Opening the Door to Patient Safety

The interview from last year resonates with me as a whirlwind of emotions, weaving together moments of insight, humour, challenges, and risks. Looking back, it was like the bold act of an unsuspecting child knocking on the door of an ogre’s castle. The slumbering giant wakes up and consumes the audacious child, yet in doing so, the once seemingly impenetrable castle door swings open. Facing the giants of bureaucracy and politics may have come at a personal cost, but the subsequent influx of much-needed investment and oversight into my organisation honours the purpose behind it all.

So, what lies ahead in this continuing journey? With the shift from a clinical role to a managerial position no longer necessary, I find myself free to refocus on the core purpose that brought me here: compassion as the foundation of patient care and safety. Exploring how cultivating collective mindfulness can inspire organisational compassion and pave a new way forward …

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Another Way

Our hospital is in difficulty. There is no getting around it.

A Zen insight my teacher once shared is as our meditative practice deepens, our ability to hear the cries of the world also grows. Hearing those cries our deep bodhicitta (heart of love) is touched and (in time) leaves us with little choice but to respond.

It seems that time may have come for me. Hearing the cries of my hospital, sometimes literally in its corridors, I put myself forward recently to take on a new role, well outside my traditional boundaries. The interview was last week and here is a brief summary of what I presented.

I started with where we were as a hospital. This was straightforward enough. Four different reports (three within the last year) make clear beyond argument how difficult the current situation is. Yet a report can at best only touch the surface of what is happening. To understand the real human suffering underlying any report we must be able to open our hearts with compassion and courage.

Embracing the suffering, instead of denying it or finding someone to blame, opens not only our hearts but also our minds. It creates the space where we can explore why and learn from it – strengthening the roots of understanding of what can be and how to get there – in a partnership of equals.

For me, I have the aspiration of seeing our hospital become a high reliability organisation. Where at any moment thousands of errors could happen but don’t. A system and culture that have been nurtured in a way to prevent potential catastrophes from manifesting. In a word, an organisation that has developed its own “collective mindfulness”.

Where does an organisation find the energy to do this ? The literature on large scale change provides a clear answer – there are five sources and each of them play a crucial part in the journey.

Nurturing and directing these energies require a different kind of leadership as well – technically referred to as “ambidextrous”. Where we use both our logical and our creative human strengths to let our best selves shine – as an individual and as an organisation.

The journey is not easy. Even more difficult might be acknowledging the harsh reality of how our hospital reached this moment and facing this with honesty, hope and patience. Yet only by doing so can we give birth to the foundation of a compassionate culture, a clarity of systems and a loving community.

I closed with a message of hope and the belief in a future our hospital could move towards. In the words of Nobel laureate Rabindranath Tagore, (a hospital) where the mind is without fear, and the head is held high

The decision now lies in the hands of a chosen four. Regardless of the outcome, my personal aspiration is to continue growing a heart of love and finding skilful ways it can express itself in my community.

Waking Up

Waking up, I smile …Thich Nhat Hanh

The last few months have been a time of personal and professional awakening.

Waking up to the physical reality of being human. Of having to accept I am not immune to the impact of the relentless pressure of the pandemic on my Emergency Department, nor to the devastation of the HSE cyber attack. And that even if I pretend otherwise, my body knows and sooner or later illness is inevitable.

It’s also been a time of pragmatic awakening. To the reality of life as a coloured doctor in Ireland. Acknowledging the presence of a systemic discrimination that is so deeply embedded it is practically invisible to those who perpetuate it. And more importantly, adapting to what is and isn’t deliverable to patients when their care is provided for by someone of colour.

Awakening is true when accompanied by action. And actions are true, when they come from a place of love, rather than from one of fear or hate.

For me, a first step is coming back to the core practice of loving kindness (“metta”). To hold in love and understanding the pain and suffering I see in and around me. And from this place of compassion, to explore how I can best use this precious life energy to alleviate suffering and discrimination.

WPW – Week 6 RPR

“For wood to burn and release its light, it must be given space.” Zen teaching

Any concerns I may have had about losing momentum were easily laid to rest this week. The ED registrars leading on different projects are moving forward with a core energy that is a privilege to nurture.

It feels like the time is right to set up a new page tracking progress more formally than these end of week blog entries. Work for the week ahead.

Closing this weekend with the personal nourishment of attending a Peaceful Hearts retreat and understanding more deeply the roots of compassion.

Start of a Journey #AnotherWay

It’s a little over three decades since I joined medical school and I find myself starting a new journey – exploring deep compassion in clinical practice.

I will be doing so through a Masters program “Human Factors in Patient Safety” offered by the Royal College of Surgeons of Ireland from this September. A little nervous, and very excited.

Human factors” can mean different things to different people. For me, it is about exploring how compassion influences the interdependence between human beings and clinical systems. Anyone who has experienced genuine compassion knows the effect it can have on clinical outcomes – how might it be possible to reproduce this at a “system” level ? And if we did, what kind of effect might it have ? In short – could there be #AnotherWay to how we deliver care ?

I hope to share what I discover over the coming months through this blog …