Ace of Spades:
Infection Control

Hand Hygiene. One of the simplest and most important things we do.

So why did we do so badly in our audit?

READD all about it.

An ideal opportunity to explore the matter.

The BTT way.

3 of Spades:
Human Factor Ergonomics

The mantra of modern healthcare: Flow, Flow, Flow.

How we do what we do is as important as what we do.

Poorly designed systems fail to lead with fluidity to the next step:

Stop. Think. Design. Do. 

Help us help you expend less energy and bandwidth doing what you do.

5 of Spades:


If it ain't written, it ain't done?

Everything makes sense when you read it in the context of here and now.

But how do you recreate that context if you ever have to defend your actions in five years time?

Menna and Sally give the BEST talk on 'Legal Issues: Reflections of an Expert Witness'.

I could listen to it ten thousand times!

7 of Spades:

Why take our word for it? Go where the experts go.

Whether you are a manager or a clinician, it is important to know what to expect from yourself and also from others.

Don't aim for the bottom line which seems to scream:

"You are competent so long as you have not been proved incompetent."

Do better. Reach for  the stars!

9 of Spades:

Self Care Strategies for Operating Theatre Nurses.


We spend so much time in high end thinking and high end doing.

It is expected of us.

How can we set ourselves up to succeed when burnout would see us fail?

Game theory mathematics to the rescue!

Jack of Spades:
Effective Teams

So you think you are a high performance team?

Try these simple questions:

What are the roadblocks which prevent you being effective?

When and in what way will the next person be harmed?

Who is your leader, when, where and how?

Is your voice welcomed and heard by all in the team?

Are your needs considered in decision making algorithms?

King of Spades:
Root Cause Analysis

In a blame culture, we stop looking for reasons as to why something happened as soon as we find someone to blame.

It feels final, right, powerful..... and wrong.

In the absence of purposeful negligence, it is likely that other things, including systems failures, will have contributed to the outcome.

It stands to Reason. James T Reason. Would you like some Swiss Cheese?

2 of Spades:
Situational Awareness

So what does Elaine Bromiley have to do with Situational awareness?

Just watch the nurses.

Situationally aware, they respond appropriately and proactively.

The fact that no-one listens is a totally other point.

"Below Ten thousand! Everyone stop, look and listen!"

4 of Spades:
Systems Processes

What can Bean Squeeze contribute to a Post Anaesthesia Care Unit?

Quite a lot, it seems.

Handling surge phenomena; developing systems approaches; strategic reactions to dynamic situations; the concept of 'the build'!

With thanks to our newest member, Anita. See what fresh eyes can see!

6 of Spades:
Identifying Deterioration

I recently noticed a pamphlet for a course:

"Care of the Deteriorating Patient: This innovative course has been designed to assist clinicians achieve the Australian Commision on Safety and Quality in Health Care NSQHS Standard 9- Recognising and Responding to Clinical Deterioration.


Guess what? It was the READD, backwards! 

READD = Identification and Care of the IMPROVING patient?

8 of Spades:

We thought we would never make it.

But we always struggle through.

But is it the best way?

ACORN's new fatigue guideline says we could do better.

Pete knows. He helped write it.

10 of Spades:
Below Ten Thousand

'Below Ten Thousand': A bit of everything in this!

A ground-up culture change using guerrilla marketing techniques.

In particular, 'Below Ten Thousand' is a strategy to quickly gain a cognitive environment that is free from ambient noise and distractions at sentinel times as well as gaining heightened situational awareness.and affirmative team behaviours.

Queen of Spades:
Graded Assertiveness

In 'Why Hospitals Should Fly',

A good example of graded assertiveness:

When you know something should be done, and no-one is listening, ask twice, then if you still haven't got the response you need, simply do it.

"We should dump some fuel."

"We need to dump fuel."

"I'm dumping fuel."

? Clinical Intuition ?

So, I was working in Cardiac, and I was telling the anaesthetists about my upcoming trip to Sydney to present on the READD, and the amazing Dr Alan Burton says: "So what have you made the Joker?"

I'm like..."I dunno. I haven't been able to come up with anything...."

To which he replied: "How about 'intuition'?"

We got into an interesting discussion about it, and is it!

from You !!

Got an idea?

Have you engaged with a student on topics in the READD?

Have something else in mind other than what we have so far?

We would love to hear from you.

You can do it.

Go on! Click the button!