Our place in the wider world

Peter Lachman,  Associate Medical Director for Patient Safety and Consultant in Service Redesign and Transformation

How collaborating with Cincinnati Children’s Hospital Medical Center is benefiting the patients of Great Ormond Street Hospital (GOSH). It is often mentioned that GOSH is considered to be one of the top five children’s hospitals in the world.

Everybody working here is rightly proud of this fact and works hard to maintain this position. You could say, perhaps, it’s a hospital for others to admire, to aim to emulate, but that’s not quite how the hospital views itself.

The staff are all too aware that the only way to improve and to do what they do best – help sick children – is to constantly be open to new ideas from outside, learning from wherever good practice is in use, to remain humble and to always, always work with others.

A collaborative philosophy

Collaboration is key to good healthcare. One way in which this collaborative and learning philosophy manifests itself is in its connections with the other children’s hospitals in the UK and also with those in other countries.

Peter Lachman, Associate Medical Director for Patient Safety and Consultant in Service Redesign and Transformation, is at the centre of some of these sharing relationships and has been pivotal in working with and learning from Cincinnati Children’s in the United States about safety.

"When I came here in 2005, I said to Jane Collins, Chief Executive, that we need to link up with the best, and in terms of quality and safety improvement, they’re the best," Peter says. "They really lead the way."

Quality and safety

"Quality and safety means the patient gets the treatment first time, every time, and doesn’t have to wait for it," he adds. "A hypothetical example of poor quality: I have two patients – one has an abnormal magnetic resonance imaging (MRI) scan and he’s going to be seen very quickly, and the other gets a referral and gets an appointment for a few months’ time. If the hospital wants to offer good quality, it must give access within two weeks because we live in that kind of age.

"Secondly, when the referral is in, it must be co-ordinated so that the family doesn’t have to jump through hoops, has no delays and gets expert opinions and results."

Working in partnership

In 2007, the two hospitals began a partnership, working to pursue their joint vision to become leaders in improving healthcare for children. By that time, Cincinnati Children’s already had four years’ experience in pursuing perfection, and GOSH had undertaken many years of modernisation in response to national targets and local objectives.

Both organisations had made progress in areas of service provision and the aim of the partnership was, and continues to be, to learn from each other’s successes and challenges.

The partnership informs many of the hospital’s improvement projects to achieve its goals of ‘no waits, no waste and zero harm’, and includes educational sessions, video/online conferences to provide shared learning (on subjects such as pressure sores, ventilator-acquired pneumonia and chronic care), executive visits to both sites and also members of the Transformation team making educational visits to Cincinnati Children’s.

Collective learning

Peter points out that in North America, all the top hospitals are "fighting" with one another for the same patients, but, as a Trust in the UK, we’re not in competition with any of them and so can co-operate with each in ways they simply cannot.

"They do share this stuff with North American hospitals, but not in the same way," he says. "The difference is that we have this relationship with Cincinnati Children’s where we really drive each other. The advantage is that we teach them some things and they teach us some things – before it was more one way. What we really want to do is take GOSH to places it hasn’t been in terms of safety and quality."

Sharing expertise

Back on home turf, Peter says the hospital would like to set up a meeting of all the children’s hospitals in order to initiate a safety forum to start sharing data and information.

"Again, this is following Cincinnati Children’s who did something similar by bringing all children’s hospitals in Ohio together and saying that we’ll compete on everything, but not on safety and quality," he says. "That’s where we should be leading the way in this country, sharing our expertise with others."

Looking ahead

But the efforts to learn from others never cease, as Peter sums up. "One of the problems of places like GOSH is the possibility of ‘the complacency of excellence’. As soon as you have that, you lose the humility of knowing what you do not know.

"What we have to do is accept our aspirations that we want to be the best according to our own potential – not the best according to other places. If our potential is to be the best in the world, then we need to aim for that.

"Can we be the best? Yes, we’ve got that potential to be the best. We really need to realise our potential and go beyond it."