College Connection Summer 2016

When things go wrong WHY NON-TECHNICAL SKILLS MATTER Jan Robinson For professionals, a discussion on the term competence tends to settle on an individual’s knowledge and skill, the technical nature of the scope of a profession’s practice. And this makes sense – it is the focus of education, of licensure, and of continuing competence. In reality, however, once essential competence is established, the things that go wrong in care delivery are more related to human behaviour and the systems supporting the care, than technical ability. The literature related to patient safety in human medicine purports that approximately 80% of error is attributed to human factors. This statistic is actually borne out in the complaints received by most regulators, where poor communication, lack of supervision, inattention to standards of practice, etc. are more prominent than actual poor medicine. To achieve safe, quality veterinary care the focus of course needs to be on the areas of highest risk to animals. Over the last two years, the College has paid increasing attention to the concept of risk in veterinary medicine and what conversations with the profession might increase attentiveness to managing potential error. Human error cannot be eliminated in practice. In fact, there will unfortunately sometimes be unintentional poor patient outcomes as a result. The question is, are we collectively paying attention to identified areas of risk and working together to minimize them as best we can. So – to pay attention to risks in practise we must include the concept of non-technical skills. While perhaps not a preferred term to the “ears” of a professional, non-technical skills are defined in the literature by Flin et al. 2003 as “the cognitive, social and personal resource skills that complement technical skills, and contribute to safe and efficient task performance.” Non-technical skills are important to any profession and are described as the following seven skills sets: • Situational awareness (attention to the work environment) • Decision making • Communication • Teamwork • Leadership • Managing stress, and • Coping with fatigue Practitioners who exemplify best practice are attentive to this skill set, knowingly or unknowingly, and achieve consistent performance in these areas resulting in reduced risk of harm to patients. The mounting science on this topic is duplicated in other Summer 2016 Vol. 32 No. 2 ISSN 0821-6320 FEATURED Your guide to Quality Practice This issue of College Connection explores Quality Practice initiatives. The College welcomes your feedback on College Connection! professions for example for pilots and their crew; the gas, oil, and mining industries; and surgical teams in human health care. Non-technical skills are fundamentally relevant to the practice of veterinary medicine. The Quality Assurance programs of the College and the profession need to embrace this concept and lead this discussion. Good patient health outcomes, individual or herd, depend on it. To read more about the importance of nontechnical skills in practice: Flin, Rhona H, Paul O’Connor, and Margaret Crichton. Safety at the Sharp End: A Guide to Non-Technical Skills. Aldershot, England: Ashgate, 2008. CONTENTS Professionalism - Respect . . . . . . . . . . . . . . . 2 Decal now available . . . . . . . . . . . . . . . . . . . 4 Learning in Practice . . . . . . . . . . . . . . . . . . . 6 Licensure in Emergencies . . . . . . . . . . . . . . 2 Quality Practice Team . . . . . . . . . . . . . . . . . . 4 Peer Advisory Conversation . . . . . . . . . . . . . 7 Strengthening the veterinary profession through quality practice and public accountability.