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After finishing the last surgery late, an operating nurse shares unwanted news with another surgery patient.
“I am really sorry to tell you that we won’t be able to complete your surgery today.”
The patient is visibly and understandably upset. She hasn’t eaten all day, took time off work, arranged childcare and even had her sister fly in to help her recover.
This time it is a make-believe scenario, acted out in a Sydney conference room by Nova Scotia Health staff and physicians, but their role-play drives home the real-life frustration patients and health care providers feel in these situations, and a problem they desperately want to avoid.
Perioperative (Surgical) Services team members from Cape Breton Regional Hospital (CBRH), Glace Bay Hospital (GBH), Northside General Hospital (NGH) and St. Martha’s Regional Hospital (SMRH), along with some Labour and Delivery staff, recently took part in the Theatre Arts Program offered by the Canadian Medical Protective Association (CMPA).
The two-day program equips teams to dig into real-life challenges impacting the teams that deliver and support surgical care, their patients and surgical access and quality. From there they come up with plans to adapt to these challenges, while also gaining required continuing education credits.
Four team members had planned to travel for the program but instead gained support to bring it to Sydney -- allowing more of their colleagues --and ultimately patients -- to benefit.
More than 30 team members from the Eastern Zone (Antigonish & Guysborough Counties, and Cape Breton Island) participated, including surgeons, anesthesiologists, operating room, recovery room and labour and delivery room nurses, registered nurse first assistants, medical device reprocessing staff, leaders, and quality team members.
After working through various learning activities and brainstorming sessions, teams wrapped-up the program by acting out a specific problem and the presenting the solution they planned to action with their colleagues, and ongoing support from CMPA coaches over the next year.
A CMPA surgeon representative and Eastern Zone Perioperative Services Director, Cathy Lynn Howley evaluated each “elevator pitch”, offering feedback on the ideas, with the overall group voting for the most clear and comprehensive pitch.
A CBRH team’s plan to support immediate skin-to-skin contact following c-sections secured them the most peer votes, but Howley is confident each project will support important improvements for patients, while leading to a stronger, more collaborative team.
“This event was truly remarkable, and I would highly recommend it for any perioperative team,” she said. “While the quality improvement projects developed by each team are important there are also hidden benefits such as creating psychological safety within the team, improving individual and team performance, gaining the perspective of each team member, and as a result, strengthening the team.”
“Seeing the interdisciplinary teams problem-solve and work together was amazing, and I am excited to see the teams work with their coaches over the coming months to implement their improvement projects,” said Howley.
Back in their workplaces, the teams have been engaging with other colleagues around six quality improvements ideas:
Eastern Zone Perioperative Quality Lead, Susie Hardy, who was part of the group that originally planned to travel for the program, was thrilled with the program participation, design, and outcomes.
“I was extremely impressed by the design of this program. Each learning activity was strategically designed to challenge us to work interdependently in meaningful ways,” she said.
“We showed up day one with ideas to improve patient care and safety and left at the end of day two with the tools and plans we needed to move our projects forward. The teamwork between our physician group, nursing staff, and medical device reprocessing team members was outstanding. I highly recommend this program.”
Her colleague, Dr. Eileen Roach, who is a general surgeon at the Cape Breton Regional Hospital agrees.
"The CMPA Theatres Arts course was a valuable opportunity to connect and collaborate with my perioperative colleagues. I learned so much about their roles, the expertise they bring, and the unique challenges they face day-to-day when trying to enact change. I truly think the experience brought us closer together as a team."
Initiatives like this one are an important part of Nova Scotia Health’s overall focus on improving surgical access and quality improvement.
Learn more about the ongoing quality improvement focus in the zone -- Meet Nova Scotia Health’s Perioperative Quality Improvement Leaders: Susie Hardy, Eastern Zone.
From left to right: Dr. Gillian MacMullin, Obstetrician-Gynecologist; Dr. Stephanie Lapierre, General Surgeon; Susie Hardy, Eastern Zone Perioperative Quality Lead and Jenna Coleman, Perioperative Registered Nurse, spearheaded this opportunity for the Eastern Zone Perioperative Services team.
Participants' choice: The collaborative labour and delivery and operating room team from CBRH received the most votes for their presentation. Their project will help support immediate skin-to-skin contact following c-sections. Research has demonstrated the importance of this contact for both birthing parent and newborns, including reducing stress hormones, supporting early bonding, supporting the initiation of breast feeding and more. Despite these known benefits, it can be less common to initiate this contact immediately following c-sections.
Team members and CMPA coaches wrap-up the successful event in Sydney.
A team from CBRH finalizes their plan to improve after-hours emergency procedure bookings.