Norwich PEM goes to DFTB19: Day 3

Although the conference was nearly over, the slate of talks for the final day showed no signs of slowing down from the pace of the last 2 days. With a focus in the first few days on evidence and EBM, I decided to change it up and focus on wellness and change in the NHS. As ever, here are my takeaways from the final day of DFTB19.

Morning Keynote:

Russell Viner on Metamorphosis: Adolescence

• Take home: Adolescents make up of the largest groups attending A&E. We fiercely claim that children are not just little adults, but do we treat adolescents as just big children? The different physiology and science at this age deserves it’s own attention

Nehu Rauktar on Seeing Stars

• Take home: Recovery from concussion takes longer the younger the child is. A teenager will take 10-14 days to recover. We aim to minimise the stimulation in the post-concussive period, but this needs to balanced up with the educational and academic needs of the child as well

Anne Weaver on Maturing your approach to trauma

• Take home: Trauma in the adolescent age group requires a mixture of skills from adult and paediatric trauma teams, but if they have never worked together, this will affect patient care at the trauma response. Simulating adolescent trauma and bringing the paediatric and adult trauma services together for this will cut down the risk of things going wrong

Morning breakout

Emily Rose on Growth Mindsets

• Take home: Failure does not define you. Failure is a growth opportunity. You can never be too old or too set in your ways to change.

Dan Magnus on Creative solutions for a broken system

• Take home: “You don’t have to set yourself on fire to keep others warm” was a rallying call for Dan when he took over as clinical lead at Bristol Children’s Hospital, and is an important message in an era of increasing rota gaps, and pressure on systems.

Neil Spenceley on Playing Chess

• Take home: We are approaching patient safety in the wrong way. We construct a reason for error, rather than fine one. Instead of asking what went wrong, we should be asking what went right? If something goes well, it cannot go wrong at the same time.

Afternoon breakout

Russ Horowitz and Cian McDermott on POCUS

• Take home: POCUS is designed to answer a binary, fixed question, fast. It doesn’t replace “traditional” radiology services, but can work beautifully alongside it.

Giles Armstrong on Don’t go breakin’ my heart

• Take home: Curiosity is the key to not missing fringe safeguarding cases. If something doesn’t quite add up, ask the child or parent about it. Be clear and open in your questioning, so that it is clear you are being nosy, don’t flirt around the subject.

Elizabeth Herrieven on Your song

• Take home: Communication with people with learning difficulties is complex, but we absolutely must get it right. If in doubt about how best to communicate with the child, ask the parents, they know the child much better than you, and can effectively break the barriers between healthcare staff and the patient

Afternoon Keynote:

Andy Tagg on Mirror, Mirror, on the wall

• Take home: The three most virulent people in your department are The Maverick, The Moaner and The [****] Magnet. If all of these personalities are found in The Leader, the problems are compounded. Engage The Maverick, and help protect them from themselves. Engage The Moaner, before their negativity becomes infectious. Engage with The Magnet, and check the most important parts of your department, to minimise the chances of things going wrong when the shit hits the fan

Fiona Reilly on The Travelling Doctor’s Suitcase

• Take home: When we are in the middle of the grind, we often lose sight of the bigger picture. Everything that we do, every skill that we learn, every piece of knowledge that we acquire is all in the pursuit of improving the lives of children. Never lose sight of that bigger picture

Ross Fisher on Curiosity is the wick

• Take home: Curiosity is the one thing that will make you a better clinician, educator and person. Curiosity in medicine is the reason we have stopped leeching patients, and why we now vaccinate. Always in your clinical life, ask yourself “what?”, and embrace the curiosity that leads to change.

And that wraps it up! An inspiring, revolutionary, and challenging 3 days in London. I am exhausted, but elated. DFTB19, you have been brilliant. Roll on Brisbane in 2020!