Howard Ryland speaks to Celia Ingham-Clark
What inspired you to get involved with FMLM?
I feel it's important for medical leaders and managers to be able to network with others who face similar challenges. Many of the roles we fulfill don't come with a rulebook on how to do it, so we either have to work it out for ourselves, or "phone a friend". I have found the contacts I have made through FMLM very valuable, and they have helped me develop my professional role. For trainees and medical students FMLM offers wide contact with medical leaders at various stages in their careers and thus an opportunity to learn from their experiences.
What impact will revalidation have for doctors in training and medical students?
Revalidation is already having an impact on doctors at all grades. It's designed to show that we are up to date and fit to practice. I think for students and trainees it gives a clear message to define your scope of practice and perform as well as you can in that arena. It will show that for senior as well as junior doctors there is a personal professional responsibility to continue to learn not just clinical knowledge, but also how to communicate effectively with patients and colleagues and to strive to improve the quality of care that you provide. I also think it will deter people from doing locum jobs in specialties outside their previous experience, which has to be good for patients.
How can trainees and students gain the skills to most effectively improve the safety of their patients?
The best way is to go through the experience of being a patient yourself and see where the gaps are! Failing that, imagine that your patients are all close relatives for whom you want to make sure everything is done as well as it can be. Don't cut corners. If you see something that looks unsafe, it's your responsibility to either fix it or to alert someone who can. One of the difficulties for some doctors is in recognizing the importance of following a set of rules, rather than simply being clever and creative to solve a medical problem. The example I would give is using a care bundle approach to put in central lines. Where this set of rules is followed properly, the rate of central line infection is much lower.
What advice would you give someone embarking on their first quality improvement project?
For your first quality improvement project choose something simple that is directly in your area of work. For example when I worked with a group of medical students in a Day Surgery module, they chose to find out if patients would prefer to walk to theatre rather than be pushed on a trolley. They used a questionnaire with all the patients in our unit for a two-week period, and found that the vast majority wanted to walk, because they felt more in control of what was happening to them. We changed our practice, and saved loads of portering time as well as improving patients' experience. The students wrote it up and got it published too.
What are your top tips for aspiring clinical leaders
Top tips for aspiring leaders. Every doctor is in a leadership position, since we get to make far more decisions about patients' care than most other health care professionals. Watch how others do it, and learn from the good and the bad. Maintain your passion for high quality patient care, and work to deliver it. As a trainee, it's possible to do something to improve quality and learn some leadership skills in every post you do. Plan at the start of each post, and reflect at the end on what you have learned.