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Patient and Staff Involvement in Learning from Patient Safety Incidents

This virtual one-day training session will provide delegates with the expertise in involving patients, families, carers and staff in patient safety incident investigations.

The emphasis will be on practicality; the day is case study led.  Delegates will be guided through communicating openly and honestly with patients and families, having difficult conversations, gathering evidence (conducting interviews) and complying with the Duty of Candour.

There will be a structured approach to assisting staff to write excellent witness statements as well as conducting formal interviews in a ‘just culture’.

Signposting patients, families, staff and carers to appropriate support will also be covered.

The session will also cover how to effectively involve patients, families, carers and staff when working remotely.

All techniques will be tested through role-play.

Delegates will learn:

 

  • How to communicate openly and honestly
  • How to issue an apology and say sorry
  • How to conduct meetings with patients and families
  • Managing expectations
  • Recognition of patients, families and carers that may need additional support through the investigation process and how to access that support
  • How to work with the duty of candour, information sharing and confidentiality
  • Involving advocates and points of contact
  • Multi-agency working and dealing with parallel investigations
  • How to help staff produce excellent witness statements
  • How to conduct interviews with staff in a blame free/fair blame culture
  • How to signpost patients, families, carers and staff to support
  • Feeding back to patients, families, carers and staff

Timings

09.00am to 09.15am  Logon, technical knowhow and introductions

09.15am to 09.45am  Principles of being open

09.45am to 10.15am  Duty of Candour

10.15am to 10.45am  Apologies; verbal and written

10.45am to 11.00am  Coffee Break

11.00am to 11.45am  Arranging meetings with family members, carers and patients, including arranging additional support

11.45am to 12.00pm  Managing expectations

12.00am to 12.30pm Gathering evidence and difficult conversations

12.30pm to 1.00pm   Lunch

1.00pm to 1.15pm      A Just Culture; fair evaluation of the actions of staff

1.15pm to 1.20pm      Addressing accountability in the context of ‘no blame’ investigations

1.20pm to 1.45pm      Supporting staff

1.45pm to 2.30pm      Interviewing staff; planning and conducting

2.30pm to 2.45pm      Tea Break

2.45pm to 3.15pm      Feeding back to staff and patients, families and carers

3.15pm to 3.45pm      Multi-agency working and dealing with parallel investigations

3.45pm to 4.00pm      Summary, questions, conclusion and feedback

Virtual Training – Investigating Incidents; A Systems-Based Approach 1 Day Course

This virtual training session will focus on the first crucial steps of any incident investigation.  The emphasis will be on practicality and a process that can be incorporated into the health professional’s working day, as well as one that can be conducted remotely. Mirroring the new Patient Safety Strategy, good practice and factors requiring change will be identified, along with their contributory factors.  All recommendations, reports and action plans will focus on systemic changes, multi-disciplinary working and implementing practical changes.  All learning points are reinforced with real life examples.  Delegates will be provided with a suite of templates to use during an investigation as part of our commitment to an holistic approach to patient safety.

This course can also be run over 2 half-days.

Delegates will learn:

 

  • How much information to gather and how to gather it

 

  • The role of human factors and ergonomics in patient safety incidents

 

  • How to involve patients, families and carers

 

  • How to organise evidence using Timelines

 

  • How to critically analyse evidence

 

  • How to conduct interviews with staff members and families

 

  • Identification of factors requiring change

 

  • Including good practice in reports

 

  • Identification of contributory factors

 

  • Identification of broken and missing systems

 

  • Making proportionate and effective recommendations

 

  • Pulling a report together

Timings

 

09.00am to 09.15am  Logon, timings and housekeeping

09.15am to 10.00am  Introductions and an overview of the investigation methodology.

10.00am to 10.15am  Human factors and ergonomics; this session will explore how human factors can influence an investigator’s approach, the importance of objectivity and tips for achieving neutrality.

10.15am to 10.45am  Gathering information; a report is only as good as the information it is based on.  Investigators must beyond simply gathering evidence to find out ‘what’ happened – they must find and ‘why’ it happened and remember to gather human factors and ergonomic evidence. This will ensure that Investigators possess enough evidence to make SMART recommendations.

10.45am to 11.00am  Coffee Break

11.00am to 11.45am  Mapping the information using simple and tabular timelines.

