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Writer's pictureThe Communiqués

Clinical Communiqué Volume 7 Issue 1 COVID 2020


In this edition

  • Editorial

  • Clinical Decision-Making

  • Working in Teams

  • Transferring Critically Unwell Patients

  • Communication in the Workplace

  • Fixation Errors

  • Learning from Influenza Epidemics

  • The Polygon of Patient Safety


Editorial


The COVID-19 pandemic has fundamentally changed the world as we know it. The ways in which we now interact with others, do our jobs, and spend our days, are being dictated by the alarming features of this highly infectious virus. At a time when we have to navigate through constant changes, in the face of competing demands and an extraordinary influx of information, it is easy to become concerned and frustrated about how we will be able to continue to deliver quality care to our patients. There is a lot of COVID-19 ‘noise’ around us at the moment. One of the challenges is learning how to find the signal in that noise; and remember the things that will help us perform our roles in times of crisis.

The Communiqués team recognises the need for clinicians to focus on the present and pay close attention to local practice changes. In every health care jurisdiction, there are people working hard to train and prepare their staff for the predicted surge in patient numbers. As such, we do not wish to add to the current arsenal of policies and protocols about COVID-19. Instead, we want to reflect on the wealth of knowledge our experts have shared with us over the years. Lessons on good communication and decision-making, working in rapid response teams, avoiding cognitive bias-related errors, optimising the management of transfers for critically unwell patients, and planning for respiratory pandemics. When our workflows and teams and practices are forced to change for COVID-19, it is imperative that we go back to first principles. By applying systems thinking over everything we do, we mitigate the potential for risks and errors arising in unfamiliar situations.

In this special feature, we have selected six past editions of the Clinical Communiqué that address key themes for improving patient safety. We recall the expert commentaries for each of those themes and reflect on a few practical considerations that are specific to managing COVID-19 patients. We also present our Polygon of Patient Safety as a critical reminder of the need to constantly learn on-the-go and maintain staff well-being throughout this period.

As our team is predominantly engaged in critical care, aged care, and public health, our focus will be on efforts to support the health care community through the pandemic. Depending on how that unfolds will determine whether we are able to maintain our planned schedule of publications. We will endeavour to return to our usual format for the next edition and continue reporting lessons learned from deaths in acute health care settings investigated by coroners’ courts. Although COVID-19 dominates our thinking at present, it is important not to lose sight of how to safely care for other patients and other clinical conditions during this health care crisis.

There will come a time when the coronial system may look at health care-related deaths in the COVID-19 pandemic to determine whether preventable harm occurred. Until then, we need to utilise lessons already learned to be proactive in our environment, nimble in our response, and adapt quickly in our clinical encounters to keep our patients and ourselves safe.

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