James Reason on BBC Radio 4 Part 2

Back in February I got very excited and wrote a post about a 2-programme BBC Radio 4 series presented by Prof James Reason. I have finally had chance to catch up with the second part of this programme – even though it aired on 5th March! Yes I have been that busy. I like being busy though so I am most definitely not complaining.  Before you read this, you may want to read my earlier post which introduces the programme.

The second installment, I am sad to report did not include pharmacists amongst the healthcare professionals invited to talk on the programme. I had hoped it might, but it is only a 30 minute programme and they really were going for the heads of the big NHS /NHS related services so, it is not surprising. Despite the lack of pharmacy input into the programme, it was still very interesting and there were lots of points that could easily apply to pharmacy practice.

Firstly Sir Liam Donaldson, Chairman of the National Patient Safety Agency commented on his own visit to the University of Michigan Health Centre who have been looking at the effects of an open policy to medical errors over the last decade (which was the focus of the previous episode of this programme). He said one thing he noticed that was very different was the training that was given to staff on how to talk to patients about the errors that had been made with their care. He also noted that the support that was provided to the patient and the family was much more than just an apology that they stayed without them throughout the whole process. In terms of our work into mental workload, the emphasis would definitely have to consider both how to train pharmacists to avoid errors, but also how to deal with them if they did happen (especially if they happened because of mental overload).

Next, a representative from the National Reporting and Learning Service talked about how the approach to errors has changed in UK healthcare over the last few years. How she felt that the daily reports (e.g. before staff started their shift on a ward) had changed to include a focus on situations or patient issues that had the potential to lead to errors being made. Again this could easily be applied to pharmacy practice (this may be especially useful for locum pharmacists).

By contrast Peter Walsh CEO of Action Against Medical accidents painted a much bleaker picture of our healthcare system today. He spoke about a case his organisation has been dealing with where the errors that had been made in a young man’s care was covered up. This young man died because of these errors, and at the time the family were made aware that some errors had been made but they were not given the full story and shockingly neither was the coroner. Peter Walsh said that cover-ups were still tolerated in our health system and that this needed to change. I agree with this, but for this to happen I think we need to implement Sir Donaldson’s observation that healthcare professionals need to be trained and supported in how to be open with patients when errors occur.

For me, it is so exciting that these programmes have been aired in the last couple of months. Pharmacy is making a huge step at the moment to changing the safety culture and for that to happen the NHS needs to be making that step too, because ultimately the pharmacy profession works within the culture of the other healthcare services and systems in the UK. The fact that this is being talked about now, gives me hope that healthcare as a whole is moving towards this change in culture…but we shall see what happens.

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James Reason on BBC Radio 4 20.02.2012

Prof James Reason's swiss cheese model (from BMJ 2000; 320: 768-70)

Jane and I got very excited yesterday when we heard that Prof James Reason was talking on Radio 4 on Monday night about medical errors. Prof Reason is most famous for his swiss cheese model (above), and when anyone talks about human factors research, or safety in organisations, his swiss cheese model is the first thing that springs to mind. He is that good and that famous!

The radio programme called Dr – Tell Me the Truth is a two-part programme hosted by James Reason about medical errors. What I really enjoyed about yesterdays episode (the next one is on Monday 27th February 2012) was hearing from a range of stakeholders in medical errors. During the programme we heard from patients, researchers, clinicians and lawyers all relating their experiences of when errors had been brushed under the carpet and when clinicians had been open and up front that they had made an error. There was even an excerpt from a qualitative interview of a patient who had experienced a medical error in her cancer treatment and subsequently enrolled in a research project with the University of Michigan. In this excerpt you heard the patient say that she had the opportunity to talk to the clinicians that made the mistake and tell them how she was so cross at herself for not speaking out more in her consultations and not pushing until she got the response she needed. One of the clinicians there turned to her and said it wasn’t her fault (which obviously it wasn’t). The patient said when recalling this meeting that this simple experience made her feel listened to and not ignored and not like this error which was to have a huge impact on her life and health was not being swept under the carpet and ignored. This same theme was echoed again and again, where patients reported just being told that an error had been made, and being able to talk to the Doctor about it helped so much. The University Of Michigan had also been involved in lots of initiatives to create hospitals where doctors were completely open about errors. At first everyone was worried this would lead to more litigation, especially in cases where patients did not experience any ill effects of the error and did not know it had happened. However, what they found was the opposite that it actually dramatically reduced how much they were paying out in compensation for medical errors see here.

Next week they will be hearing from Sir Liam Donaldson about whether the same principles could work for the NHS. Also from other healthcare professionals. I am hoping we hear from a pharmacist too in the next programme. There are so many professional groups in the NHS that it would be a shame (and biased) if they just talked about errors made by doctors.

BPS Psychology in the pub

The highbury vaults in Bristol. This is not where this psychology in the pub talk was held, but many psychologists can often be found here due to its proximity to the Uni of Bristol Exp Psych dept!

On Wednesday evening I attended a social event held by the south-west hub of the British Psychological Society. This was great because after the “outside the box inside pharmacy” conference both Jane and I commented that there were no similar local events for psychologists that were being run by our professional body (which is the British Psychological Society). Not long after we said this, as if someone was listening in to our conversation, or reading my mind (or simply down to coincidence) I received an invite to the psychology in the pub session. The great thing is that this is going to run once a month and there is an informal talk from a local psychologist about what they do / a piece of their work. How great is that! Ok, so I sound a little geeky now, but psychology is such a diverse subject that you can’t be an expert in every aspect of psychology so it is great to talk to other psychologists and learn from them a little more about psychology.

