26th September 2016

On the 26th September 2016, the Royal Hospital for Sick Children (RHSC) hosted its first Clinical Change Forum event.

The audience heard three thought-provoking presentations from different teams from the RHSC. Each presentation highlighted fantastic improvement projects, and prompted discussion with the audience about the challenges encountered when delivering some of this work.

Following the success of the forums held in June, the RHSC event continued with the theme:  ‘How do clinicians and patients manage risk in challenging situations?’

Every day clinicians have to make decisions based on risk. Increasingly these involve balancing clinical, safety, patient choice and other factors.

For example:

• Patients with ‘unsafe’ swallowing function but who ask for standard feeding 
• Patient asks for a specific treatment which is reported to be benefiting people with their condition; clinician feels it will not benefit the patient in their case
• Surgeon discovers new risk factor for an operation on the day of theatre; patient says they do not want to delay and will accept the extra risk 
• People who desperately want to go home from hospital but professionals feel discharge will be unsafe
• ‘Best Practice’ guidelines recommend admission; the individual asks to be treated at home.

And there are many other instances.

Clinicians often feel under pressure to ‘own’ these risks.  The reality is more complex and there are dangers in over-simplification. 

Clinical change forums provide an opportunity to have a wider discussion and to raise issues of specific cases.  By doing so, we hope to increase our collective awareness and understanding of the realities of these complex but everyday situations.