11.45am to 12.15am  Critical Analytical Skills – How to identify missing or incomplete evidence

12.15am to 12.30pm Summary

12.30pm to 1.00pm   Lunch

1.00pm to 1.15pm      Recap on Module 1

1.15pm to 1.45pm      Critical Analytical skills – how to prepare for interviews. How to conduct interviews with staff members and families

 

1.45pm to 2.30pm      Identification of good practice and factors requiring change.  The importance of standards and precision writing.

 

2.30pm to 2.45pm      Tea Break

2.45pm to 3.15pm      Identifying contributory factors, including human factors, broken and missing systems.

 

3.15pm to 3.45pm      Focus on writing excellent recommendations, benchmarking, reasonable/measurable action plans and producing standardised reports.  Example report format provided.

 

3.45pm to 4.00pm      Summary, questions, conclusion and feedback

Virtual Training – Investigating Incidents; A Systems-Based Approach 2 Day Course

This virtual 2-day training session will focus on the first crucial steps of any incident investigation.  The emphasis will be on practicality and a process that can be incorporated into the health professional’s working day, as well as one that can be conducted remotely. In line with the new Patient Safety Strategy delegates will be taught how to identify both good practice and care delivery problems will along with their contributory factors.  The session includes modules on Information Collection and Organisation, Human Factors, Precision Writing and the production of SMART recommendations. 

Delegates will be provided with a suite of templates to use during an investigation as part of our commitment to an holistic approach to patient safety.

Delegates will learn:

 

  • How much information to gather and how to gather it
  • The role of human factors and ergonomics in patient safety incidents
  • How to involve patients, families and carers
  • How to organise evidence using Timelines
  • How to critically analyse evidence
  • How to conduct interviews with staff members and families
  • A guide to precision writing
  • Identification of good practice
  • Identification of care delivery problems
  • Identification of contributory factors
  • Identification of broken and missing systems
  • The key elements of SMART recommendations
  • How to pull the final report together

Course Timetable – Day 1

 

9.00am to 09.15am    Logon, technical knowhow and introductions

09.15am to 09.30am  Overview of the investigation methodology.

09.30am to 9.45am    Human factors and ergonomics; this session will explore how human factors can influence an investigator’s approach, the importance of objectivity and tips for achieving neutrality.

9.45am to 10.15am    Gathering information; a report is only as good as the information it is based on.  Investigators must beyond simply gathering evidence to find out ‘what’ happened – they must find and ‘why’ it happened and remember to gather human factors and ergonomic evidence. This will ensure that Investigators possess enough evidence to make SMART recommendations.

10.15am to 10.30am  Coffee Break

10.30am to 11.15am  Mapping the information using simple and tabular timelines.

11.15am to 11.45am  Critical Analytical Skills – How to identify missing or incomplete evidence

 11.45am to 12.00pm Conclusion, Questions and Set up for Module 2

12.00pm to 1.00pm   Lunch

1.00pm to 1.15pm      Recap on Module 1

1.15pm to 1.45pm      Critical Analytical skills – how to prepare for interviews. How to conduct interviews with staff members and families

1.45pm to 2.30pm      Identification of good practice and care delivery problems.  The importance of standards and precision writing.

2.30pm to 2.45pm      Tea Break

2.45pm to 3.15pm      Identifying contributory factors, including human factors and broken and missing systems using wagon wheel and barrier analysis.

3.15pm to 3.45pm      Focus on writing excellent recommendations, benchmarking, reasonable/measurable action plans and producing standardised reports.  Example report format provided.

3.45pm to 4.00pm      Summary, questions, conclusion and feedback

 

Course Timetable – Day 2

 

9.00am to 09.15am    Logon, technical knowhow and introductions

09.15am to 10.15am  Witness statement case study

10.15am to 10.30am  Coffee Break

10.30am to 12.00pm  Planning for interview.  Question drafting case study

12.00pm to 1.00pm   Lunch

1.00pm to 2.30pm      Incident Investigation case study from start to finish.  Reports will be submitted to and marked by the trainers.

2.30pm to 2.45pm      Tea Break

2.45pm to 3.15pm      Case study continued.

3.15pm to 3.45pm      Delegates receive feedback on their incident investigation reports.

3.45pm to 4.00pm      Summary, questions, conclusion and feedback

Virtual Training – Quality Assurance of Incident Investigation Reports

This interactive virtual workshop (for a maximum of 18 delegates) looks, in detail, at the common mistakes investigators make.

