Difficult discussions: raising safety concerns

This year, the central theme of “Speaking up and Speaking Out” was addressed throughout the AfPP Congress as part of a sustained campaign to improve patient safety. Strategies for changing the culture within acute care are crucial to ensuring staff, patients and relatives are able to raise concerns over safety without fear of victimisation. With this in mind, the programme aimed to help perioperative practitioners to have “difficult discussions” with colleagues, understand the human factors that affect safe working practice, and ultimately influence change in the theatre environment. High profile speakers and delegates both displayed exceptional candour in sharing their experiences of serious failures, the difficult discussions that followed, and the lessons learned. Sir Stephen Moss, the chairman of Mid Staffordshire NHS Foundation Trust, gave a particularly sobering presentation on “Mid Staffs: too close for comfort”, prompting delegates to respond with accounts of their own mistakes, feelings of vulnerability when speaking up, and the issues they have encountered when challenging unsafe behaviour.

Raising concerns

AfPP’s president, Diane Gilmour, set the scene for discussion on raising concerns at the opening session of Congress stating that she did not want to work in an environment where she felt “unable to speak up” when she saw the potential for harm. Speaking up is a daunting task, which takes courage, conviction and determination, she acknowledged, commenting: “Staff should be empowered to raise concerns – whether this is about skills mix, staffing levels, inappropriate behaviours or poor practice. However, we all know of occasions when, despite all our best efforts, we have not been listened to.” Over the years, there have been numerous incidences of high profile safety failures and examples of whistleblowing in the media.