1st place - Self-Care, Resilience and Mindfulness (SCReAM) Course
Project lead - Alexandra Humphreys ST7
Project team - Helen Marshall (University Hospitals Plymouth NHS Trust), Lead organiser, ST5, Alexandra Humphreys (Royal Devon and Exeter NHS Foundation Trust), Organiser, ST7, Phillipa Squires (Torbay and South Devon NHS Foundation Trust), Organiser, Locum Consultant
Project aims:
The aims of the SCReAM course are to:
- Enable individuals to identify symptoms of burnout in themselves and others
- Equip individuals with the knowledge, understanding and techniques to avoid burnout
- Inform individuals of the avenues of help available
- Enable individuals to improve:
- Their resilience to challenging events
- Their management of stress
- Their work-life balance
- Help individuals to prioritise activities that promote wellbeing
- Provide individuals with techniques to improve their interactions with challenging colleagues
The SCReAM course is a one-day course that runs annually. The inaugural SCReAM course was held on 25 June 2018.
Beneficial effects on wellbeing:
SCReAM was designed to address the fact that 56% of trainee anaesthetists in the surveyed region felt that their job negatively affected their mental health, and 82% were found to be at a higher risk of burnout. The team focused on the key recommendation from that report: ‘Doctors should reflect on how well they look after themselves and how they support each other’.
Their initial on-the-day post-course feedback was globally positive with all talks rated as 'excellent' or 'outstanding'.
To determine if the course had a more longstanding impact, the team sent out a post-course impact survey 8 months later. This survey was designed to show if improvements had been made for individuals against the parameters set out in the report. The team achieved a 61% response rate and their results are as follows:
- 100% felt SCReAM was beneficial.
- 100% felt better able to avoid burnout.
- 100% felt able to identify symptoms of burnout in others, and 90% in themselves.
- All respondents felt confident that help was available and knew how to access it if needed.
- In terms of behaviour changes as a result of SCReAM:
- 100% felt more resilient to challenging events
- 90% felt better able to manage stress
- 80% felt better able to manage work-life balance, and now prioritise activities that promote wellbeing.
- 80% felt that it had improved their interactions with challenging colleagues
- 70% have taken up mindfulness practice
- All respondents felt they had a better understanding of mental health issues since SCReAM.
- 90% said they had discussed ideas presented with colleagues.
2nd place - The Sleeping Pod Project
Project lead - David Cronin ST3
Project team - David Cronin (Dept of Anaesthetics and Intensive Care Medicine, North Bristol NHS Trust), Anaesthetics Trainee Representative., ST3, Sarah Dolling (North Bristol NHS Trust)
Project aims:
The aims of this project were as follows:
- Assess the impact of losing dedicated on-call rooms
- Identify a rapidly deliverable solution to this problem
- Assess how introduction of sleeping pods impacted on trainee fatigue and wellbeing
Beneficial effects on wellbeing:
The team's initial survey, responded to by 83% of trainees (30/36), demonstrated that 43% of trainees had fallen asleep driving home after a night shift, correlating with national data. The loss of dedicated sleep facilities was mentioned as a “grave concern” in the comments section of the survey.
Trainees who worked during the period of transition from losing on call rooms to the final introduction of sleeping pods were in agreement; dedicated on-call rooms are ideal (and should be preserved) but sleeping pods are an acceptable minimum standard. New trainees were extremely satisfied with the sleeping pods.
From a subsequent survey, completed by 69% of trainees (25/36), 91% found the pods readily accessible, 79% stated that the pods were comfortable. All trainees agreed that, in the absence of the pods, there would be a significant impact on ability to rest. The only significant issue raised is that they are in a department lit by motion-activated lights. As a result, the lights stay on for 45 minutes after the sleeping pod is accessed. Black-out covers have been put over the pods as a temporary fix and investigations are being made into a fuller solution.
Excellent communication channels between trainees and consultants allowed this project to respond to a need in an acceptable time-frame. The role of the Trainee Representative in this interaction was vital. Going forwards, this relationship will be used to provide timely feedback regarding rest facilities and other issues as they arise. The ‘Sleeping Pod Project’ has been a watershed event that demonstrates how collaboration between trainees and consultants can improve staff wellbeing. Departmental presentations focusing on sleep and fatigue have encouraged dialogue between colleagues, and we have promoted a daily check asking if on call staff have rested and if they are safe to drive home, as advocated by Farquhar et al.
3rd place - Anaesthetic Families - "The Firm - Take Two"
Project lead - Eireann Allen ST5
Project aims:
- Improve trainee experience, value and joy inside and out of the workplace
- Improve access and opportunity for support (colleagues and external)
- Develop a tiered system of support with the aim that all trainee doctors will have at least one supportive colleague they identify with
- Develop a system where trainees can work together to co-produce and develop wellbeing initiatives through sharing of ideas and discussion
- Develop a mentoring network
- ‘Welcome pack’ for trainees with photos of key people (TPD, Rota masters, College tutors, ACTA trainee committee, who-you-should-know!)
- Trainee presence at CT1/ST3 induction
- Bleep-free deanery-wide teaching afternoons four times per year – ‘SESSA training days’
- Regular social events linked to educational afternoons – Edinburgh Anaesthesia Festival (August), Christmas Quiz (December), Spring Ceilidh (March), Families “School Sports Day” (planned May 2019)
- Greatix Awards – acknowledging colleagues who make an important difference to training experiences – for Consultants /ODP/Theatre Team of the Year. Building a positive culture and encouraging Learning from Excellence.
- Development of ‘Anaesthetic Families’ – families made up of Consultants and trainees of different grades.
- Training of mentors through the Association's course
- Continuing with existing buddying system
- Whatsapp groups for each hospital to facilitate rapid communication
- Regular trainee-led ACTA meetings (Chair, Secretary, LTFT, Junior Rep, Social, ICM, Pain, Webmaster roles – elected positions)., intentionally hosted on midweek evenings in a pub with grub available to promote engagement
Beneficial effects on wellbeing:
The 'welcome pack' helps to encourage a warm, friendly and engaged faculty and trainee body that are easily approachable. Pictures have been added to all the important contacts so that faces are recognisable.
Over 100 anaesthetists took part in a very competitive “Families Christmas Quiz”. Consultant staff also organised their own teams if they weren't part of the families teams.
The Association endorsed a mentoring programme. There are now 17 trained mentors, with hopes to expand.
SESSA training days – Focus on “Non-technical skills”. Themes included “What makes a good anaesthetist – through the eyes of others” and “The Expedition – altitude/transfer medicine but also performance-related marginal gains by a sports psychologist”. Written feedback has been resoundingly positive.
Social events – after each training day – Edinburgh festival drinks in August, Christmas Quiz, and Spring Ceilidh with Awards ceremony for inspirational consultants, Intensivists, ODP's and theatre teams. The mantra: Learning from excellence awards – Greatix-ing those who are awesome and go the extra mile!
Trainee forum days – face-to-face afternoons with deanery leads to listen to and respond to feedback.