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On 4th December 2013 Hanson Renouf organised their inaugural professional liability lecture. The event was a success and despite falling on a wet, dark Wednesday evening was attended by some 70 professionals from the health service, dentists, fire service and several other areas. The event was by invitation only and was free, however donations were collected for the Great Ormond Street Love Hearts Appeal, totalling £300.
On 4th December 2013 Hanson Renouf organised their inaugural professional liability lecture. The event was a success and despite falling on a wet, dark Wednesday evening was attended by some 70 professionals from the health service, dentists, fire service and several other areas. The event was by invitation only and was free, however donations were collected for the Great Ormond Street Love Hearts Appeal, totalling £300.
Professor Martin Elliott, Paediatric Cardiothoracic Surgeon and Co-Medical Director at Great Ormond Street Hospital, flew to Jersey specifically to deliver the lecture. He is renowned in the medical world for how he has revolutionised the way surgery is undertaken at Great Ormond Street Hospital.
The evening was opened by Advocate Timothy Hanson, Partner and head of the Liability team at Hanson Renouf, who confessed to being slightly unnerved by being in a room where quite so many people had seen several of his team with no clothes on! Alexandra Baker and Lisa Simpson, both associates at Hanson Renouf, then followed. They discussed the Bolam and Bolitho tests in medical negligence claims, as well as recent developments in calculating damages including the Helmot v Simon case.
Professor Elliott then took to the stage and with the perfect blend of humour, honesty and humility imparted his knowledge to a fascinated audience.
He taught his 10 Rules of being a good surgeon, while telling anecdotes and showing powerful presentation slides. His rules didn’t touch upon the surgeons’ technical ability any more than to say that a surgeon should play to their strengths; instead they focussed largely on the importance of effective teamwork, improvement, reducing risk and also accountability.
Professor Elliott demonstrated how dramatically things have changed since 1950 by showing a newspaper heading which read ‘Hole in heart baby survives!’ and comparing it to a recent headline ‘Hole in heart baby dies!’ Our expectations have clearly changed with the advancement of medical procedures.
He went on to describe how one day after surgery he and a colleague were in the doctors’ lounge watching Formula 1 when they noticed a distinct similarity between a pit stop and the process involved when transferring a patient from theatre to Intensive Care. They also noticed how seamlessly the Formula 1 team worked together. They contacted Ferrari to see whether they might be willing to share their knowledge with GOSH and to their astonishment the team arrived at the hospital a week later. The Formula 1 team emphasised how important it is to practise procedures and to ensure that every eventuality has been taken into consideration thereby also encouraging flexibility and adaptability. Prof. Elliott exemplified this by asking what use is it to have a cardiac surgeon leading the medical team during transfer if the patient requires resuscitation. Clearly at this point the anaesthetist, who is specifically trained for this eventuality, should take the lead.
The next step in the transformation was a practical one; where should each member of the medical team be? For this they enlisted the help of a ballet company who observed the transfer process and then choreographed it. Each member of the team now knows exactly what is expected of them and where they should be; the process is seamless and silent where once it verged on chaotic.
Interestingly Mr Elliott also mentioned that he likes to mix his teams up as often as possible; in his opinion if people work too closely together they become complacent and are more likely to cut corners.
This leads succinctly to one of his other rules, ‘remember that a patient is loved by someone’, he questioned what right a surgeon has to take a risk with the life of somebody else and introduced us to the heart breaking story of Bethany Bowen (this can be found on www.risky-business.com).
The handover period would appear to be a somewhat contentious issue. Professor Elliott feels that a lot should be learned from the pilots of the Red Arrows who after every single air display or rehearsal will have a full debrief. Seemingly they have developed their own light-hearted system in order to learn from mistakes, the example used was ‘you flew a metre too close to me, you owe me a beer’. The point is though, without the debrief there is no real chance to discuss where issues have arisen and inevitably even less opportunity for improvement. Sadly, due to the very nature of the job, debriefs are rare in the medical profession; post surgery the team scatters and after a long shift the priority is to get home.
Mr Elliott touched upon the impact that transparency has on improvement. He explained how he took to sticking the results of surgical procedures on to theatre walls and how he made the results of individual surgeons available for viewing (the graphs take into account the risk and complexity of each procedure so the overall picture is a true reflection). These simple changes led to a dramatic improvement in surgical outcomes, for example, the vast reduction in the incidence of post-operative bleeding.
He talked about another very simple improvement that has had an immensely positive effect on mortality rates. Inspired by the likes of British Airways, Atul Gawande, a surgeon and journalist who is widely known as an expert on increasing efficiency in modern surgery, introduced the medical checklist. This is a checklist that must be filled out before each surgery, as in the case of eg a British Airways pilot regarding take off, the surgery does not start until there is a tick in every box.
Professor Elliott’s lecture was delivered in a way that made complicated matters and concepts appear very easy to understand and logical. There were many messages to take away from the evening and the knowledge shared can be applied to any profession.
It was an inspiring talk that prompted debate and piqued interest as reflected in the sheer volume of questions that were raised at the end.
We were delighted with the event and look forward to Hanson Renouf’s professional liability seminar next year.
