Kate Granger by @kendonaldson

Last week on dghealth Kate Granger told the story behind her #hellomynameis campaign and on Tuesday 23rd June NHS D&G were delighted to welcome her to the Easterbrook Hall where she spoke to over 150 healthcare professionals.

Kate Granger and audience crop comp

Kate, and her husband Chris Pointon, had embarked on a two week whirlwind tour of 15 healthcare organisations around the UK to promote their campaign. We are really privileged as Dumfries was their only stop in Scotland and early on in her presentation Kate explained why. As part of her clinical attachments at medical school in Edinburgh she spent four weeks in Dumfries working with Dr Ian Hay in Elderly Care medicine. She had such a good time, and was so inspired by Ian, that she chose to specialise in Elderly Care and is now a Consultant in Yorkshire.

Kate Grnager TalkingIt is difficult to find the words to describe how humbling it was to hear Kate tell her story. She is very matter of fact about her diagnosis of terminal cancer, her journey through chemotherapy and the complications that ensued…and her prognosis. The power of a clinician seeing care “from the other side” cannot be underestimated.

 

On one occasion, after a change of ureteric stents, Kate became unwell with a fever and had to be admitted to hospital. A nurse took her history in the emergency department, as did a young doctor and another nurse administered antibiotics. She is unable to tell us their names as they never told her. In fact the nurse who gave the antibiotics didn’t even check her name band or allergy status before plugging her into a drip and starting them running – all the time talking to another colleague.

Kate Granger and students comp ii

However she did remember Brian’s name. Brian was the porter who took her from the ED to the ward. He introduced himself, asked her how she was, recognised she was in pain and ensured that he pushed her bed slowly over all the bumps as to minimise her discomfort. In short he was kind. He cared. Unfortunately there were other examples of poor introductions and she found herself ‘Emotionally Reflecting’ (or as Chris pointed out ‘Whinging’) about this and decided to do something – hence #hellomynameis.

This is about more than just an introduction. It’s about effective, skilled and compassionate communication. It’s about the little things, a smile, a hand on hers, the offer of a drink. It’s about true person centred care and seeing every patient as an individual, a person. ’See me’ as Kate puts it. If when you enter a patients room you lower yourself to their level and introduce yourself with a smile then your conversation will follow a different tack than if you stand towering over them eulogising to the entourage of nameless followers at the end of the bed.

Hazel Borland Kate Granger Jeff Ace and Chris Pointon crop ii

Kate is now an MBE. She has met numerous politicians (all rather keen to jump on the bandwagon!!) and celebrities and the #hellomynameis brand is now truly global. Hospitals in many countries including the USA, Australia, Italy and Sierra Leone have embraced it. The latter example is extremely powerful as, during the Ebola outbreak when clinicians were forced to be completely sealed in protective clothing, #hellomynameis stickers could be put on the visors of helmets so that patients would know the name of the doctor or nurse caring for them.

Kate’s talk was inspirational. The courage she and her husband demonstrate in touring the country telling her story time and time again is breathtaking. I know I can speak on behalf of everyone who made it to the Easterbrook by saying how proud we all were to have met Kate and Chris. While Hazel Borland and I waited for her to arrive we both confessed to some nerves at meeting this celebrity. We told Kate this and she responded “but I’m not a celebrity, I’m just a normal Yorkshire lass” and this was what came over throughout her visit. Despite everything she has been through, and all she has achieved, she remains grounded, normal and human.

Kate’s talk was recorded on video and will be available for all to watch soon.

Kate Granger and Ken

 

#hellomynameis….Kate by @GrangerKate

Hello type_RGB_for webHello my name is Kate. I trained at Edinburgh University and in our later clinical years we spent time in the surrounding district general hospitals. For me this meant making the journey over to Dumfries to complete my Medicine for Older People attachment. I was obviously inspired by this placement as once qualified I subsequently chose to train in that specialty.

MY imageEverything was going perfectly with my career and indeed my life. I was happily married to my husband Chris, we had a lovely home in Yorkshire and had a fantastic network of supportive family and friends. However, in summer 2011 our lives were to take an unexpected turn and change forever.

I became acutely unwell while on holiday in California. Initial investigations in hospital showed I had acute kidney injury secondary to an obstructive uropathy. The reason for the obstruction was numerous tumours throughout my abdomen and pelvis. Incurable cancer. Out of blue. Age 29.

I’ve been through a great deal of healthcare since then and as a doctor have been a keen observer of my experiences on the other side. It has made me reflect long and hard about my own clinical practice and really think about what constitutes good care. I have come to the conclusion that those factors are really very simple; quality communication; remembering the little acts of kindness can have the biggest impact; person centred healthcare with true shared decision making and always trying to see the person behind the disease or condition.

