Ben Shippey

An idea. ‘Microharm’. Healthcare spends huge effort investigating ‘big bad’ - rare adverse events like death, or loss of limb. Could we be better by focussing more on common, avoidable ‘microharms’ like delay, thirst, pain and distress? Over to you…

@RingGo_parking Four day response time. 👏🏼

@rallydoc We would like to look into this further for you, can you directly message us with the following information: Mobile number, Email address, & vehicle registration details of your enquiry. Yk

Been trying to communicate with @RingGo_parking all day to correct information in their database that I can’t correct with their app. Spectacularly awful UI and ‘virtual assistant’.

@andymoz78 @DrNeilStone I’ve just returned to Twitter… That post might keep me here! I’m humbled by your comment. It was a privilege to have played a small part in the development of some wonderful intensivists (like you) over the years.

@DrNeilStone H/T @rallydoc who was (and I am sure still is) one of the finest medical educators I had to good fortune to be trained by.

I think specialty training for doctors in the UK is too long. Not medical school - 5 years is fine - but postgraduate specialty training is wayyyy too long

@doctimcook @Anaes_Journal 😂

@doctimcook @Anaes_Journal Can I come and work where you are, then?

After twenty years of banging on about this, I have given up hope that healthcare will ever take HF/E seriously…

@Alastair__Ross @ga5manwilliams @DrGrays_Elgin @NHSGrampian @Scotambservice @Scot_STAR @EMRSscotland I try quite hard to be inoffensive. Don’t always achieve it…

@ga5manwilliams @Alastair__Ross @DrGrays_Elgin @NHSGrampian @Scotambservice @Scot_STAR @EMRSscotland Bless you! Keen to help if I can.

@rallydoc @Alastair__Ross @DrGrays_Elgin @NHSGrampian @Scotambservice @Scot_STAR @EMRSscotland If this is real…please 🙏

@andibuttri @KenCatchpole New TIVA pumps require an additional confirmation step before they will start. No warning that they haven’t started. So the ‘old’ sequence of button presses on a pump which is nearly identical to the old one results in no drug delivery… We need a #setuptofail hashtag!

@kmozolowski You know what ‘getting off at Haymarket’ mean though? 😂 You OK? Been a while!

@rallydoc These are all words I hear you lot use and indvidually I know what all of them mean. And yet I have no idea what they mean when said together. #LostInTranslation #WrongSideOfTheBloodBrainBarrier

Anyone else think that doing a prehospital RSI with ketamine and roc, then placing a 7,0 tube is a bit like ‘getting off at Haymarket’?

@KateBurkeNHS @MKHospital There are vegetables in that one picture than we see in a year in Dundee… Can Frank come for a visit? Please?

@addictedtosmacc Yes. But only the easy ones. We leave the tricky ones to the real superheroes.

WE HAVE NO IDEA WHAT THIS MEANS BUT AS LONG AS THE INTUBATION WAS DONE WITH VL THEN IT MUST BE OK. DO ANAESTHETITS DO INTUBATIONS TOO NOW?

@KenCatchpole I read them… (maybe not all of them)

@rallydoc 137 (mostly ignored) journal papers and counting..... ;-)

@KenCatchpole And you are right. Well done. Keep going!

@rallydoc This is why I've been harping on about the mistaken focus on NTS/CRM/Teamwork training/checklists for at least 15 years. Sure it can have limited benefits, but it's also led to the reinstatement of blame-and-retrain in a way that looks legitimate, but just keeps the status quo.

@KenCatchpole While whitewashing with a thin layer of non-technical skills masquerading as HF/E. Before adding another checklist/sticker/checkpoint/online module. Increasing complexity and clinician workload in the expectation that this one extra step will ensure it ‘never happens again’…

@rallydoc Because in healthcare it suits everyone to stop looking for causes at the person to provide the illusion of control and an otherwise functional system, which retains the status quo, obfuscates other causes, perpetuates harm and, ironically, backs clinicians into a tighter corner.

@KenCatchpole Usually followed by the lazy suggestion that staff need better/more frequent/additional education.

@KenCatchpole I call it ‘blame at a remove’. (You’re shit because your) HF/SA/comms/DM were impaired.

@AirwayLegend @doctimcook @NicholasChrimes @UniversalAirway @SafeAirway @AndyHiggsGAA @Anaes_Journal Please stop equating ‘human factors’ with ‘humans are incompetent’. You are inaccurate, and you damage progress towards safer care when you do. HF (ergonomics) is the science which explores the interaction between humans and their environment. Not an explanation of errors.

@doctimcook @NicholasChrimes @UniversalAirway @SafeAirway @AndyHiggsGAA @Anaes_Journal I agree. Human factors aka negligence or incompetence is the main reason for ‘unrecognized’ esophageal intubation Straight blades are well known to avoid/rescue failures for example. Ask some ENT surgeons especially the ones who perform Head & Neck operations JJ Henderson also