Below 10,000 Medical
Surgery Stat! The Game
Fatigue: An Organisational Policy
Fatigue ACORN References
Fatigue Mitigation Frameworks
Executive Level Recommendations 1
NUM's Role in Fatigue Management
Tectonic Plate Tetris Workload Theory
High Performance Health Care Teams
Antus Benner psychologica
Human Factors Study
The Art of BTT
BTT Honour Roll
BTTM Brag Board
Steve Bolsin's Letter of Recommendation
Dr Amutha Samuel's Recommendation
June 4, 2014
A Long Time Ago, in an Operating Theatre far, far away......
One thing that we haven't talked about in relation to our implementation of BTT is the prior work we
inadvertently did: engaging our colleagues in the development of a flexible mindset.
I must admit that this has been an entirely incidental and happy convenience, because to us at the
time, we were just having fun.
But the matter cannot be diminished as I suspect it was a vital co-contributor to our success.
In actuality, we were creating our own brand of offbeat fun. But in doing so we were opening
communication channels, increasing susceptibility among our colleagues to new ideas, educating
them about the value of different ways of thinking, and practicing engagement and feedback
So there was the Great Satellite Lottery when a Near Earth Orbit Asteroid was passing so close to
Earth that it was to pass through the geosynchronous ring.
We printed the entire Wikipedia satellite inventory (all 8 pages), and gave everybody the chance to
pick, free of charge, three satellites they thought the asteroid might knock out of the sky.
We had fun with it for weeks as we recruited, explained, drew diagrams on the whiteboard, and
waited for the moment of truth.
Of course the asteroid missed them all completely, and all three prizes passed to Dr Gordon for
steadfastly refusing to pick any!
There was the 'Finding a Meaning for the word 'Yardang' day', where everybody was asked what
they thought it was. 'Yardang' eventually passed into our vernacular as an expression indicating
surprise, with complete disregard for its real meaning.
Then there was the Lucky Horse Race Sweep of the 18th of August 2011.
We conducted a sweep for the anniversary of a race run in 1984.
Everyone who came into Recovery got to pick a ticket out of a vomit bowl, and all winners won a
Unbeknown to the participants, at least when they picked out their ticket, all tickets in the vomit
bowl had the same name: 'Fine Cotton', written on them.
Except for one, which bore the name: 'Bold Personality'.
So of course, everybody won a prize!
After all, it was a horse substitution racket we were celebrating, wasn't it!
Free Freddos. Much excitement. No complaints.
We went wild with some quantum physics and an empty box one day to the extent that Pete, one
of our technicians, is now a resident expert on the nuances of Schrödinger's Cat.
We've had so many more 'events' that I really can't remember them all.
So when we came to introduce the concept of BTT and we were actually being serious for a
change, we found not only a receptive audience, but an audience who knew we welcomed
engagement, feedback and collaboration all as simply a part of the process.
They also knew we could make the idea fun, and that there was always likely to be a twist in the
marketing campaign each step along the way.
And nope. We didn't expect everyone to be on board straight away.
We took our opportunities as we found them: a noisy theatre here, a difficult situation there, an
ensuing conversation with the parties involved: we sold them the headache, then we sold them the
aspirin, as they say.
There are early adopters, late adopters and conscientious objectors. But that is ok.
We approached people one at a time, starting with those we knew had participatory thinking styles
and whom we knew could give us useful feedback.
Fortunately, those same people also had strong networks, and so, when after their collaboration
they saw the product had merit, they talked amongst themselves.
Thus, much work was done without our knowledge or effort.
The take home message is that BTT was an overnight success that was ten years in the making.
Expect setbacks. Expect resistance. People will be people. Plod along, one conversation at a time.
Success or not, you will have increased the critical mass of knowledge regarding the negative
impact of noise and distractions at sentinel times during an operation.
And you will find when you least expect it someone somewhere sometime engaging in selfselected
affirmative behaviour change.
When you find that person, applaud them.
Patient Safety Learning Awards
September 27, 2018
October 18, 2015
Letter to John Gibbs
October 17, 2018
Weather or not
November 8, 2019
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