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  1. Recognising risk and...
  2. Recognising risk and improving patient safety (R²IPS)
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Recognising risk and improving patient safety (R²IPS)

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d7581 (Published 03 December 2011) Cite this as: BMJ 2011;343:d7581
  1. Manav Bawa, core trainee 2, orthopaedic surgery,
  2. Kerry Carlin, general practice vocational training scheme 1
  1. 1Countess of Chester NHS Foundation Trust, Chester, UK
  1. manavbawa{at}gmail.com

The recognising risk and improving patient safety (R²IPS) course is a one day theoretical course organised by the Countess of Chester NHS Foundation Trust. It aims to teach a strategy that will enable trainees to identify, intervene in, and prevent the components of personal and team behaviours that contribute to increased risk for patients and adverse outcomes. It also helps junior doctors to challenge situations where they believe that a medical error may occur. The course is new but is becoming more and more popular with junior trainees.

Who is it for?

This course is mainly aimed at newly qualified foundation doctors, as it complements a part of the foundation curriculum, but it is useful for any grade.

How is the course structured?

The day is made up of lectures and presentations, each followed by a group discussion and workshops. The day is based on the “R²IPS beacons,” those factors whose presence or lack are thought to be central to most hospital errors. The R²IPS beacons are:

  • Communication

  • Fixation

  • Confusion

  • Leadership

  • Trepidation

  • Policies and procedures

  • Time pressures

  • Humanity.

What is covered?

The course has four workshops: situational awareness, communication, leadership and team working, and empowerment. In the final workshop a discussion takes place about a particularly difficult situation where a participant feels disempowered and unable to challenge a decision made by one of his or her seniors that would have led to a medical error. The group then analyses the situation and comes up with the best way to approach and challenge the senior.

When did you do it?

In 2008. It is a good idea to do the course near the end of foundation year 1, after you have been exposed to medical errors and had experience of them.

Why did you do it?

Patient safety is central to good medical practice. We thought this course would be excellent in giving us a structured approach to risk assessment and therefore an ability to identify and prevent medical errors before they arise. One of the most useful and important learning points is how to gain empowerment to challenge a decision in a situation where you disagree with a colleague or a senior doctor.

How are the candidates assessed?

Although there is no formal assessment, skills are continually assessed throughout the day through interaction and group discussion with tutors who are experienced at risk assessment. All candidates are awarded a certificate of attendance and participation.

How much does it cost?

It is free for candidates from the trust and £100 for external candidates.

Was it worth it?

Definitely. Using the R²IPS beacons has helped us to be more aware of medical errors and to be able to spot them and intervene before they happen. We have greatly improved our communication, leadership, and team working skills, and we feel more confident with our role in the working environment. The course includes many topics that need to be covered to pass the foundation years.

The course is very well organised and is interactive throughout the day, maintaining the group’s focus and interest. Members of the teaching faculty are helpful and approachable. A buffet lunch is included.

Top tip

Read the booklet provided in advance so that you have a good understanding before the course.

Further information

  • Further information is available from the R²IPS coordinator, Critical Care Unit, Burton Hospitals NHS Trust, Queen’s Hospital, Belvedere Road, Burton upon Trent, Staffordshire DE13 0RB; tel: 01283 566333 x 4099; fax: 01283 593008; Elizabeth.mortlock{at}burton-tr.wmids.nhs.uk.

  • For information about gaining a place on the course contact Ann Baker, clinical training manager, Education and Training Centre, The Countess of Chester NHS Foundation Trust, Chester CH2 1UL; tel: 01244 365687; fax: 01244 365686; ann.baker{at}coch.nhs.uk.

Footnotes

  • Competing interests: None declared.

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