I was fortunate to be asked to chair some of the sessions at the 5th ASPiH (Association for Simulated Practice in Healthcare) National Conference Changing Behaviours Improving how Humans and Systems work together in Healthcare this week. My first thoughts were that’s great but I’m an Occupational Psychologist and not directly involved in simulation. The conference however covered a broad range of Human Factors and Patient Safety topics. The first session I was lucky enough to chair was an interactive session on mental load and clinical decision making by Prof Aidan Byrne from Cardiff University. This session asked volunteers to play Tetris whilst being attached to i-phone app which buzzed intermittently until taped to be turned off, further volunteers were asked to complete other tasks at the same time such as mental arithmetic. Whilst generating lots of laughs these fun experiments demonstrated that as the volunteers mental load increased so did their reaction time, taking longer to tap the buzzing device. It was clear to see the Emergency Department consultants in the room, who managed to juggle competing tasks and high mental load very efficiently! Many years of practice I suspect.
This experiment had been repeated many times in a naturalistic environment, replicating the same findings. When consultants had several things to attend to treating patients, answering staff questions their response times dropped significantly. The group were able to recount many interesting examples from their own experience. A discussion around the basic principles of cognitive psychology, duel processing, and cognitive dissonance ensued.
The second session I was asked to chair was a session by Dr Maxine Craig Head of Organisational Development at South Tees NHS Trust. This interactive session focused on helping teams to reach their full potential. Maxine discussed the work she had done in South Tees helping dysfunctional teams work together, by developing a series of training programmes which involved psychodynamic principles, that most of us psychologists will be familiar with such as transactional analysis including ‘the drama triangle’ and the ‘Parent, Adult, Child relationship’. These helped to address with entrenched, dysfunctional team behaviours. She then discussed several organisational culture change theories in particular Dichotic OD, and gave an open and honest account of the challenges she faced in her Trust. Finally she highlighted to work she has been doing with NHS IQ on building a resource for those involved in organisational change.
I was also able to catch two of the keynotes. The first a moving presentation from Hege Ersdal from SAFER in Norway on Low-dose high-frequency simulation, saving lives of babies on a global scale. Hege presented a study that developed a simulation intervention for midwifes in Tanzania, evaluated using the Kirkpatrick model. Through using this established evaluation method she was able to evaluate knowledge transfer and found the simulation exercise need to be administered in ‘low doses’ but ‘high frequency’ i.e. to regularly train the midwives in short session outside the deliver suites, to make it as close to the real world context as possible. The converse ‘high dose’ ‘low frequency’ was not effective i.e. a long training programme annually. This intervention decreased mortality at the hospital by a staggering 40% and saved many babies lives.
The final key note was by Justin Moseley from NATS, ‘Towing the Iceberg: Can education and training change the culture of professional practice?’ Justin discussed how Human Factors principles have been implemented in Air Traffic control, particularly Team Resource Management. This was derived from Crew Resource Management in the airline industry. He was able to draw the parallels to healthcare and give examples of how this has improved team working in NATS.
For anyone interested in Applied Psychology, Human Factors, Patient Safety, Healthcare or Simulation I would say this conference is a must, it was clear that the psychology of behaviour and cognition are important factors in how those employed in Healthcare behave, interact and make decisions that ultimately affects patient outcomes and patient safety. The next conference is going to be held in Brighton on the 3rd to the 5th of November, 2015, I hope to see some of my Psychology colleagues there!