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Greater with GREATix

The embedding of incident reporting in our safety culture in emergency medicine has been a bedrock underpinning our culture of improvement and governance in recent years. We are nearly all familiar with the busy shift, when something didn't go the way we wanted for our patient and the words "I'm going to DATix that" are uttered. Ideally not as a tool for punishment, but genuinely because we feel (and hope) that this system might flag the problem in a systematic way and potentially prevent it from happening again. But how often are we thinking seriously about the things that go really well. The systems, individuals or examples that exemplify best practice, innovation or when we are at our best. 'Learning from Excellence' ( from Plunkett and colleagues in Birmingham has been leading the way on this in the UK (1) and doctors from the Leicester Children's Emergency Department (Sinton, Lewis and Roland) have written eloquently about this and the GREATix - a tool for 'positive incident reporting' (2).

What we are planning in the Bristol children's emergency department, similar to other departments, is to use the GREATix system (or similar) for reporting examples of excellent clinical practice, great teamwork, exemplary compassion or care or other practice that we would want to celebrate and/or replicate. These submitted forms will be fed back individually to those involved. Each month a GREATix will be chosen to illustrate a particular theme or example from which we can all learn. But as part of You Got This we will be taking that further and each month one GREATix will be picked at random and the individuals involved will receive wellbeing gifts or rewards from the You Got This team. A small gesture to highlight the fact that learning from excellence is not just abut the learning involved but is also about showing staff that their fantastic work is valued and from time to time comes with rewards.

The kind of excellence that we see so often in medicine that we can learn from is not simply about improving care and safety for our patients. It is also about making us all the best that we can be and there is just cause to celebrate and be proud of our achievements and our successes. It helps to sustain us, nourishes the soul and spurs us on to support our patients and our colleagues with enthusiasm and energy well into the future.

1. Kelly N, Blake S, Plunkett A. Learning from excellence in healthcare: a new approach to incident reporting. Archives of Disease in Childhood Published Online First: 04 May 2016. doi:10.1136/archdischild-2015-310021

2. Sinton D, Lewis G, Roland D. Excellence Reporting (GREATIX): Creating a Different Paradigm in Improving Safety and Quality. Emerg Med J 2016;33:901-902.

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