The background to What I learnt this week can be found by clicking here:

A list of previous #WILTW

165. A third idea to counter a third ‘type’ of error

164. Good questions are as important as good answers

163. Spot the well child, not the ill one

162. The Traffic Light Analogy: Patients aren’t cars

161. You can’t repeat that, I said it in public! 

160. The blood test that causes harm

159. How did you not see that? 

158. Managing risk: Don’t get burnt, a singe will do

157. Statistically, the thing most likely to kill me, is me

156. The Ghost Guideline

155. Why are so many children ill? 

154. An Emergency Department ‘gebrochenrolltreppe” phenomenon

153. Abdominal pain in children: illness vs individual

152. Same Child, Different Room, More Risk?

151. The dangers of Formophilia

150. When experience doesn’t help learning

149. The Helicopter Hover: Counterfeit Cognition

148. Five soft markers of organisation aptitude

147. Dogmalysis or Pragmatogenesis?

146. Do you why the parents are concerned. Why Not?

145. Practice what you preach or preach what you practice?

144. When laughter causes pain 

143. You can’t “Click & Collect” Healthcare

142. If you know what it’s not, it is ok to not know what it is? 

141. A Mental Health 5-a-day

140. With great (digital) power comes great responsibility

139. Failure – likely and visible

138. The three curses of organisational culture

137. Is the #NHS crying wolf?  

136. If the NHS ran Disney

135. Jugaad

134. Don’t Multi-Task, Multi-Think

133. It’s easier to recognise wrong from right

132. The Look

131. Why a coffee replenishes more than just caffeine levels

130. Variation: Is it poor, or just different, practice that frustrates? 

129. Perspective

128. Do nothing without appearing there is nothing to do

127. A pre-mortem to prevent a post-mortem

126. Malignant Meeting Mindsets

125. Do we need Quality Insight rather than Quality Improvement?

124. Feeling meek? The only time you are allowed to CUSS

123. Acting on instinct: Blessing and Curse 

122. Medical Conferences: Time to include everyone? 

121. Unconscious Incompetence at scale? 

120. Does it matter what the public think of doctors? 

119. Should we learn how to make mistakes?

118. Patient care is not sport but should it be funded like it is? 

117. Why does no one answer the phone in hospitals?

116. How not to manage flow (or no more forms please) 

115. Digital Downtime

114. Surprise: When fear collides with joy 

113. Sepsis and Self-doubt

112. Time to embrace a new style of conference

111. Seeing the doughnut instead of the hole

110. The presumed love of a parent: an uncomfortable cognitive bias

109. Failure Fatigue

108. Learning from, rather than on, patients

107. Is our response to failure misplaced in medicine? 

106. Don’t cause unnecessary distress! P.R.E.D.I.C.T before your paediatric procedure

105. Risk and Change: Useful in an Emergency?

104. Filter Failure – not just knowledge overload

103. What healthcare can’t learn from Leicester’s football success

102. Hospital Humour

101. Children’s experience of emergency care as a measure of quality

100. Who are unprofessional professionals?

99. Should we stop making the complex simple?

98. Is your powerpoint slide teaching or are you?

97. Everything worth fighting for unbalances your life

96. Quality improvement as a clinical skill

95. The dilemma of the last patient

94. The seed of doubt

93. Let’s consider ‘appropriateness’ inappropriate

92. Oh NHS, you are still sick

91. Giving those who need the most the least

90. Intentional leadership is just management

89. Making sepsis an eucatastrophe

88. You’re wrong, but does that make me right?

87. As calm as you are, is as calm as she’ll be

86. Is quality defined by a standard of care you didn’t expect to receive? 

85. Resolution or Resolve for 2016 

84. Avoid a confirmation cock-up this christmas

83. Should we simulate like spacemen? 

82. How the #NHS spirit “pulls through”

81. Patient safety in complex contexts

80. Maximising the social capital of the NHS

79. The signs of burnout

78. Is excitement a return on emotional and physical investment?

77. The need to improve my social media hygiene

76. The power of feedback to your face

75. Can medicine learn from the Television Match Official?

74. Missed Diagnosis – do we fear for ourselves or our patients?

73. If you can’t trust oxygen what can you depend on?

72. The imposition of implication

71. Can rudeness cause harm?

70. The amount of night in a night shift

69. Not knowing what other people know is uncomfortable

68. The impact of i-phones of doctors’ decision making

67. 5 things specialities don’t understand about “Ed”

66. Simulating harsh lessons from history

65. A parents’ view of the world may also be knee high

64. Don’t just ‘hear’ a symptom and don’t just ‘see’ a sign

63. Are hearts and brains enough without courage?

62. How to learn something you don’t understand

61. Why you need a digital holiday

60. I am not negotiating the way you think I am

59. The Poison of Passion

58. Are you calling for help for you or your patient?

57. Quality is not one box to tick

56. Confirmation bias – the cousin of over confidence

55. Noise from stress or stress from noise?

54. Not everyone knows how to hold a child

53. Admission is not the safe option

52. Learning to live with not always learning

51. I am gender biased

50. Still learning, Still training, Still Experiencing

49. The importance of listening and language

48. Does time make teams?

47. Being honest with the trouble with twitter

46. Maintaining Morale – What movers and medics have in common

45. Safe checklists versus speedy check-ins

44. Understanding the patients who may make you angry

43. You can make a little effort go a long way

42. Whose change is it anyway?

41. Patience can be the cruelest of virtues

40. What estate agents can learn from healthcare

39. The importance of capacity in system AND self

38. Bringing two worlds together

37. Paracetamol – a simple drug with not so simple dosing

36. Research Resilience

35. Rejecting the notion of the Emergency Department referral ‘bomb’

34. Not everything should be open: the value of “Closed Loop Communication”

33. The real value of Simulation

32. The Xmas review

31. The Education in the Observation of Education

30.  How to get people to alter their typical ‘change’ vintage

29. Changing your perspective on time allows time to give you perspective on change 

28. Some uncomfortable truths about insight

27. Not revealing your grief doesn’t mean you are not hurting

26. The challenge of learning something new

25. Am I narcissistic in my enjoyment of emergency care?

24. The justification of risky behaviour with public or patient safety

23. Good “Leadership” is tangibly unrewarding but ultimately fulfilling 

22. The frustrating advantage of being difficult 

21. Don’t discharge your discharge summary responsibility 

20. Balancing proper procedure with paediatric passion 

19. What you see is maybe not what I see? 

18. Am I really learning..?

17. The importance of #connectingwith 

16. Everything is awesome 

15. #doctorwho would have no difficulty adopting a more managerial role 

14. #Everybodycounts – really everybody does!

13. Organisation is more than files and folders

12. It’s not what you say it is how you say it

11. The importance of being part of a team (Sir Bradley Wiggins says so!)

10. Learning not to be as busy as a “Backson”

9. Feel the fear and do it anyway

8. It’s not you, it’s me

7. The Challenge of Compassion

6. Remember what you loved to do…

5. Accepting I’m a curator and examiner of knowledge rather than a gatekeeper of it

4. Shared values doesn’t always mean shared vision

3.The power of personal stories 

2.The importance of ‘shared’ gut feeling

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