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Do something in your power to make a difference

It’s a small detail. If you are accompanying someone down a corridor as a healthcare professional- don’t stride ahead. Ideally walk alongside the person or let them lead the way if they know where you are headed. If they are wheeling a buggy and carrying a bag offer to help by wheeling the buggy.  Just try it. You might like how they respond. Apart from that you can learn so much about the person even before the consultation begins:

So instead of a doctor assessing a patient’s blood pressure, body mass index, chronic conditions, hospitalization and smoking history and use of mobility aids to estimate survival, a lab assistant could simply time the patient walking a few meters and predict just as accurately the person’s likelihood of living five or 10 more years—as well as a median life expectancy. Scientific American

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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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Your greatest value is your ability to solve problems

As a healthcare professional you may face problems that require problem solving at the least and the generation of creative solutions ideally. How do you hone your creativity?

The results revealed that leadership clarity is associated with clear team objectives, high levels of participation, commitment to excellence, and support for innovation. Team processes consistently predicted team innovation across all three samples. Team leadership predicted innovation in the latter two samples, and there was some evidence that team processes partly mediated this relationship. The results imply the need for theory that incorporates clarity and not just style of leadership. For health care teams in particular, and teams in general, the results suggest a need to ensure leadership is clear in teams when innovation is a desirable team performance outcome. West et al

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Quitting work may be the best thing you can do

 

Do you quit work? At least until it’s time to be back in the office, clinic, shop or hospital? Are you constantly taking calls and texts from work even on vacation?

Recreational travel may increase creativity by relieving workers from stress, providing diversifying experiences and increasing positive emotions. Consequently, vacations may boost creativity, apparent in a greater variety (flexibility) and originality of ideas after work resumption. de Bloom  et al

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What did you expect yesterday?

As you walked through the front doors at work yesterday what were your expectations? Were you hoping:

  1. To serve to the best of your ability
  2. To learn something new
  3. To enjoy good company doing something meaningful
  4. To make a difference to someone
  5. To earn a big pay cheque
  6. To pass the time before home time
  7. Something else?

Which was it? How did you feel at the end of the day? How do you think those who interacted with you felt at the end of the day?

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Are the barriers to access in healthcare physical?

Imagine you have back pain. Your doctor suggests you need special scan. You have to travel an hour across town to get to the hospital where you have an appointment at 9 am. You take the morning off but hope you might get to work in the afternoon. It’s peak hour traffic as you arrive at the hospital. The queue to get into the car park stretches down the street. You join the line of cars and realise it’s now 8.45am. The X-ray department is a long walk from the car park. Just as you get to the entrance to the parking lot the attendant indicates that it is full and you have to try and get a spot on a side street. The chap in the car behind you is getting frustrated- are you waiting in the queue or trying to back out? It’s a one way street you can’t turn the car here. It’s now 9 am you are going to be late- not sure how late. You toy with the idea of just going home.

In November 2011, an editorial in the Canadian Medical Association Journal called hospital parking fees a barrier to health care, saying the charges amount to “parking-centred health care,” and recommended hospitals stop charging patients for parking. The editorial stirred up a debate in the media. The Ontario Nurses’ Association, for one, agreed with the recommendation and noted that many of its members could tell stories about patients who had avoided seeking care or had cut appointments because of high parking costs. Canadian Nurse

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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 don’t people tell their doctor?

Do you know why your customer, client or patient chose you today? If you are his doctor John made an appointment this morning because he thinks he may have an inherited illness. His uncle recently died from this condition and it all started with weakness in his arm. John has noticed that he has pain and weakness in his right arm when he lifts heavy things at work. This morning he nearly dropped the kettle when making a cup of tea. He isn’t going to tell you what he is worried about but he expects you will tell him he doesn’t have that condition after all the tests you will perform right? His uncle had lots of blood tests and scans.

In quite a number of contacts with a new reason for an encounter (22%), the ideas, concerns, or expectations of the patient remain undisclosed. A second main finding is that the expression of concerns and/or expectations is correlated with fewer prescriptions (univariate, logistic regression analysis, and also after exclusion of patients without an ‘a priori need for medication’). Although the causal relationship remains uncertain, the observations may indicate that systematically disclosing the patients’ real expectations and concerns could lead to less medication use. Matthys et al

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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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