A very interesting article and comments, arguing that although Consultant numbers have increased, Consultant productivity has decreased due many systemic factors including workforce planning (including lack in increase in nurses), social and community care capacity limiting patient flow, and capital e.g. lack of ICU beds, IT infrastructure.
Many questions are raised though, such as how can ‘productivity’ be a accurately and meaningfully measured in a useful and comparable way in such a complex system. Also, how does one account and value ofter features such as quality and safety? It’s complex!
Useful guidelines so that anaesthetists and ODPs are on the same page…
Pre-list briefing, explore current position of trainee(s) and what they would like to achieve (as objectively as possible) during the day, and achieve the following at post-list briefing:
- Trainee to have:
- Acquired new or developed/reflected on existing knowledge
- Learnt new , developed or reflected on existing technical skill
- Learnt new, developed or reflected on new non-technical skill
- Feedback from trainer to trainee – positive and negative (constructive)
- Feedback from trainee to trainer – positive and negative (constructive)
(If more than one trainee, senior can teach the junior, which feedback on teaching content and methods from consultant +/- trainee)
- Private room
- Do the above!
- Feedback on the process
I found this worked very well!
Focus and communicate on the WHY.
Not the how or what.
5 practices of exemplary leadership:
– Challenge the process
– Inspire a shared vision
– Enable others to act
– Model the way
– Encourage the heart
From Kouzes and Posners leadership challenge
“Walk in the shoes of the people we serve. Think like a patient, act like a taxpayer.”
Simon Stevens’ (CEO NHS England) speech setting out vision for NHS in the Five Year Forward View.
J. Larsson et al (BJA, 2013) say he/she is:
- structured, responsible and has a focused way of approaching tasks
- clear and informative, briefing the team about the action plan before induction
- humble to the complexity of anaesthesia, admitting own fallibility
- patient centred, having personal contact with the patient before induction
- fluent in practical work without losing overview
- calm and clear in critical situation, being able to change to a strong leading style
A.F. Smith et al (BJA, 2011) found the most highly ranked attributes were:
- ‘strives for excellence’
- good communicator
- clinical skills
Sandhurst guide to developing leaders:
Have at least 2 anaesthetists present for KTS/delivery of placenta.
RCOG guidelines require presence of consultant anaesthetist.