Clinical Governance is paramount in the effective running of a hospital and should be seen by everyone involved within healthcare as a top priority. This interview with Peter Lee, Senior Medical Officer, Metro South District, QLD Health explores the link between communication and culture and how this effects clinical governance

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Clinical Governance 2011:
Continually improving the quality of services and
safeguarding high standards of care
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Q&A with Peter Lee, Senior Medical Officer of the Clinical
Governance Unit from Metro South District within Queensland
Health
www.austhealthweek.com.au/clinicalgov
Health IQ:
Now maybe, firstly, you can start off by giving us a brief background of your career
and current position in relation to clinical governance.
Peter Lee:
Sure. I currently am dividing – teaching/running a program within the Metro South
District of Queensland that we call Communication and Patient Safety shortens to
CaPS. It’s a training program for healthcare staff but not just clinical staff for
absolutely everybody who works in healthcare. This program has come about
through an evolution I was involved before that with a program called Human Error
and Patient Safety. But before that I’ve had a wide variety of medical experiences
including general practice, refugee camp work, overseas work in remote area stuff,
flying doctor work, and even some medical administration as well. So, quite a wide
variety of things.
Health IQ:
Now, we know that large numbers of patients still suffer adverse events in the
healthcare system. What’s the link between this and communication.
Peter Lee:
Yes, it’s interesting and many people don’t realize that the literature is now bearing
out what healthcare people have thought for a long time which is that communication
breakdowns are actually right at the core of a lot of the things that go wrong for
patients, and so the studies that are coming out now are often saying 70% or 80% of
the things that go wrong have an identifiable communication breakdown somewhere
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2. in the chain of events. It’s always a chain of events – we know that, but if we can get
into the communication stuff which is of course complex, but if we can do
communication better we know that we can improve the safety for our patients a lot.
Health IQ:
Well surely you can change a person’s communication style, it’s part of their basic
personality, right?
Peter Lee:
Interesting. By improving communication we are not trying to change people’s
personality. What we are trying to do is teach them skills, and we see
communication skills as being skills that can be learned and adopted and tried and
played with, very much like we teach people technical skills and we expect for all
healthcare people clinical and non-clinical to be able to teach them the technical
skills of their job, and doing good communication along with things like good decision
making and so on are now being talked about as non-technical skills. So, we’re not
trying to change people’s personality but we are trying to improve their skills.
Health IQ:
Now, can communication training really work, and maybe what results have you
seen as a result?
Peter Lee:
Yes, interesting, and of course, it’s the question everybody wants to know – does it
work? We do know that a lot of health jurisdictions have identified that
communication is a major part of patient harm, but we also know that a lot of them
are reluctant or resistant about trying to do something about it, because it seems
hard and you wonder whether it will work. We’ve actually got good evidence now for
definite effect at several levels of evaluation. We know that people think it’s a good
use of their time for example. There are different ways of looking at that question –
does it work? We know that people find it relevant, we know that they learn things
because they tell us later about things they’ve learned. We know that it changes
their behaviour, and we know that it actually changes the culture on the floor, and
again, let me say that clinical and non-clinical staff get involved in this. Because
everyone communicates and everybody contributes to that communication culture.
So we do have pretty good evidence which I’ll be presenting at the conference.
Health IQ:
You’ve mentioned culture, and I just want to further that a little bit. Can
communication training be a vehicle to improve the culture of an institution and
thereby improve clinical governance?
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3. Peter Lee:
Well, I believe it can, yes. We had such a surprising success with this program that
we devised in this one area with Queensland Health, we’ve kept it quite local, we’ve
done it unit by unit, and then we’ve been asked by entire institutions to train every
single staff member, clinical and non-clinical and so the success that we’ve had is
because the people who have come actually change what they do on the floor and
it’s just so rewarding to get the kind of feedback that we do from middle managers
and from senior managers that they see the culture around them changing and then
we also get similar feedback from the people on the floor saying it’s a nicer place to
come to work and they feel that they’re looking after patients better. So all of that, I
believe does add to an improvement in clinical governance because it makes people
more willing to talk about what’s going on, more willing to address problems that they
find openly without blame and to make things better for patients.
Clinical Governance 2011 forms part of the Australian Healthcare Week a
series of events for healthcare practitioners. You can visit
www.austhealthweek.com.au/clinicalgov for more information or to register
you can call Judy on 02-9229-1000.
Dr Peter Lee, B.A., M.A, M.Sc, B.M.B.S.
Senior Medical Officer – Human Factors and
Communication,
Queensland Health.
Peter’s varied medical career has covered work in Hong Kong,
China, Burma and PNG, as well as hospital, General Practice
and remote area work in Australia, including a year with the
Royal Flying Doctor Service based in Cairns.
Moving to Brisbane, he led Queensland’s highly successful Human Error and Patient
Safety (HEAPS) program for over five years, and he now directs the ‘Communication
and Patient Safety’ initiative that gives staff at all levels the skills and tools to allow
‘communication for safety’ at individual, team and systems levels. He also runs ‘Front-
line Communication’ training programs for clinical and non-clinical staff, as well as
advanced communications training in areas such as ‘Open Disclosure’ following
adverse events.
Before studying medicine, Peter was a ‘human factors’ psychologist, working in the
areas of road safety and aviation safety, with qualifications from Cambridge and
Monash Universities.
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