The psychology in the pub sessions were kicked off by a talk from Jo Maddocks who is a chartered occupational psychologist and co-founded an occupational psychology group in Bristol – called JCA. His area of expertise was emotional intelligence and he and his colleagues devised a questionnaire to assess emotional intelligence (which he delivers with a lot of interactive group work for companies). What was interesting was that the key to understanding emotional intelligence is reflecting on your own behaviours and your own emotions and figuring out how others are going to respond – and if they don’t respond in the way you expect, then you reflect on that too, and so on. It did spark a few thoughts in my mind and finally I know something about EI, a topic which I remember hearing about when I did my a-level psychology class.

I am looking forward to lots more of these events, despite the rumours psychologists are great fun, and I really enjoyed meeting those that went on Wednesday.

Hungarian National Gallery July 2011

The last part of mine and Mr F’s honeymoon was spent in Budapest. It is such beautiful city as you can see from this shot of Parliament (in Pest) taken from Buda. Did you know Budapest is made up of two main towns – Buda and Pest (I was so excited to learn that). Anyway, whist we were there we visited the Hungarian National Gallery (http://www.mng.hu/en) as we knew from our guide book that the gallery had a stunning permanent collection of Hungarian art from the last few centuries. However what I wasn’t expecting to see was a collection of art created by people diagnosed with autism and Asperger’s syndrome.

For me the most exciting part of this exhibition was that these pieces of art were accompanied by qualitative quotes (below) about these individuals’ experiences of the world and every day interactions with people. What a wonderful insight into their lives these individuals had offered the visitors to this gallery. This exhibition was as revealing as artists’ self portraits.

I often work with qualitative methodologies in my reserach in fact I don’t think I could ever consider doing a piece of research that didn’t have a qualitative element. For me this exhibition demonstrates just how effective and essential these methods are. The richness of data, the depth of understanding of experiences in an individual’s own words and in this case, drawings.

I often hear from other researchers (including some psychologists) that qualitative work is airy fairy. When I read these quotes below the words that spring to my mind aren’t airy fairy or touchy feely. I will let you make up your own minds! 

Above and below are a couple of photos of paintings that the quotes accompanied. They don’t show the work in the greatest of detail. Many of the paintings and drawings were like this, lots of abstract patterns. One piece, which I don’t have a photo of, had similar patterns formed out of the number 6 written again and again.

This was such an elegant combination of art and psychology for me that I just had to share it. I highly reccommend a visit to the HNG and definitely a trip to Budapest if you haven’t been. Not sure what my next post is going to be about yet. I have to say so far writing for this blog has been a great exercise in organising my thoughts!

I should learn not to speak too soon!

This blog thing is not as easy as I thought! I will get into a posting routine I am sure, but I found myself with complete writers block the last few days. So my plan to post everyday idea has already failed.  I think partly because I was very excited about two of our very great friends from yorkshire coming to stay with us. They have now been and gone – and my mind has re-focussed a little. I think my writers block was also down to the fantastic weather we have had in the UK the last week and I just couldn’t bring myself to stay inside and write. Has anyone else thought how odd it is to be out in summer clothes and flip flops given that half the leaves from the trees are on the ground?

I also said in my last post that I was going to write about the think aloud technique, but I have just decided to write a conference abstract on it, so I will write that post later on with a link to the abstract (and eventual presentation) if it gets accepted to save repeating myself.

So what to write about instead? Well one thing I was quite excited about was that I unexpectedly got to visit the Freud museum in Vienna in July. I hear there is one in London too, but I have never been to that (although it is now on my list of things to do next time I am in London). Anyway, I have to admit, my knowledge on Freud and psychoanalysis is rather sketchy, it is not a field I have studied in any great depth, mainly because I am not involved in the therapeutic side of psychology and the bulk of psychologists working in academia (that I have encountered in my studies at the Universities of Birmingham and Bristol) do not teach Freudian theories. In fact the last time I remember learning about Freud was during my psychology AS Level. Despite my lack of knowledge of Freud’s work,  it is hard not to be intrigued by a man who has had so much influence on the field of psychology especially the therapeutic disciplines and of course other fields like psychiatry.

The great thing about this museum is that it had a fully stocked library with all the references on psychoanalysis that you could ever want (in several different languages – what a treat for people studying psychology). However, as this trip was made during our honeymoon (I have a very understanding husband) I didn’t look through all that material. What I did see was a brilliant timeline of all Freud’s achievements, the people he worked with the major events in his life outside work and with his family. What an amazing life he had – the people he worked with and met! I also realised on reading more about his work and life, that he had been greatly involved in the early studies of agnosia and aphasia. I hadn’t come across his work, in this area – which is maddening considering the year I dedicated to studying psychology and agnosia and aphasia are two large topic areas in this field. So this got me reading some more and I remembered a special issue in the Psychologist that I had read in 2006 linking Freud’s concepts to current neuropsychology and neuroscience.  In this special issue I re-read Prof Mark Solm’s article in this special issue and found out there is a research group called Neuropsychoanalysis that have been going long enough to have their own journal (see: http://www.neuropsa.org.uk/). The thing is I don’t know what to make of all this. I haven’t started to read the material on the neuropsa website yet. I am sure there are links between Freud and Neuropsychology – but are they really that extensive (or extensive enough for a whole research group and regular journal articles)? I am going to have to read more and find out – but I am slightly scared that I might agree with them…which would be a massive re-evaluation of my standpoint on all things psychological.

On a slightly less serious note I was also massively jealous that Freud had a framed certificate for his membership with the British Psychological Society. Things just aren’t the same nowadays. We (the graduate members) get a card (like a credit card).

Anyway! Here I am at the Freud museum. I can highly recommend it if you are in Vienna its only just outside the main city centre and its not a big museum, you could get lost in the books for days, but otherwise it is a good 1-2hr distraction.

My visit to the Freud museum in Vienna

My thoughts on Freud and Neuropsychology will be continued!

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