I have written, blogged, spoken about and tweeted most of my healthcare experience to date. This led almost two years ago to #hellomynameis. It was summer 2013 and I found myself unexpectedly in hospital with post-operative sepsis after a routine stent exchange. During that admission there were a fair few problems with my care, but it was the absence of something so simple, so routine that distressed me the most. An introduction.

No matter which discipline of healthcare you train in, I’m sure that introductions are covered as an important part of interacting with patients. In Medicine we even assign marks in exams for introducing yourself properly. But somewhere along the line in some places this simple courtesy has been lost.

As an avid exponent for both healthcare improvement and social media I decided that it was just not enough to simply complain. My complaint would be politely acknowledged but nothing would change. Therefore, after an inspiring conversation with my husband, in which I was plainly told to “stop whinging and do something”, we set off on the #hellomynameis journey.

On the 31st August 2013 I tweeted:

“Going to start a ‘Hello my name is…’ campaign. Have sent Chris home to design the logo.”

nursing conferenceWho could have guessed that would lead me on a path to being awarded an MBE for services to the NHS and improving care? The concept is incredibly simple; use the immense reach of social media to remind, encourage and inspire healthcare professionals about the importance of introductions and their place in the delivery of person-centred care.

Since that first tweet we have been working incredibly hard spreading this message as far and wide as possible. I have lost count of all the conferences I have spoken at and all the tweets I’ve sent. The #hellomynameis hashtag has made over 200 million impressions on Twitter. It has spread all over the world. Our latest enterprise is the #hellomynameis tour where in the space of one week in June we are planning to visit 15 healthcare organisations to talk to staff about our story and how the campaign was born. I’m happy and excited to say that Dumfries hospital will be a part of the tour.

With PM

I dedicate a huge amount of time and energy to raising the profile of patient experience in the healthcare agenda. I feel it is something that is sometimes not given the prominence it deserves. But that is changing and the patient voice is becoming louder and more powerful. Patients need to know who is delivering their healthcare, to build relationships with and be able to trust those people. #hellomynameis simply reminds us all of that.

Dr Kate Granger MBE is an Elderly Care Consultant in Yorkshire. She will visit NHS Dumfries and Galloway on June 23rd 2015

Resistance is futile by Euan MacLeod

Euan Borg 1

Assimilation or Integration?

For those of you familiar with Star Trek you will immediately recognize the Borg phrase Resistance is futile. The full version is “We are the Borg. Lower your shields and surrender your ships. We will add your biological and technological distinctiveness to our own. Your culture will adapt to service us. Resistance is futile.”[.

Is that how it feels for you as we undergo a period of change and is Integration a bit like the equation below?

 

The rule for integration isEuan Borg 2 providedEuan Borg 3

Euan Borg 4

Well what can the Borg add to this?

I decided to research this a bit more and see if the Borg approach to other species was just as simple as taking them over and those species who were assimilated losing identity and just becoming part of a big machine.

The Borg operates toward the fulfilment of one goal “achieving perfection”, they exhibit a rapid adaptability to any situation or threat, and they have an ability to continue functioning after what may seem a devastating or even fatal blow.

So what is the goal of Integration, I think most of us would agree that it is designed primarily to improve the delivery of high quality compassionate care by enabling all involved in delivering that care to function more collectively.

Resistance to the changes that integration brings may develop unless people think that they will make a powerful positive difference to patient care. We will also I think need to feel that changes will enable us to do our jobs better and maintain, strengthen and develop the key working relationships that high quality compassionate care is based on. To be able to operate compassionately is a key relational aspect to our character as human beings.

 Euan Borg 5

The strength of the Borg collective is a pervasive collective consciousness that enables all the drones to feel what the other drones are experiencing, in the collective each individual is given constant supervision and guidance, being part of the collective consciousness offers advantages to the individual drones. Does being part of something bigger benefit you in delivering compassionate care and what are those key relationships that help you achieve that goal?

 Euan Borg 6

The Borg are more interested in assimilating technology than people and they don’t assimilate any old species only those who might add to their overall goal of progress towards a more efficient way and achieving perfection. At times the outcomes and progress we are chasing seem more about productivity, efficiency and cost effectiveness, and perhaps less explicitly so about high quality compassionate care.

Pursuing high quality compassionate care should deliver productivity and efficiency so perhaps assimilating those aspects of how we all do our work into a collective approach that delivers high quality compassionate care will be helpful.

