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Working with patients and families following an incident

Elaine Spencer Serious Incident Investigator Brighton and Sussex University Hospital NHS Foundation Trust spoke at today’s serious clinical incident conference on:

• working with patients and families when an incident occurs
• liaising with patients and families
• applying ‘being open’ principles
• our experience in Brighton and Sussex

Elaine's presentation focussed on working with patients and families following a serious incident, but Elaine pointed out that it is important not to forget the staff and often devastating consequences for them also.  

Elaine said; "people want to be listened to... most are unbelieveably understanding when harm has occurred.  We need to be open, honest and compassionate even if in the short-term honesty can make things difficult."  The Duty of Candour means that there is now a statutory duty to be open when a harm has occurred, as well as a responsible duty.  Guidance from the NMC and GMC about being open and honest has recently been released - available here.

Elaine discussed how to approach patients and families with compassion, offering to visit them in their own home, and how to go about acknowedging what harm has happened, how to say sorry, and how to explain and keep patients and family informed about the investigation and report.

Elaine's full PowerPoint presentation is available for download at the end of this page.

More than one in ten people admitted to hospital are harmed unintentionally by its care (Vincent et al 2001). How we respond to a serious incident is crucial to patients and their families/carer’s on-going experience. 

Duty of Candour requires openness and transparency when things go wrong and harm is caused to patients. In our professional lives we will be faced with events that are unintended or unexpected and we are required to respond by acknowledging, apologizing and explaining. The essential steps in this process will be reviewed as well as the application in practice of the principles of Being Open. 

Healthcare professional are often doing their very best in challenging circumstances. Some of the human factors that influence our ability to perform safe care are explored and how this influences our understanding of events and influences the investigation into a serious incident.

Finally, the important aspects of interviewing staff to gain the maximum information will be reviewed and the support mechanisms available for staff.

Further reading:
The Health & Social Care Act 2008 (Regulated Activities) Regulations 2014
Being Open Framework NPSA 1097 (2009)

Elaine works within the Safety & Quality Team at BSUH investigating serious incidents and is currently leading the introduction of the Duty of Candour within the Trust. Elaine has previously worked as a consultant nurse in cardiology at Guys and St Thomas NHS Foundation Trust introducing and evaluating nurse-led services and as a clinical director of S&C Healthcare providing clinical and management services to the NHS. She has been involved in designing, delivering and commissioning innovative services, including complex care pathways. Elaine has shared her knowledge and expertise widely as a public speaker, a lecturer and is widely published.

Future events of interest:

Masterclass: Root Cause Analysis for Beginners
Thursday 10 September 2015 
Hallam Conference Centre, London

Reducing & Monitoring Avoidable Hospital Deaths attributable to problems in care
Thursday 8 October 2015 
Hallam Conference Centre, London

Leading your Organisation to Zero-Harm
Thursday 22 October 2015 
Manchester Conference Centre, Manchester

Root Cause Analysis: 2 Day Intensive Training Course
Wednesday 4 November 2015 — Thursday 5 November 
Cavendish Conference Centre, London

Leading your Organisation to Zero-Harm
Thursday 10 December 2015 
Hallam Conference Centre, London

Download: elaine-spencer_1105.pdf

8 July 2015


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