psychologist + clinician How unsafe is healthcare frequency of harm complexity of disaster The psychology bit humans as hazards and heroes how errors occur self-awareness exercise Implementation the model for improvement action planning

6. Examples: Wrong Engine Kegworth Jan 1989 The complexity of disasters Wrong Kidney Llanelli Feb 2000

7. ‘The psychology bit’ Eight key human factors

8. Situation awareness Also: Colour changing card trick Smoke filled room The door

9. Merrill & Read

10. Analytical formal measured + systematic seek accuracy / precision dislike unpredictability and surprises Driver business like fast + decisive seek control dislike inefficiency and indecision Amiable conforming less rushed + easy going seek appreciation dislike insensitivity and impatience Expressive flamboyant fast + spontaneous seek recognition dislike routine and boredom Personal styles Controls emotions AskTell Shows emotions See the Improvement Leaders Guide

11. Implementation: The Model for Improvement