Welcome to the Medical Claims UK blog!

By way of quick introduction, my name is David Goodman and I am a legal journalist working at Winston Solicitors LLP who specialise in medical negligence claims.

For my opening post I thought I would publish details of an interesting piece I came across on the BBC News website from a renowned surgeon. It touches on issues that we encounter regularly from a legal perspective when dealing with clinical negligence claims.

In his article for the BBC dated 5th January 2010, Dr Peter McCulloch said that the Nuffield Department of Surgery, where he works, is looking at ways of using techniques from other industries to help patient safety. He uses an example where there had been a routine, if difficult, operation, leading to the patient’s health declining through a breakdown of communication between hospital staff.

The case study is one that we are all too familiar with and is worth repeating here: 

“The story of the patient in the intensive treatment unit (ITU) was one all the consultants at the Morbidity and Mortality meeting had heard before: most of them had had a similar case themselves. The original operation had been long and difficult, the patient frail and unfit.
 
The surgeon had been worried, but initially all seemed to go well. The surgeon ordered intensive observation and gave detailed instructions for post-operative care. But when the patient became ill on the third night, these had not been transferred, the appropriate care had not been given, and the vital recording in the notes had been lost. The nurses knew what to do, but the registrar, who had reluctantly filled the vacant rota posting at the last minute and was inexperienced in the speciality, did not. Insecure and not wishing to appear incompetent, he attempted to manage the situation for several hours without senior help. Help from other departments had been hindered by evident tensions between the registrar and the nursing staff, leading to confused communications. By the time senior help was called and theatre prepared, the patient's situation was grave”

Dr McCulloch suggests that three things are needed to improve reliability in healthcare:

1. The system needs to be reanalysed to eliminate the obvious pitfalls.
   
2. The training of staff to improve communications.
   
3. The use of technology to be assessed.

Effective communication is essential if healthcare is to work properly and there has to be a move away from a fear of confronting problems.

Dr McCulloch mentions aircraft training in briefing, debriefing and keeping a "flat" hierarchy which can improve both teamwork and technical error rates in operating theatres. He also mentions the car production “Toyota”-style re-design of ward care processes, saying that using the input of the "coal face" workers, can dramatically improve them.

I like this piece and the thinking of trying systems from other industries. It’s innovative and new working practices have to be looked at without prejudice. However, the question has to be, does the healthcare system as a whole want change? Does it embrace change in the way Dr McCulloch would like?

Do you work in healthcare?

If so, what do you think and can you think of any other examples of how working practices in other industries can improve healthcare? Let me know.