Radical thinking

Definition

Analysing processes/problems at root level

Challenging the core assumptions/beliefs

Coming up with new/different solutions

Time you had to think radically

QI project…CEPOD

Had to challenge local beliefs about why it wouldn’t work

S: wasted 1 hour/slow to start

T: (radical idea/change)

introduce golden pt system (do a simple case while prep the sick one)

To do this need surgeons, scrub team, ward all on board

A:speak to all stakeholders. Identify perceived barriers, ask them what could helo

R: new protocol, piloting now,

Start/End statement

I can recognise, champion, and safely implement change that challenges established practice.”

Clinical example of radical

A time I had to think—and act—radically was during efforts to improve patient flow and theatre efficiency in paediatric elective surgery and CEPOD pathways.

In paediatric electives, we introduced a “sip to send” approach, allowing children to have clear fluids closer to theatre time rather than prolonged fasting. While the evidence base existed, local practice was still conservative. Implementing this required a shift in mindset across anaesthetics, nursing, and surgical teams, as it challenged long-standing habits around fasting safety.

Similarly, for CEPOD, I led the introduction of a “golden patient” system—identifying and optimising the first case of the day in advance to reduce delays and cancellations. This required coordination across wards, theatres, and on-call teams, and a move away from a reactive to a proactive model of care.

In both cases, the challenge wasn’t generating the idea but translating a non-traditional approach into routine practice. I engaged key stakeholders early, including consultants, nursing staff, and theatre coordinators, to understand concerns and barriers. I used available data and evidence to demonstrate safety and benefits, and where needed, started with small-scale implementation to build confidence.

There was understandable resistance initially, particularly around patient safety and operational risk. Addressing this required clear communication, reassurance, and visible leadership. I made a point of being present during early implementation phases to support colleagues and troubleshoot issues in real time.

The outcomes were positive. “Sip to send” improved patient comfort and reduced dehydration without compromising safety, and the golden patient system led to more reliable theatre starts and better utilisation of CEPOD capacity.

This experience reinforced that thinking radically in anaesthesia often means challenging ingrained practices, but doing so in a structured, evidence-based, and collaborative way. It also highlighted the importance of leadership in bringing others with you when implementing change.

More QI

DART teams

?best example as was involved in all phases??

Thr

Conclusion

This experience reinforced that thinking radically in anaesthesia often means challenging ingrained practices, but doing so in a structured, evidence-based, and collaborative way. It also highlighted the importance of leadership in bringing others with you when implementing change.