Share this page!

Dr Gordon Caldwell Profile picture
Twitter logo
Feb 7 • 6 tweets • 7 min read
humanriskpodcast.com/dr-gordon-cald…

We need to Run Faster than Diseases Progress in Patients.

So much #NHS Hospitals can do to unblock A&E & Wards without waiting for more Social Care - #CutTheCrap

@mnt @BBCr4today @BBCNews @TheIHI
youtube.com/live/Z8Kkg20G7… for those who prefer video to podcast - starts at 12:04pm #NHS Drowning in Paperwork
@DrGrumble @rakeshspatel

Not to mention

#Policies
#Guidelines
#email
#Datix
#MandatoryTraining
#Appraisal
#Revalidation
#ePortfolios
#Committees
#Governance

No wonder there are queues of patients everywhere in #NHS

Doctors want to Doctor
Nurses want to Nurse


Who Knows Where The Time Goes?

No one, because management do not stand in an #Ohno circle at the frontline seeing which actions 'Make the Patients Better'
An #Ohno Circle - new managers were not allowed to leave the circle until they could start to identify some waste of staff time or waste of resources in the productive work

#CutTheCrap dropbox.com/s/3ddiw1lww13x…
None of the well intentioned managers, leaders, regulators, educationalists, seem to start by asking

How much time do we have to treat a cohort of acute patients?

But they all add now processes that 'Only add a minute' until they threaten timely treatment and every Target

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Dr Gordon Caldwell

Dr Gordon Caldwell Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @doctorcaldwell

Dr Gordon Caldwell Profile picture
Feb 8
Misdiagnosis and Cognitive Overload in the Clinical Workplace causing Morbidity and Mortality. Look at the notes pages in this PowerPoint. 10 Quality Indicators for Clinical Consultations

dropbox.com/s/niz0e1h1hc7k…

@HumanRiskLtd @nialldowney @TheIHI @AndrewElder @cuttingforstone ImageImage
How to create conditions for Misdiagnosis that can kill or seriously harms patients.

#PulmonaryEmbolism

#AddisonsDisease

and Counter Measures

#DiagnosticCockpit dropbox.com/s/qkbpmcxe85b0… ImageImageImageImage
Time is the Great Diagnostician

We must intervene before the patient dies Image
Read 7 tweets
Dr Gordon Caldwell Profile picture
Feb 7
Just now
Right now
@CarolynFahm feels like April today
Read 4 tweets
Dr Gordon Caldwell Profile picture
Jun 21, 2021
It’s interesting I’m being told how long is ideal in #NHS for Clinical Consultations in Outpatients by ‘management’, who can hold as many meetings of undefined purpose and length as they wish at short notice & expect my participation @djnicholl @PeteGordon68 @vincentconnolly
The most important Meetings in #Healthcare are between Patient and Clinician but are not the ones valued and prioritised by management

dropbox.com/s/vd7fybw50ml9…
Imagine if management’s meetings were subject to same rules as outpatients?
Schedule 6 weeks in advance
New Agenda items 30 mins max, Reviews 15 mins. Extra items can be added by anyone but all items must still be discussed. Items for other meetings can be added in Willy Nilly
Read 13 tweets
Dr Gordon Caldwell Profile picture
Jun 19, 2021
I don’t think of myself as a great doctor but I know there is no success in medicine without preparation and organisation therefore I have just spent 2hours organising our inpatients medical case note folders after today’s #WardRounds @DrGrumble @CLOSLER @j59dd
I don’t know what had happened in the 3 weeks since my last Physician of the Week but someone must have decided that entropy into chaos was the best way to organise inpatient clinical notes and won everyone over. Entropy is easy, organisation is unremitting hard work
I cannot do #WardRounds nor #Outpatients without knowing who the patient is as a fellow human being and without Problems Lists but many contemporaries seem happy without either. I follow #LarryWeed @VisualDx @writer_samshem
Read 7 tweets
Dr Gordon Caldwell Profile picture
Nov 17, 2019
Yes, that’s what I trained for too

I weep watching our Junior Doctors wrangling with dreadful disconnected paper & computer IT which gobbles up their working time & undermines their Clinical Reasoning thus putting Diagnosis & Patient Management at risk
At a ‘Winter Pressures’ meeting on Friday I said we could make our already good 4hr performance an hour better if we had Usable IT and cut out the quintuplication of information into multiple different bad paper & computer IT systems @acutemedicine @PeteGordon68 @nhshBoyd
I type Discharge Summaries using the horrible #NHSHighland #IDL software but it has to be something really really important to persuade me to use Hospital version of #SCIGateway for inter hospital referrals - retyping name address GP into badly designed IT. Intensely frustrating
Read 4 tweets
Dr Gordon Caldwell Profile picture
Mar 9, 2019
#DNACPR or Will For The Final Stages of Dying?

dropbox.com/s/7ybniuov566r…

I observe that every Consultant struggles with DNACPR because of the negative framing. We (I?) must change the framing

@JohnLauner
Consultants & Juniors at #FortWilliam like this

You are not dying now
Your health is frail
One day your health will deteriorate badly and
We will know you are dying and
What should we do for you then?

Patient usually answers

Let me go, Doc

dropbox.com/s/7ybniuov566r…
Then we have to say

Sounds like you said

Me, #IWantAPeacefulDeath?

Then in this crazy UK culture you need a Red #DNACPR Licence for a Peaceful Death

‘Oh no, Doc, I’m not going to be #DNACPR’

We must reframe the whole ‘Near End of Life’ conversation @JohnLauner @TheIHI
Read 12 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

Send Email!

:(