Discover and read the best of Twitter Threads about #ICRE2018

Most recents (4)

Lots of talk at #ICRE2018 about incivility in the learning environment.
@HopkinsMedicine implemented a multifaceted intervention to address the problem of the "Untouchables" —individuals who engaged with impunity in transgressive or disruptive behaviour
journals.lww.com/academicmedici…
Intervention incudes:
1) Publicly discuss Untouchables problem across @HopkinsMedicine system
2) Coordinate & formalize mechanisms to identify, assess, remedy disruptive
behavior
3) Training in leadership behaviors to encourage voice
4) Build capacity for difficult conversations
Key piece = Safe at Hopkins -- graded remediation process
- communication that emphasizes impact of behavior on culture of safety
- referral for coaching / skill-building
But if behavior does not improve, findings can be cited as support for removal from position of power
Read 3 tweets
The #ICRE2018 debate on the #BawaGarba case tightly links issues of #MedEd and #ptsafety — in the first 10 mins, have already heard about just culture, safe supervision, learning from mistakes, diagnostic uncertainty, systems failures & 2nd victim
Here are some more #MedEd #ptsafety topics being discussed at #ICRE2018 plenary:

Speaking up
Teamwork vs teaming
Handoffs
Fatigue and its impact on clinical performance
Psychological safety
Empirical data on patient safety incidents that involve residents:

Lack of supervision (~50%) and handoff problems (~20%) among the most common contributors to serious safety problems

Landmark article from 2007:
jamanetwork.com/journals/jamai…

#ICRE2018
Read 16 tweets
Now up -- @eddeestyle leading a discussion on how to introduce discussions on human factors in residency education at #ASPIRE #ICRE2018 #ptsafety
For some, the term human factors may not be familiar. Here's a common definition:

"Human factors is the study of the interrelationship between humans, the tools and equipment they use in the workplace, and the environment in which they work."

who.int/patientsafety/…

#ICRE2018
Here's a real world example for how human factors influence behaviour and performance.

The urinal fly.

This simple intervention reduced spillage by 80% and cleaning costs by 8%.

washingtonpost.com/news/wonk/wp/2…

#ICRE2018 @eddeestyle Image
Read 7 tweets
We start with discussion of #ptsafety culture and how to introduce discussions in #MedEd. Stacy Ackroyd uses this powerful video from @MedStarHealth to trigger reflection and discussion on ones organizational safety culture #ICRE2018 #ASPIRE
One of the major challenges facing #ptsafety is a culture of disrespect. Revisiting 2012 paper by Lucien Leape in @AcadMedJournal -- highly relevant for #ICRE2018 and its focus on the learning environment this year journals.lww.com/academicmedici…
Sobering excerpt that still rings true:

"A major contributor to disrespectful behavior is the stressful health care environment, particularly the presence of “production pressure,” such as the requirement to see a high volume of patients."

#ICRE2018 #ptsafety #MedEd
Read 5 tweets

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