Human Factors Team Training – TeamSTEPPS pilot – good practice Barnsley NHS

Many incidents, claims and complaints involve poor communication and team working as a contributory factor or a root cause. Currently team training is not mandatory for NHS staff and many people assume staff already know how to work well as a team. TeamSTEPPS® (Team...

EUROCONTROL Model example Just Culture Policy

The implementation of the concept of “Just Culture” is now widely seen as key for further improvement of aviation safety through more and better reporting of aviation occurrences.  An essential condition for establishing a “Just Culture” at national level is an...

Circle of Care a model for Compassionate Human Factors in Healthcare

Circle of Care is a model for Compassionate Human Factors in Healthcare, created by the Simulation and Interactive Learning Centre (SaIL) at Guy’s and St Thomas’ NHS Foundation Trust (GSTT) in collaboration with Clod Ensemble’s Performing Medicine programme. It helps...

Wrong implant never event report

The NHS strives to learn from its mistakes but is often criticised for failing to investigate incidents properly, and for failing to share lessons learned more widely. This report is a redacted report from a Never Event investigation. The Trust involved wishes to...

Safer Clinical Systems – A proactive approach to building safe healthcare systems

A reference guide for Clinicians and Managers by the Safer Clinical Systems Team at Warwick Medical School. It’s time to do something different in patient safety. In healthcare, our approach to patient safety is almost entirely reactive. In other words, the first...

Healthcare Safety Investigation Branch – Expert Advisory Group Report

The Government have published the Expert Advisory Group report which recommends how the new “Healthcare Safety Investigation Branch” in NHS England should be established. You’ll be aware that the CHFG have campaigned for many years for a robust independent...