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24 October

Theatres launch '10,000 feet' safety initiative

Theatres set international standard

Theatres have launched a three-month trial of a new safety initiative that is hoped will empower all members of staff to speak up and help prevent serious incidents.

If any members of the operating team have concerns during a procedure, they can call ’10,000 feet’. Everyone is then required to stop, think and focus on the task at hand without distractions.

The concept is taken from the aviation industry. After research showed the majority of incidents occurred at take-off and just prior to landing, all non-essential communication in the cockpit was forbidden, allowing the pilots to fully concentrate on their jobs.

The idea was adopted into operating theatres by two nurses in Australia and was then introduced into the UK by nurse Robert Tomlinson at East Lancashire Trust.

Theatres’ matron Nick Archer read about the East Lancashire’s award-winning work as part of his degree research and was keen to bring to the concept to Mid Essex.

“When we’re in the theatre, we need absolute engagement, quiet and concentration. And when something isn’t going right, we need a safe phrase,” said Nick.

“We’ve introduced mobile phones, computers, radios and bleeps into the operating theatre environment, and you’ve got a patient in the middle. Then you introduce anaesthetists, surgeons, ODPs, nurses and radiographers, and there is a chance that concentration can be lost.

“This is a great opportunity to give anyone within the room the confidence to challenge because we have specific times – for example when a patient is about to have their anaesthetic or where they’re emerging at the other end – when it’s really important that there’s quiet. We’ve also had incidents where if somebody had have spoken up we may have possibly prevented something.”

Nick hopes that the introduction of the initiative can lead to a shift in culture.

“They rolled it out in East Lancs and it’s been a huge success. They’ve won lots of awards for patient safety and improvement and they’ve been mentioned in a CQC document which talks about changing culture.

“To change the culture, we want people to recognise that we do need to do things slightly differently. There are human factors that are involved with many of these incidents but this is about teamwork and communication and empowering staff.

“10,000 feet can flatten hierarchy and deescalate the emotion – it gets rid of the shouting, the finger-pointing. It gives that safe voice to every person in the room and it evokes a behavioural response that accords with best practice.

“We’re going to trial it for three months and then at the end of it we’re going to review the feedback, survey the staff and look at whether we need to tweak it. We’ve got the backing of the senior leadership of the hospital and it is something we’re looking to embed for the long term.”