Working towards a safer IR department: “Developing common purpose and objectives”

“Concentrating on hazard identification, developing safety policies and most importantly, changing the culture in the team to engage meaningfully with these processes” was a principal message presented by Costa Tingerides (Leeds Teaching Hospitals NHS Trust, Leeds, UK) at the British Society of Interventional Radiology (BSIR) annual scientific meeting 2022 (2–4 November, Glasgow, UK), who spoke on his experience as safety lead in a teaching hospital’s interventional radiology (IR) department.

SPEAKING TO DOCTORS AND OTHER professionals, Tingerides explained how he found it difficult to get universal support on safety processes within the department as there was lack of consensus on what the priorities should be: “I propose to you that there is a spectrum of perfectly reasonable attitudes towards safety” he continued, “on one end you have got Atul Gawande and The Checklist Manifesto approach to safety and on the other end you have got the Charles Dotter approach with the core values of innovation, courage, tenacity […] I think that most IRs [interventional radiologists] if you ask them, they will place themselves towards Charles Dotter so I had my work cut out for me.”

Using examples from other safety critical industries, Tingerides emphasised the paramount importance of developing and adhering to safety policies in reducing risk in a meaningful way. He argued that healthcare is not on par with other safety critical industries in this domain. He supported this position by outlining a recent highly publicised independent investigation led by Bill Kirkup concerning failures in East Kent Maternity Services. He pointed out that despite numerous inquiries on similar failures, the same systemic problems remain.

Tingerides expanded Kirkup’s thesis that the failures identified in East Kent were similar to those found in previous initiatives and investigations over many decades. The response to those failures were unsuccessful in preventing a “recurrence of remarkably similar sets of problems in other places”. Kirkup outlined a set of recommendations aimed at improving safety culture. These include monitoring safety performance and addressing flawed teamworking.

Concluding his report, Kirkup stated that his recommendations are not “easy or necessarily straightforward” to implement but they must be addressed “if we are to break the cycle of endlessly repeating supposedly one-off catastrophic failures.”