JHCMoments
Don’t Let This Window of Opportunity Pass You By!
On 25 June 2024, the Medical Affairs department hosted an impactful talk titled “Don’t Let This Window of Opportunity Pass You By!”. Sponsored by Marsh Singapore, the talk aimed to emphasise the importance of promptly recognising and responding to medical emergencies and critical test results. The session featured speakers Dr Juan Sze Joo and Dr Jimmy Lee from Emergency Medicine, and Dr Shanaz Sajeed from Intensive Care Medicine.
The discussion centred on a clinical incident from JHC, providing relevant insights into the importance of rapid response and decision-making in critical situations. Our staff were introduced to tools and techniques designed to enhance their abilities in managing high-pressure emergencies. The key takeaway was that proper crisis response skills can save lives, highlighting the critical need for healthcare professionals to react calmly and communicate effectively during medical crises. This session was particularly beneficial for frontline staff seeking to improve their competency in emergency management.
Dr Juan Sze Joo opened the talk by stressing the importance of accurate and timely diagnoses for positive health outcomes. She highlighted that diagnostic errors, including delays and inaccuracies, often lead to poor patient outcomes. This aligns with the theme of "Improving Diagnosis for Patient Safety" for this year's World Patient Safety Day on 23 September 2024. Dr Sze Joo emphasised the need to investigate root causes of incidents to learn from mistakes and prevent recurrences. Common issues include knowledge gaps, poor procedures, inadequate communication, and staff burnout. She also shared mitigation measures at JHC, such as HMS notifications, code red alerts, and improved staff allocation and scheduling.
Dr Jimmy Lee shared insights from the incident, stressing the importance of escalating issues to senior staff when necessary. Using the analogy of "smelling the cheese," he advised attendees to recognise personal thresholds and detect lapses as abilities degrade under pressure. He emphasised identifying emerging crises through environmental cues, clear communication, and promptly engaging backup support to prevent minor issues from escalating into major incidents.
The final speaker, Dr Shanaz Sajeed, discussed tools and techniques for improving decision-making and communication under pressure. He drew parallels between aviation and medicine, noting the need for high-stakes decision-making and communication skills in both fields. In medicine, professionals follow "diagnose, treat, communicate," similar to aviation's "aviate, navigate, communicate." Dr Shanaz outlined situational awareness involving recognising cues, synthesising them, anticipating developments, and prioritising actions. Experts rapidly analssyse situations by pattern matching against prior experience. Effective communication, he stressed, involves the 7Cs: Cite names, Call it out clearly and concisely, Choose words wisely, Command if needed, express Concern, Close the loop, Clarify if needed, and Can say can, cannot say cannot.
Good decisions are made with 40-70% of available information, avoiding both impulsive decisions and analysis paralysis. The FOR-DEC method provides a framework for time-critical decisions. Dr Shanaz emphasised using all resources, including staff, space, equipment, information, and processes. He urged nurses to escalate issues directly to senior doctors for red zone patients, as messaging is often insufficient. He also advised against cancelling automated code blues, as these alerts indicate critical parameters, not just cardiac arrest.
The event featured important exchanges between stakeholders. Chief Nurse, Ms Ng Sow Chun, emphasised the need for nurses to promptly escalate issues to doctors when patient safety is at risk. She stated that nurses should be commended, not criticised, for appropriate escalation and urged reporting any senior doctor who reprimands a nurse for proper escalation to senior nursing staff. Chief Nurse also advocated for a cultural change, emphasising that escalation is about caring for patients and staff and that it is our shared duty to prioritise patient safety through timely escalation.
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The talk provided valuable insights and practical skills for our staff, reinforcing the message that being prepared and responsive in medical emergencies can significantly impact patient outcomes.
