P29 Human factors learning in obstetrics (HALO). (November 2018)

• Record Type: Journal Article
• Authors: Websdale, Daniel; Merrick, Kathleen; Flynn, Marina; Wright, David; Major, Donna; Purva, Makani
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 4(2018)Supplement 2
• Page Start: A64
• Page End: A64
• Publication Date: 2018-11
• Subjects: Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2018-aspihconf.121
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Introduction: Human factors awareness within the NHS is becoming established due to its association with cultural change and empowerment of staff for patient safety and clinical excellence (National Quality Board, 2013). Add to this the need for inter-professional leaning due to the increase of silo working and tribalism between separate professions (Bleakley, 2006). Therefore HILS developed a human factors course for Obstetrics and Gynaecology ST1s and local midwives to promote inter-professional learning. HALO was first established in September 2015 by Dr Kathleen Merrick who was a simulation fellow at HILS; the course has now become an established part of the curriculum for ST1 doctors in the region as well as for midwives in the local trust with a total of 86 candidates taught. Method: The course is facilitated by Obstetrics and Gynaecology specialists and midwives with the use of lectures, scenarios and group activities. The topics below were explored and discussed for approximately one hour: Personality Types – Insights Training Bullying/Undermining – Communication Scenario of a handover Errors – Martin Bromley video Stress/Distraction – Simulated scenario of a PPH in theatre Root Cause Analysis – Group work relating to PPH scenario, patient retained swap Debriefing – Pre-recorded scenario of a mother collapsing during a pool birth Pre and post-course questionnaires using a 5-point Likert scale were completed by all candidates to measure confidence levels and self-awareness of the topics above. Open ended questions were used to gain qualitative feedback on the course. Results: All areas showed at least 1.05 improvements on the post-course Likert scale. The mean awareness of influences of candidates own behaviour increased from 3.61 to 4.47.While understanding of the root cause analysis improved the most from an average of 2.87 to 4.40. Full mean score of results are shown in the table: Example of qualitative feedback: 'Really appreciated the experiences of other area's practices and training with multi-disciplinary teams' Discussion: As the qualitative feedback shows integration of human factors and inter-disciplinary learning is positively received, efforts should be made expand this form of training to other courses and specialities who work regularly in multi-disciplinary teams. All quantitative data showed increased confidence which suggests they felt better equipped to challenge detrimental clinical situations. However longitudinal feedback from previous candidates could be beneficial to determine if the skills learnt on the course have been acted upon in the work environment. References: Bleakley A, Boyden J, Hobbs A, Walsh L, Allard J. Improving teamwork climate in operating theatres: The shift from multiprofessionalism to interprofessionalism. Journal of Interprofessional Care2006;20(5):461–70. https://www.england.NHS.uk/wp-content/uploads/2013/11/nqb-hum-fact-concord.pdf