The Health Education England working across the West Midlands Compassion 2016 Prize Award was won by Dr Amelia Reynolds.
"This patients case was a particularly difficult yet heart warming story which touched a large number of people. Hence we were asked to discuss her case at our hospital Schwarz Round, to help reflect on the experience but also share our emotions. I found it incredibly rewarding to do so, and the process of sharing and reflecting helped me to move forward and learn from that experience. Hence it made sense to write those thoughts and emotions down, firstly so I can look back on them in the future when I feel comfortable to. But secondly to also share that I don't feel as a profession we share our emotions and concerns enough, that we try to maintain a hardened professional exterior for the sake of our persona, whilst sacrificing possibly our mental stability.
It is a rare opportunity to share both the positive and negative experiences you have had whilst caring for a patient and demonstrating compassion towards them. A chance to offload any thoughts and worries that you have which you may have felt uncomfortable to do so with the colleagues that you work with daily. I found the experience incredibly rewarding, not only to offload those burdens I carried, but also to receive feedback on my actions, but also that I wasn't the only one feeling guilty and upset by the patients loss. It helps to build bridges and develop a closer working relationship not only with the patient but also with your colleagues, so you know next time in a difficult situation you feel supported.
A reflection on the tragic case of a 30 yr old lady who presented with painless jaundice and evidence of a mass in the area of the caecum with extensive metastases. She was clearly even on day 1 of her admission incredibly unwell, with limited opportunity for a cure. She became quickly aware of this and wanted to go home to spend time with her family and her dogs. The consultant was keen to get a liver biopsy to enable identification of the primary tumour and the possibility of palliative chemotherapy. However the biopsy took a couple of days to organise, by which time she had continued to deteriorate significantly, becoming too encephalopathic and unwell for a safe discharge home. I had an enormous sense of guilt around this, as I felt that the biopsy was unnecessary, as she was so unwell that we were just putting her through invasive procedures to no avail. She was desperate to see her dogs, hence infection control rules were broken and the 2 dogs brought onto the ward. She became calm and content again, proving that palliative care is so much more than anticipatory medication, as the dogs provided her with so much joy that she did not notice her pain or agitation. She unfortunately passed away very quickly after this, yet her family were incredibly gracious in their loss. She demonstrated to me the importance of listening to your patients wishes with regards to their care, treating them as a person rather than as a medical condition, and doing what is best for them as a person rather than putting them through invasive procedures for only minimal gains. Also that we need to share our emotions better, to enable reflection and enhancement of our future care."
The Health Education England working across the West Midlands 2016 Prize Award One, was won by Dr Anuradha Venugopal.
"Though initially, I learnt about the FY prize award through a generic email from the West Midlands Deanery, I decided to enter the competition after I presented my work at a regional audit and QI symposium and won a prize for best presentation. I also felt that in the off chance of winning the competition, this would be a good platform to drive home an important point that concerns-even if raised by an FY1 doctor- will be heard to and acted upon if the intentions and actions are in the right spirit and through appropriate channels.
The award is a fantastic opportunity to present a QI project one is truly proud of. It does not have to be a project where changes are all implemented and the results have gone from zero to a hundred. The workings of a QI project are very different to an audit and it is the process that needs to be talked about rather than the results and their implementation. And discussing the process from an FY1 point of view gives that added perspective from grass root levels about understanding a problem and recommending changes to be implemented. It gives us the confidence at a very early stage to objectively put across our views and reflect on what went well and what we could do better. And better still, if the submission wins a prize, the recognition, monetary award and the opportunity to present to an elite audience definitely makes it all the more worthwhile.
As an FY1 in Haematology, I very quickly realised that the existing handover process was far from robust. The out of hours on call system, the cross cover between 2 specialities, the complexities of a super speciality compounded with lack of induction or an organised hand over routine meant information was passed on an ad-hoc basis. This I found was inconsistent, unreliable and dangerous. When patient safety became an issue, I initially raised it locally and then escalated it to the powers that be with objective evidence that this was not merely my gut feeling but the general perception among all the junior doctors from FY1s to CT2s. The recommendations involved a change in the rota, switching over to the electronic handover function on the trust's communication system and finding a way to involve registrars in the handover process without a change in their working pattern. All these changes, as obvious, do not take place overnight. I then decided to author a manual on the daily workings of the haematology unit titled 'Life (can be) Made Easy-on Haematology' with information on general duties, clinical teams, on call patterns and other such generic information. Though the other recommendations are still work in progress, this handbook is one such contribution from my end that was approved in time for the next cohort of junior doctors and offered some clarity to the complex working pattern of the specialty.
The most encouraging part of this seemingly arduous task of improving the quality of handover was the support and positive response garnered and the fruitful discussions about changes needed that I participated in as a direct result of this project.
It will be months before full-scale implementation of the recommendations occur but my contributions have been a vital step towards change. QI projects are not mere CV enhancers and should not be treated as such. They can having a lasting impact on the daily workings of a unit, specialty or even Trust. And when it comes to patient safety- there is no excuse- it is everybody's business, irrespective of our individual ranks."
Page Updated on: 4 July 2017