Delegates will work on a real incident report and will use lessons learnt during the one-day Incident Investigation training to constructively critique it. 

Issues that will be explored include quality of information collection, misuse (or non-use) of tabular timelines, un-structured critical analysis, the use of vague language, failure to take into account human factors and ineffective recommendations.

The workshop will also explore how to provide encouraging and effective feedback to investigators.

Delegates will learn:

  • How to identify inadequate information collection
  • How to spot when an investigator has not used the correct investigation tools, including Tabular Timelines
  • How to identify deficient critical analysis
  • How to ameliorate vague language
  • The key components of a well-drafted recommendations
  • How to provide constructive feedback to investigator

Course Timetable

10.00am to 10.15am  Registration and Introductions

10.15am to 10.30am  Overview/recap of RCA

10.30am to 10.45am  Case Study – delegates review report and provide initial feedback

10.45am to 11.15am  Information gathering.  Group work.  Delegates review report in light of discussion.

11.15am to 11.30am  Coffee Break

11.30am to 11.45am  Simple timelines.  Group work.  Delegates review report in light of discussion.

11.45am to 12.00pm  The use of tabular timelines.

12.00am to 12.30pm  Additional information required.  Group work.

12.30pm to 1.00pm    Critical analysis: factors requiring change and good practice.  Precision writing.  Group work.

1.00pm to 1.30pm      Lunch

1.30pm to 2.45pm      Critical analysis: contributory factors (including Human Factors) and barrier analysis.  Group work.

2.45pm to 3.00pm      Coffee Break

3.00pm to 3.30pm      Recommendations and Action Plans.  Group work.

3.30pm to 3.45pm      Providing constructive feedback.

3.45pm to 4.00pm      Conclusion

Virtual Training – Complaints Handling In Healthcare

This virtual training session will focus on the.  The emphasis will be on practicality and a process that can be incorporated into the health professional’s working day, as well as one that can be conducted remotely. This interactive and practical course will provide a structured approach to complaints handling and incident investigation.  Delegates will be guided through initial responses to complaints, letter writing, communicating with patients and families, along with gathering the evidence (including conducting interviews) conducting an analysis of the issues and evidence, and production of the final report.

The methodology taught will be one that can be incorporated into the health professional’s working day.

All techniques will be tested through role-play.

 

Delegates will learn:

 

  • How to communicate clearly and how to issue an apology
  • How to conduct meetings with patients and families
  • How to scope the complaint or incident
  • How to work with the duty of candour, information sharing and confidentiality
  • How to help staff produce excellent witness statements
  • How to conduct interviews with staff in a blame free/fair blame culture
  • How to manage your time including practical guidance on running a complaints investigation at the same time as undertaking your usual role
  • How to increase staff confidence in producing reports and ensure a consistent approach across the Trust with the provision of report formats and checklists

Timings

 

09.30am to 09.45am  Logon, technical knowhow and introductions

09.45am to 10.00am  Delegate’s experience of handling complaints and undertaking investigations is established.

10.00am to 10.15am  An overview of a systems-based approach.

10.15am to 10.45am  Gathering information; a report is only as good as the information it is based on.

10.45am to 11.00am  Coffee Break

11.00am to 11.45am  Scoping case study

11.45am to 12.15am  Meeting with family members, carers and patients

12.15am to 12.30pm Role play

12.30pm to 1.00pm   Lunch

1.00pm to 1.15pm      Recap on the mornings’ key lessons

1.15pm to 1.45pm      Critical Analytical skills – how to prepare for interviews. How to conduct interviews with staff members and families

1.45pm to 2.30pm      Exercise

2.30pm to 2.45pm      Tea Break

2.45pm to 3.15pm      Using timelines to structure analysis

3.15pm to 3.45pm      Drafting response letters

3.45pm to 4.00pm      Summary, questions, conclusion and feedback

Healthcare Record Keeping and Documentation Training

Accurate patient records and documentation should be an essential part of every health and social care practitioners’ professional practice. Too often they are vague and abbreviated, even sloppy, which not only affects patient care but also impacts on any future legal action, Inquest or Inquiry.

This one-day course will provide health and social care professionals with a guide to excellent record keeping principles to govern day-to-day practice.

