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Dr Henrietta Hughes, the Patient Safety Commissioner for England, visited the Oxford Simulation, Teaching and Research Centre (OxSTaR) at the John Radcliffe Hospital on Friday 16 February.

The OxSTaR banner and a group of people sitting in front of a glass-fronted bookcase in a seminar room

The meeting was attended by (back row left to right) Rosemary Warren (OxSTaR Centre Manager), Katherine Edwards (Director of Patient Safety and Clinical Improvement at Oxford Health Innovations), Olaf Ansorge (Associate Professor, Neuropathology), Gerard Mawhinney (DPhil Student and Consultant Nurse), Olivia Lounsbury (Johns Hopkins Children's Centre Quality and Safety Team), and (front row left to right) Anny Sykes (Deputy Chief Medical Officer, Oxford University Hospitals NHS Foundation Trust), Helen Higham (OxSTaR Centre Director), Henrietta Hughes (Patient Safety Commissioner for England), Irene Tracey (Vice-Chancellor of the University of Oxford) and Kevin Talbot (Head of the Nuffield Department of Clinical Neurosciences).

Developing innovative training to strengthen individual and team performance in healthcare and improve patient safety

OxSTaR provides a state of the art simulation suite where medical students and healthcare professionals can rehearse scenarios with realistic mannikins and patient actors. Without fear of harming patients, they are able to enhance their ability to cope with medical emergencies. The OxSTaR team has been developing and delivering award-winning training for over 15 years to improve individual and team performance in healthcare, with the overarching aim of putting patient safety first.

The role of the Patient Safety Commissioner for England is to promote patient safety and make sure patients' voices are heard. Although independent of both the government and the healthcare system, the Patient Safety Commissioner is funded by the Department of Health and Social Care and remains accountable to Parliament. This allows the Office to focus on what matters to patients.

It was a real pleasure to share our work in patient safety teaching and research, and our vision for the future with someone who is obviously as passionate about this subject as we are. - Helen Higham

Helen Higham, Director of the OxSTaR Centre, gave a presentation focusing on patients being at the heart of OxSTaR's work. The first Human Factors training in the Oxford University Hospitals NHS Foundation Trust (OUHT), which focuses on systems-based approaches to improving safety, was developed over a decade ago to support staff in improving team performance and implementing robust solutions to safety concerns in their clinical areas.

During the COVID-19 pandemic the OxSTaR team made all their learning materials freely available online. Healthcare practitioners worldwide sent positive feedback on the resources showing how to use PPE and other procedures such as turning patients safely on to their fronts to make it easier to breathe (known as proning).

In addition to training materials, the team uses evidence-based methods to develop innovative cognitive aids such as checklists to help healthcare practitioners feel confident about what to do in particular emergencies. The key to the success of these aids is to develop them with the team who are going to be using them, and to employ standardised layouts and language.

One of the checklists, incorporated into the 'SCOOP' course (which was developed with the endocrine surgical team at the OUHT after a serious safety incident), has been adopted nationally. It describes a technique to relieve pressure around the airway if there is a haematoma after thyroid surgery. Alongside this, the team developed an easily reproducible model of a neck to enable healthcare teams to practise the procedure. Since this training was introduced in Oxford, teams have been able to respond to airway complications after thyroid surgery much more effectively.

Speaking about the meeting with the Patient Safety Commissioner for England, Helen Higham commented: 'It was a real pleasure to share our work in patient safety teaching and research, and our vision for the future with someone who is obviously as passionate about this subject as we are.'

Empowering patients to be involved in treatment and research

Helen Higham is co-supervising a part-time DPhil (PhD) student and Consultant Nurse, Gerard Mawhinney, with Neuropathologist Olaf Ansorge, on a project aiming to put the 'Person in the PICTuRE'. This project investigates the barriers to patients giving their consent to donate tissue for research. Gerard and Olaf gave a presentation about this work, which is funded by the Medical Research Council.

The barriers to consent include time pressures (in a busy clinical environment, people are sometimes not asked whether they would like to be involved in research), being asked in the wrong place (patients would often rather decide away from the clinic), and feeling obliged to say yes because the person asking you is delivering your treatment.

The research builds upon Gerard's previous work on personalised video consent in spinal surgery, where a video recording of the conversation between the patient and the clinician is shared. The patient can then take this home to discuss with their families. This empowers patients to make decisions about their treatment. The team are now working with Oxford Digital Health to develop an app to take this idea further.

Consent is also at the centre of Henrietta Hughes' strategy as Patient Safety Commissioner. Her overall aim is to work with people like those at OxSTaR to make patients part of the team, and part of the solution. She said: 'I would like to thank all the staff at OxSTaR who made my visit so interesting and enjoyable. I was impressed by the innovative training they are providing to the future health workforce.'

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