March 6th 2014 is Change Day in Australia. Change Day is a movement promoted by individuals working within the health system. It is all about each of us Making a Pledge to do one thing (or many things) to improve the health and wellbeing of others. What pledge can you make to improve patient, client and consumer health outcomes?
I’ve got to thanks Tessa Davies of the excellent paediatric emergency medicine site Don’tForgetTheBubbles for putting me on to this – change is something that I have struggled with – not so much to get used to (the alternative to evolution is, after all, extinction!). Rather I have struggled with making change happen…
Some things seem blindingly obvious as amenable to change in my (albeit small) pond. I am interested in the translation of new concepts that will make a difference in patient care, particularly in my interest of emergency medicine and airway management – indeed the focus of much of my blog posts is around this. There are some GREAT ideas out there via the FOAMed community, many of which have immediate practical application to the world of rural medicine.
My dream has been to incorporate that into my local institution – and to spread the paradigm wider amongst the SA country hospital community and further afield. Sadly effecting change has not been an easy process.
These are by and large simple ideas – what many FOAMed people would consider ‘no shitters’ :
- apnoeic diffucion oxygenation and use of challenge-response checklist with kit dump for ED RSI,
- participation in the national airway registry,
- airway plans A-B-C-D clearly articulated in theatre with the availability of appropriate difficult airway equipment
- use of low-fidelity, high rep sim for in situ training of clinical staff (doctors, nurses, paramedics),
- crisis management and action cards for use in ED
- promote FOAMed as a powerful asynchronous learning tool for rural clinicians
…sadly this has been harder to action that I would have anticipated. Lack of clear leadership within Country Health SA and local resistance to ‘crazy shit on twitter’ has not helped my enthusiasm, but I will keep plugging away.
So my motto for change has been to slow down, relax and to ‘smile and wave’ – to change the things I can change, and not to worry about the things I cannot.
“Seven days in the week – ‘someday’ and ‘one day’ aren’t them.
Live your dreams, embrace change in life”
More inspiring change pledges were made from my mate Casey Parker up in Broome – my spies (well, rural generalist about Oz Jamie Doube who spent a few weeks locuming up there) tell me that as a locum he was unable to commence a case until plans A-B-C-D had been verbalised. Sensible policy, particularly when locum docs are around. Casey has made a brilliant pledge for ChangeDay – read his piece on The 7 Laws of Diagnostics.
Meanwhile – what is YOUR pledge?