 Euan Borg 7

So assimilation or integration or is it a bit of both

Looking up definitions of these we find it most commonly is applied to questions of immigration, culture and identity

Questions about culture and identity are fundamental as we go through this process, how we react to that will to some extent define whether we experience assimilation or feel that we have become integrated into a bigger whole that displays parts of our unique culture and contribution in fulfilling our goal.

The Borg operates on a basis of collaboration and this is built on mutual altruism, mutual concern and mutual support which are focused on achieving their goal. Can we do the same?

Euan McLeod is a Senior Project Officer for the National Bed Planning Toolkit

Healthcare Science & The Patient Journey by Adele Foster

“Allow me to introduce you to the world of Healthcare Science”

Have you ever wondered just how many people are actually involved in a single patient journey?

It’s easy to account for people when you receive face to face care for example from Doctors, Nurses and AHPs but what about the unknown entity.

5 years ago I would never have known all the unique skills and talents that were used in the patient journey until I attended a meeting of those unknown entities. Even though my badge said that I was from Microbiology and the other attendees were from completely different domains, I found that I had something in common with them all.

So what was it that I, the above group and this picture have in common?

 Adele 1

(Taken from – Extraordinary you 2010 – Department of Health)

Science, Science was what connected us.

As a group we are all Healthcare Scientists and we make up the fourth largest clinical group in NHS Scotland. We are a diverse group comprising of more than 50 disciplines and are divided into three strands:

  • Life sciences the study of illness and disease – involving laboratory and phlebotomy services.
  • Physiological sciences are all about the study of the body and organs. This covers things like audiology, cardiac physiology and respiratory physiology
  • Physical sciences focus on developing techniques and technology for diagnosis and monitoring patients. Involves Medical Physics, Medical illustration and Maxofacial services

 

Collectively 60 million laboratory tests and 730000 clinical physiological measurements are undertaken by healthcare scientists, some of the services we provide are:

  • complex and specialist diagnostic services, analysis and clinical interpretation
  • direct therapeutic service provision and support
  • Introduction of technological and scientific advances into healthcare, and undertaking research, development and innovation

–          performance and quality assurance, risk management and clinical safety design and management

The Healthcare Science workforce plays a critical part in delivering healthcare. More than 80% of all diagnoses are reached with a contribution from healthcare scientists but it is not just to patient care, our skills are used for innovation and intervention

The model of healthcare is changing with increasing complexity and changing demographics, there is greater focus on preventative approaches and being pro-active instead of reactive.

So how does Healthcare Science fit in with this, and what can we contribute? – Many of us are behind the scenes in departments that most hospital staff have little reason to visit; this has led to us having often been described as the Cinderella service.

Over the past few years the Scottish government has supported Healthcare Science and has been very much involved in the creation of both National and Local lead posts. Most NHS boards now have a local lead and in NHS Dumfries and Galloway this is the post that I am very proud to have recently taken up and my reason for sharing this information with you today. We have a Healthcare Science Advisory Committee composed of different strands that feeds into Area Clinical Forum on a monthly basis.

On the 11th May, the Healthcare Science contribution was laid out in The Scottish Healthcare Science national delivery plan 2015-2020, this publication sets out service improvements that will deliver high quality and sustainable health and care services for Scotland. It focuses on:

  • Stream lining health technology management
  • Point of care testing
  • Demand optimisation
  • Developing sustainable services

–          Creating a new model for clinical physiology services

Adele 2The future vision within the delivery plan is that “healthcare scientists work with health and care teams and patients across the whole health system, driving proactive and flexible seven day services that provide diagnostic and service solutions throughout patient pathways and life course”

With the multitude of national visions and the ever changing landscape of health care provision it is all too easy to feel overwhelmed but we should not lose hope in the aspirations of our visions, but instead engage as a multi disciplinary team and contribute to new thinking, new solutions and new ways of working to ensure the future of health care is the best that it can be.

We as healthcare scientists are an integral part in helping to change service delivery and in transforming patient pathways, by being part of the whole patient journey. With the National delivery plan we have an opportunity to make ourselves much more visible and we have so much to be proud off.

I look forward to meeting and working with many of you over the coming months.

Adele Foster

Healthcare Science Lead NHS Dumfries and Galloway

 

Do you recognise some of these familiar faces of Healthcare Science within DGRI?

 Adele 5

If you would like to learn more about Healthcare Science please use the links below:

http://www/gov.scot/Publications/2015/05/8743

 http://www.nes.scot.nhs.uk/education-and-training/by-discipline/healthcare-science/all-healthcare-science/publications.aspx

Adele 4