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Ineffective handover can be fatal

Imagine what might lead to the worst outcomes in healthcare. It doesn’t actually have to happen but it might help to identify what could go wrong before it ever does. In most cases it will be a failure to communicate.

Ineffective hand-off communication is recognized as a critical patient safety problem in health care; in fact, an estimated 80% of serious medical errors involve miscommunication between caregivers during the transfer of patients. The hand-off process involves “senders,” those caregivers transmitting patient information and transitioning the care of a patient to the next clinician, and “receivers,” those caregivers who accept the patient information and care of that patient. In addition to causing patient harm, defective hand-offs can lead to delays in treatment, inappropriate treatment, and increased length of stay in the hospital. Joint Commission Perspectives

Much of what might make a difference needs those involved in whatever role to do basic things.

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Do you use your powers of observation?

Healthcare professionals and doctors in particular need to be observant. Many, if most are observant because it can make the difference between an early diagnosis and an early demise. I remember an ambulance crew saving a patient’s life not only by their rapid transport of a confused suicidal patient but because they noticed and reported the white mark around the lip of the glass she had been found drinking from. It turned out it was soluble aspirin and the patient was quickly diagnosed with salcylism.

The same powers of observation can be used to find new solutions or perhaps better solutions to common problems. Healthcare professionals are in contact with patients more than any policy maker or bureaucrat. If history has taught us anything it is that the most valuable solutions to healthcare problems are likely to be generated by those who don’t dismiss small details.

In a sense, curiosity is the mother of innovation. People often think that they will struggle to be innovative because they feel that they are not creative. Creativity is certainly useful, but curiosity is really all that you need to get the process started. Curiosity about what’s going on around you, and then curiosity about how an idea would work in another context. So, turn off autopilot mode in your brain, and be curious! Paul Matthews

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Do you perform any rituals when you consult?

Before a surgeon gets anywhere near a patient in the operating theatre he must wash his hands, put on a gown and gloves. He then drapes the patient and cleans the skin. As he makes his first incision there is no mobile phone on the table, he banishes all distractions and appreciates that the job isn’t over until he has sutured the wound. Whatever you do for a living how do you approach the job? If you adopted rituals would you perform better? Bacteria can destroy a surgeons work. What contaminates your work and how does that manifest in your results?

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What does your face say?

Are you aware what your facial muscles are doing when you are engaged in conversation? What about your neck and your shoulders? What do they leak about your mood? Your attitude? Your perspective? Is it possible they are sending entirely the wrong message?

Even though, there was no evidence found that displaying positive facial expression will increase the level of follower trust in their leader (both, affectively and cognitively) and their perceptions of leadership effectiveness, still the opposite was found to be true, which is a negative relationship between negative facial expressions and leadership effectiveness. This means, that the more the leader expresses negative facial cues such as lowered eyebrows and lip corners down, the less effective he or she is.

Pia Loeper, University of Twente

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