AfPP RESIDENTIAL CONFERENCE 2019
Rob Tomlinson, RGN, East Lancashire Hospitals NHS Trust
harmony,” he continued, “but there seemed to be people who were undertaking the World Health Organization (WHO) checklist but not following guidelines.” Rob listed two other common themes of a never event: l A surgical site marking error l Noise and distraction in a theatre.
It is the latter that the Trust’s initiative sought to address. “We needed tactics to reduce the noise and distraction, which can induce physical harm on a patient, such as surgical site infections,” explained Rob. “The longer the patient is on the table, the more exposed they are to airborne bacteria. “We introduced the same ‘Below 10,000’ theme that is used on airlines – when this is announced on board, cabin crew exit the cockpit to enable the pilot to concentrate. In a theatre environment, this improves the patient experience by reducing disturbances and increases situational awareness for staff. “One of the key benefits is that this also enables people not in authority to speak out.” Producing a graph, Rob demonstrated the differing pressure of mental workloads during surgery, revealing that an anaesthetist’s ‘peaks’ coincide with a surgeon’s ‘troughs’. Having identified these divergent peaks it was clear that “Below 10,000 feet” provided a conduit for everyone in surgery to stop and concentrate. Rob continued: “Because the phrase is non-personalised, no offence can be taken,
Chris Pointon, the husband of the late Dr Kate Granger MBE
and it’s an opportunity to empower people, by flattening any hierarchy, and helping to eradicate the ‘blame culture’.
“Since implementing the ‘Below 10,000 feet’ strategy at our Trust, it has increased awareness of the importance of theatre communication and human factors. We are grateful for the positive executive support, the backing of the AfPP, and the CQC has described the initiative as ‘outstanding’.” The AfPP now plans to use this as part of a safety initiative, but wants more research and evidence.
“Hello my name is…”
Undoubtedly, the highlight of the conference was a personal and thought-provoking talk by Chris Pointon, the husband of the late Dr Kate Granger MBE. Kate died in 2016 aged 34, after five years living with a terminal cancer diagnosis. Throughout that time, Kate and Chris raised more than £250,000 for charity and changed global healthcare through a campaign started in 2013 called #hellomynameis. Chris is continuing Kate’s work by raising awareness through social media outlets and conference talks. Chris described how he met Kate when she was 29 years old, and already diagnosed with terminal cancer. One year after meeting, they got engaged and set up a three-point
Since implementing the ‘Below 10,000 feet’ strategy at our Trust, it has increased awareness of the importance of theatre communication and human factors. We are grateful for the positive executive support, the backing of the AfPP, and the CQC has described the initiative as ‘outstanding’. Rob Tomlinson, RGN, East Lancashire Hospitals NHS Trust
SEPTEMBER 2019
plan to travel the world, focus on family and friends, and concentrate on their careers – Chris was in retail and Kate was a consultant taking care of the elderly. “Although I was not involved in healthcare, I soon became thrust into that fraternity,” noted Chris. “We married, and six years later we took an extended holiday to California. Kate wasn’t feeling herself and she said that if the pain became too much she’d see a doctor when we returned to the UK. However, when the pain was so intense that she was writhing around, we went to ER, and discovered that her kidneys were blocked by tumours. The cost of that visit was $30,000. “We returned to the UK and, over a period of six months, Kate was in hospital for four. She had a rare, aggressive form of cancer and was given 12 months to live. Our dreams of creating a family were destroyed and we had to quickly re-evaluate our lives. “During the protracted chemotherapy sessions, Kate started writing a book, describing how it was possible to still have fun during a terminal illness. She had a bucket list – firstly, to renew our wedding vows, and secondly, to return to work for as long as she could.”
It was at this point that Kate established fundraising efforts, and took a decision to stop her chemotherapy. Chris observed: “Within three weeks of stopping chemotherapy, Kate was back on the ward. She was an excellent doctor and she was also being asked to speak at events around the world. Her view, from a patient’s perspective, was that ‘communication is key’.” Chris then played a video that Kate made in 2014, where she described her experience as a patient, rather than a doctor. Kate described how a junior doctor visited
her after an MRI scan. “He sat down next to me, but looked away,” she said. “He then told me, ‘Your cancer has spread,’ and left. I never saw him again. In the NHS, we must remember that we are breaking bad news to patients every day. We need to think about that. “Conversely, my oncologist asked if I
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