Learning From Serious Incidents - Support Programme for Trainees

AIMS: A significant number of Psychiatrists will experience a serious incident (SI) whilst in training. CNTW Trainee Led Implementation Committee (TLiC) felt that the trust SI reporting process and support offered for trainees was inconsistent, anxiety provoking and at times insensitive. We decided to review existing processes to support trainees through SIs and develop a programme that addresses these areas. AIMS OF PROGRAMME: Improve trainers’ confidence in supporting a trainee involved in SI. Establish robust mechanisms to support trainees involved in SI METHODS: Process: System for weekly notifications of incidents from trust safety team and producing a useful algorithm to decide thresholds for reporting to Live flow (Health Education North East). Trainee notification of incidents via their named Clinical and Educational supervisors. Trainers support: Produced a template that would form basis of discussion with trainee covering educational and governance areas, resources and support offered- uploaded to trainee's portfolio/form R for ARCP review. Workshop conducted for trainers to enhance their knowledge in supporting trainees. Trainee support: Rolling training programme for trainees-sessions from trust SI team, trainee sharing personal experience of involvement in SI, Coroners Inquest by trust Legal department and Interactive Human factor approach-based case studies. Ongoing support from trust safety team- immediate (team debriefing, after action reviews) and long-term support (SI panel and legal representation) offered to all trainees. Learning opportunities offered - observing coroners and joining SI panels. RESULTS: All sessions rated excellent. Sessions of trainee's perspective, legal perspective and case study discussions being rated the best. Almost all trainees felt that the session would have a significant impact on their clinical practice- in particular contemporaneous documentation reflecting decision making. Many felt the need for an informal peer support group that they could access. Workshop for trainers was also rated good/excellent. CONCLUSION: Creating a culture which supports reporting concerns around safety and focuses on learning is crucial. Trainers often feel ill equipped to support a trainee. Our programme which now includes a peer support group provides a comprehensive and systematic package to help address all these areas and promote a culture of openness with quality and safety being the top priorities, right from a grass root level.