Patient safety 1 - How can we build a culture of safety in paediatric healthcare?

RCPCH Podcasts

Healthcare is inherently risky and so as child health professionals we need to make patient safety a priority in all our actions. We need to think about safety all the time.

In episode 1 of our series on paediatric patient safety, we speak with Dr Peter Lachman, who develops and delivers programmes for clinical leaders in quality improvement at the Royal College of Physicians in Dublin.

As Peter explains on the podcast, we healthcare professionals need to know patient safety theory - but, more importantly, we need to know how to apply it, drive improvement and create a workplace culture that fosters safe working practices.

Everyone - from the most junior member of the team to the most senior paediatric clinical leader - needs to think about patient safety all day every day. A safe culture takes time to build. Shared activities such as handover, huddles and debrief can model good behaviour and benefit performance. Repeating behaviours that represent a safe culture can create a virtuous cycle which can change deeply held attitudes and beliefs, then ultimately the safe culture overall.

Thank you for listening.

Dr Natalie Wyatt, RCPCH Clinical Fellow and Jonathan Bamber RCPCH Head of Quality Improvement

Produced by 18Sixty

Please be advised that this series contains stories relating to child death and harm. All views, thoughts and opinions expressed in this podcast series belong to the guests and not necessarily to their employer, linked organisations or RCPCH.

Download transcript (PDF)

About the Patient safety podcast series

As doctors we ‘first, do no harm’. However, the systems in which we work are rife with safety issues and resultant harm. In thinking about how to improve this, we have brought together leaders in the field to discuss challenging and thought-provoking issues around keeping our children safe in healthcare settings. We hope you will be entertained, educated, and energised to make strides in improving the safety of the children that you care for.

There are lots of resources that expand on this on the RCPCH Patient Safety Portal, including the theory of patient safety culture and examples of how people across the UK are doing this well. Visit at https://safety.rcpch.ac.uk.

More about Dr Peter Lachman

Dr Peter Lachman develops and delivers programmes to develop clinical leaders in quality improvement at the Royal College of Physicians in Dublin. He works with HSE Global in Africa, and he was Chief Executive Officer of the International Society for Quality in Healthcare (ISQua) from 1 May 2016 to 30 April 2021. Peter was a Health Foundation Quality Improvement Fellow at IHI in 2005-2006 and then went on to be the Deputy Medical Director with the lead for Patient Safety at Great Ormond Street Hospital 2006-2016. Peter was also a Consultant Paediatrician at the Royal Free Hospital in London specialising in the challenge of long-term conditions for children.

Peter is the lead editor of the OUP Handbook on Patient Safety published in April 2022; Co-Editor of the OUP Handbook on Medical Leadership and Management published in December 2022; and Editor of the OUP Handbook on Quality Improvement to be published in 2024.

Topics/organisations/papers referenced in this podcast

• ISQUA (International Society for Quality in Healthcare)
• Oxford Professional Practice: Handbook Of Patient Safety
• IHI (Institute for Health Improvement)
• Human factors - on RCPCH Patient Safety Portal
• S.A.F.E. Collaborative - on RCPCH Patient Safety Portal
• Cincinnati Childrens Hospital patient safety
• Paediatric Early Warning System (NHS England)
• BMJ Quality & Safety journal
• Lachman, P., Linkson, L., Evans, T., Clausen, H., & Hothi, D. (2015). Developing person-centred analysis of harm in a paediatric hospital: a quality improvement report. BMJ quality & safety, 24(5), 337–344
• Health Foundation
• A framework for measuring quality, with Professor Charles Vincent et al
• WellChild: the national charity for sick children
• Applied human factors - on RCPCH Patient Safety Portal
• 5 whys
• SEIPS (Systems Engineering Initiative for Patient Safety)
• Psychological safety- on RCPCH Patient Safety Portal
• Situational awareness - on RCPCH Patient Safety Portal
• MaPSaF (Manchester Patient Safety Awareness Framework)
• Top Gun
• Irish Certificate in Essential Leadership for New Consultants
• Rolfe et al's reflective model (PDF) (what now what so what)
• NHS England: Improving patient safety - a practical guide