When our Birth Outside The Box team decided to facilitate staff lying on the table in theatre in order to gain insight and generate discussion about ways we can improve patient experience in theatre, we had no idea how popular and powerful the project would become. Our initial film was seen by thousands within a few days and the internet was soon buzzing with discussion of our little project.
“Why did it have so much impact?”
I think it was because it was such a simple idea, which was fun, and because we made it so easy to participate. Because we took photos of everyone and used them to illustrate ideas via facebook and twitter it meant that even team-members who couldn’t or wouldn’t come to theatre were still able to participate adding comments to the posts so they still played a part.
The popularity of the project has meant that several trusts are now considering doing their own #TheatreChallenge and it will be fascinating to see how the project evolves in different environments. Many people keep asking me how to do Theatre Challenge so I thought it was worth a blog post which sets out all the steps we took and the things we had to consider but bear in mind that every unit is unique so you may face different challenges in your unit and equally you will all have different experiences depending on how your unit works to start off with.
You need to make sure everyone is on-board with your project and you need to ensure that the “sub-teams” are also included. They might not be keen on your idea to start off with but try to include at least some members of each team at each stage of the project. This gives them ownership and they will be more likely to spread the word.
We have 2 theatres on our labour ward so we decided that if theatre 1 was free then there was very little danger of needing to use theatre 2 in a rush. So theatre challenge took place in theatre 2 when theatre 1 was empty. Your ward may well work differently so you need to work out a plan which works for you.
Don’t be dis-heartened if you meet with some resistance at first. There is always a way round every problem. I was initially told that issues relating to infection control and access would make the project impossible but once we came up with a plan and spoke to theatre team managers they were happy to support us and we’ve not had any issues at all with using the theatre. We posted laminated copies of the dress-code etc on the door of theatre 2 and in handover room so everyone knew what they needed to do.
You can view the film we made here: https://youtu.be/R1X1dbJHlmc It didn’t take long to make and we involved theatre team in our filming.
You really don’t need very much kit for theatre challenge. Obviously you will need a set of drapes but if you store them somewhere safe the same set can be re-used. That’s about it! Just make sure that there are plenty of scrubs for people to wear.
We experimented with different scenarios but none of it was pre-planned. We just put people on the table and let the conversations evolve. It was interesting learning how the theatre bed and all its component parts worked. You might find it useful to have a member of theatre team present to help you with the attachments.
We created pledge forms for staff and feedback forms for the women and we also created a display so that staff could reflect before and after the challenge and comments from facebook were included in the display. All pledges were then added to the display as we went along. You might decide to use a newsletter instead or have a formal meeting for staff reflection.
“If you don’t have a forum then you really should. Its an excellent way to share unit news, articles relating to CPD and encourage staff to attend study days and conferences.”
We found using our unit’s private facebook forum an excellent way of involving staff who weren’t there on the first day and letting people know when we were aiming to have a session. Most of the the time it was impromptu. We shared photos on the forum with comments and this encouraged people to reflect on their own experiences. All participants were made aware that pictures would be posted and encouraged to post their own photos. I have to say that any initial concerns that staff might be inappropriate were quickly dispelled. Everyone posted responsibly and thoughtfully. This allowed us to post some emotive images that normally would never be shared from theatres and this in turn prompted lots of discussion and ideas. Posts on twitter gave the project a much wider reach and meant that professionals from other units were also able to contribute. A post on our local MSLC page also generated useful contributions from women who had been to theatre with the “tilt” being a big issue for these women.
“#TheatreChallenge has given staff the confidence to try new things to improve patient experience and allowed staff to see things from the point of view of the different professionals involved in care”
I cannot begin to stress enough just how much fun we had doing #TheatreChallenge. However amidst all the laughter was a huge amount of learning. Lying on the table is incredibly powerful, especially when the drapes go up.
The project created a buzz in our unit which is still there. The atmosphere in theatre is different. Staff feel enabled to try new things and to ask women what would help their experience. Not only did the project enable staff to see things from the woman’s point of view but its also allowed the theatre team to see it from the midwives point of view and vice versa. Doctors became aware of issues facing midwives such as the importance of skin to skin and midwives were able to see things from the anesthetists’ point of view. This has helped to create a more cohesive team in theatre. It is notoriously difficult to change practice in any unit but #TheatreChallenge has created a forum whereby multiple ideas can be considered at once and because these are being viewed in the context of the bigger picture with all members of the team included they will hopefully be more likely to be successfully implemented.
Thank-you for reading. Please share