STORY

Question 1

Conflict

Answer 1

Conflict with EO Consultant
PEX on EO patient
Not a Standard practice
From my experience - not a Standard practice - this was from SNR EO SS
I knew the patient - Not benefit from this intervention
Politely declined this intervention
Took it seriously - Research review - sought

Question 2

Bullied JMO

Answer 2

I do not like bullying culture or tolerate trainee getting bullied
Zero tolerance
Confidentiality/Private
Gather information
Severity/nature - Emotional /physical - Severe >report to director
Not severe > report to JMO wellbeing team/SOT
Support the trainees
Check if other trainees are affected - patient safety compromised
Cooperate with investigation

Question 3

Incompetent Colleague

Answer 3

Collect facts - Subjective or Objective data - Patients outcome
Support
Confidentiality/Private
Report this issue/Discuss
Formal/Informal way (Face to face discussion)
Any associated factors - Internal/External factors (Personal issue)
Approach - Open/Non judgmental/ Holistic
Training & education issue - Professional development issue

Question 4

Leadership qualities

Answer 4

COVID pandemic
Busy patient flow
Staff shortage from furlough
Supported each other
Acknowledge team input

Question 5

Quality improvement

Answer 5

To keep standards of care
Few QI program
I have been involved in Sim based education/training
Problem - Attending internal emergencies - lack of leadership, providing Advanced life support, lack of team based approach, crowd issue, documentation of serious incident
Simulation scenario - run twice a week - inculcates the training/education addressing this issues - JMO & nurses attend this session
Simulation program is well received/ positive feedback from this program.
This is a ongoing process - I am still overseeing this program - training CNEs - helping to improve the quality of attending internal emergency

Question 6

Performance of the unit

Answer 6

Clinical/Non clinical
ICU is Multidisciplinary specialty - working towards to common goal
Unit is not performing - unit performance is compromised -patient management is compromised
As an intensivist - I am proactive - I always address performance issue at the earliest
Poor performance could be at multiple levels - data we collects give valuable information into the problem
My approach >
Clinical
Review the data
Ex: SMR - Comp
Readmissions
Pressures injuries
Hand hygiene audits
Long stay
Exit blocks
Compare the data > with similar sized unit
Compare the data > with the previous year data
As the activity of the unit gone up
New staff - not familiar with policy/protocol
Address specific issue identified
Working party - Composition of the party depends the problem we are addressing eg: Catheter related sepsis - include Infection control CNC, ID physicians
Audit-reauditing -to review the compliance
New staff aware of the protocol/Access to the protocol
Education/training
Nonclinical :
Patient information /Complaints
Research output
Performance of trianee in the exam
Cultural issues -Bullying
Interdisciplinary issue

Question 7

How do you promote Quality improvement and safety