This document discusses performance optimization in healthcare. It addresses questions like what, why, who, where, and how to optimize as well as examples of optimization. Key points mentioned include optimizing for different roles like doctors, nurses, and managers. The document also discusses metrics like competence, confidence, and "safeness" as well as strategies like simulation and debriefing to aid in optimization. References are provided to related publications and educational resources.

1. Performance
optimisation
@damian_roland

2. “Are you dead?”

3. What are we optimising?

4. High Likelihood Low Likelihood
Low criticality
High Criticality
What are we optimising?

5. Why are we optimising?

6. Who are we optimising?

7. FY1 / FY2 CMT
ACCS Paediatric HST
Medical Student
Student Nurse Band 6 ED Nurse
Trust Grade
Anaesthetics

8. FY1 / FY2 CMT
ACCS Paediatric HST
Medical Student
Student Nurse Band 6 ED Nurse
Trust Grade
Anaesthetics
Pharmacy

9. FY1 / FY2 CMT
ACCS Paediatric HST
Medical Student
Student Nurse Band 6 ED Nurse
Trust Grade
Anaesthetics
Pharmacy
Managers

10. Your colleagues

11. Where are we optimising?

15. How are we optimising?

24. “How much fluid did you give?”
“10mls/kg”

25. “How much fluid did you give?”
“10mls/kg”
“How much did they weigh?”
“Oh No! They didn’t weigh 11kg, they were 11 years
old!”

26. via https://emblog.mayo.edu

27. “Simulation is the set up for the
debrief.
Perfect debrief is one in which
the instructor would say
nothing.”
- Mike Sterling (NASA)

29. Thanks @srrezaie
“Arrogance in the face of competence”
– Nassim Taleb (or the Druning-Kruger Curve)

30. Roland et al. A qualitative study of self-evaluation of junior doctor performance:
Is perceived ‘safeness’ a more useful metric than confidence and competence?
BMJ Open 2015;5
Clinical
Performance
outcomes
Competence
Low High
Reported
Confidence
Low Safe Suboptimal
High Unsafe Safe

32. “Share your knowledge. It is a way to achieve immortality.” – Dalai lama XIV

33. Google “Damian Roland” for email
@damian_roland
Please follow
East Midlands Emergency Medicine Educational
Media (EM3
)
@EM3FOAMed

34. Roland D Have we forgotten to teach how to think? Emerg Med J 2017;34:68-69
@damian_roland

35. Roland D Have we forgotten to teach how to think?
Emerg Med J 2017;34:68-69 @damian_roland