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.
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.”
She highlighted the fact that the Department of Health has announced a consultation on the proposed amendments to the NHS constitution, which will include whistleblowing. AfPP will be responding to the consultation and is urging delegates to do the same. Diane Gilmour added that these efforts will need to be supported by strategies that encourage staff to speak up, while promoting organisational change.
“Leadership, encouragement, listening in a culture of openness, and learning from mistakes are all key factors. We need to highlight the consequences if someone does not speak up and to point out whose responsibility it is. For example: is it good enough to flag the issues in an email to your manager, then do nothing more and expect them to take this further?” she questioned.
“Discussions with AfPP members, this year, have shown that there have been small but very significant changes in the culture of teams in theatre. Although this has not been seen across every theatre and every department, there has been some genuine progress,” she continued. “Improving team characteristics should aid communication and reduce patient harm, while there is increasing awareness of the importance of human factors in improving safety culture and enhancing teamwork.”
Diane Gilmour observed that staff, today, feel more empowered to speak up when they see potential harm. However, she suggested that this may only be within a closed environment and she questioned whether staff would feel comfortable raising concerns outside of this arena with regards to staffing and skill mix, for example.
“While there have been some steps in the right direction, cultures within organisations need to change significantly to ensure they are open, transparent and allow staff to speak up and be heard without retribution,” she concluded.
About the AfPP:
The Association for Perioperative Practice (AfPP) was established as the National Association of Theatre Nurses, known as NATN, in 1964. It is a registered charity working to enhance skills and knowledge within operating departments, associated areas and sterile services departments. It aims to enhance the quality of care in the NHS and the independent sector throughout the UK.
www.afpp.org.uk