Content

  • Recognise the importance of patient records and documentation and how they may be used in the future
  • Practical guidance on excellent record keeping
  • Enable managers to assist their staff in producing unfamiliar documents, including statements, with confidence
  • Introduction to the 3 critiquing tools to maintain accurate record keeping
  • Basic oral evidence presentation skills
Giving Evidence at Coroner’s Court Training

This is a course for healthcare professionals who may have to give evidence at an Inquest.  It is also suitable for those who may have to support staff in the immediate aftermath of a patient death and at Coroner’s Court. 

The day is split into two sections; section 1 covers how to prepare to give evidence and section 2 covers giving evidence at Inquest.  

Every delegate will be cross-examined by a Healthcare Lawyer and Inquest Advocate to experience, in a protected environment, the level of scrutiny their evidence may be subjected to.  Every delegate will be given personal feedback and guidance on how to improve their own, individual presentation skills.  

NB – no live cases will be discussed

Content

  • Writing witness statements
  • Critical analysis of evidence 
  • What to wear
  • Language to use
  • What to expect on the day
  • Interface between a Serious Untoward Incident Investigation and Inquest
  • The purpose of an Inquest
  • What about staff who have left?
  • Court visits
  • The difference between an expert and a witness of fact
  • Giving oral evidence
  • How to deal with lawyers’ techniques
  • Jury Inquests
  • Conclusions and PFD Report
Informed Consent Training

Course Overview

Informed Consent has always been of vital importance to all healthcare practitioners but the case of Montgomery v Lanarkshire Health Board (2015) put clinicians’ practice of consenting patients back in to the spotlight; doctors can no longer rely on the Bolam test when deciding what information to give patients.  

This one-day course will clarify the principles of informed consent as well as provide an overview of the current law relating to treatment of those who lack capacity and who are unable to give informed consent. 

All delegates will have the opportunity to discuss their own areas of concern with an experienced healthcare lawyer. 

There will be practical guidance given on day-to-day record keeping. 

Content

  • The law governing informed consent of patients; case law and national guidance 
  • What is voluntary consent? 
  • What does informed mean?
  • How to apply the legal principles to day-to-day practice
  • The current law governing treatment of those who lack capacity; the doctrine of emergency and the doctrine of best interests
  • Deprivation of Liberty Safeguards (the current position)
  • Advance Decisions and Advance Care Planning 
  • Capacity assessments
The Organisational Duty of Candour Training

Course Overview

This one-day in-house course, led by an experienced Barrister and Accredited Mediator, covers the legal and professional regulatory framework surrounding the duty of candour, the background to the duty and what it means in practice.

The training will include sessions on meeting and communicating with patients and families. It will also cover what is a notifiable safety incident (both in an NHS and non-NHS context), moderate and severe harm, making apologies, compensation, supporting staff, an overview of Root Cause Analysis and record keeping. 

The emphasis will be on developing the practical understanding of the key concepts and the skills needed to ensure compliance with the duty of candour. 

Content

  • Fundamental principles and policy background – what is the duty and why is it there?
  • Statutory framework – NHS Trusts, primary care and others
  • Professional duty and Codes of Practice
  • What is a ‘notifiable safety incident’?
  • The threshold(s) for a notifiable safety incident – when does the duty engage?
  • Required actions: notification, investigation, apologies and documentation
  • Accountability and responsibility: organisations, clinical leads and individuals
  • Apologies and admissions of liability – are these the same?
  • Meeting with patients, service users and families
  • Investigating incidents – using Root Cause Analysis
  • Communicating in writing – clear, accessible and person-focused
The Use of Restrictive Interventions – the Legal Framework

Course Overview

This practical masterclass will offer practical guidance on the use of restrictive interventions and the legal framework.

Healthcare professionals may not think that they use restrictive interventions however enhanced observations, physical restraint, mechanical restraint, chemical restraint, searches, seclusion and long-term segregation are all considered to be restrictive interventions and should be used with appropriate policies and procedures in place. It is important that restrictive interventions are used legally and ethically and also part of a care programme aimed at reducing the interventions.

Delegates will have the opportunity to raise issues and concerns specific to their own practice. The course will be run by an experienced Mental Healthcare Lawyer and will be case study led.

Content

  • Overview of the Mental Capacity Act and Mental Health Acts and Codes of Practice
  • Review of case law and DoLs provisions
  • Best Interests Assessments 
  • Incident de-briefs and reviews
  • Care Plans
  • Documentation; a practical guide including the introduction of the FMA (five-minute appraisal) system