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SCReaM Projects

HF Projects:

We have a number of ongoing HF projects within the programme, some examples are outlined below.

Emergency Prompt Cards: The project implementing the prompt cards into our Theatres was the first of our HF projects. Since then, we have continued to evaluate the use of the emergency prompt cards and introduced the role of the Reminder Of the Cards (ROC) to support their use.

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Pledges: As part of the training courses, delegates are encouraged to undertake a ‘pledge’: something from the course that has resonated with them and they wish to try in their working lives. These are small, simple and time bound. Delegates are supported in creating and carrying out their pledge by faculty and are encouraged to share their successes and challenges with their own course peers in a closed forum. Past examples have included improving team briefs, encouraging positive feedback, improving sleep quality, drinking more water, or using people’s names during a brief. To-date, delegates have completed in excess of 150 pledges, making small but significant improvements to their working environment.

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As with most HF work, these projects remain ongoing and often utilise Quality Improvement's (QI) PDSA (Plan-Do-Study-Act) methodology to continue to improve and build on their success.

HF Engineering


This is the newest component of the programme aimed as providing HF Engineering support to programmes across the Trust. We apply known and recognised HF tools and techniques and models (such as the SEIPS 2.0 model shown below) to support these large scale Transformation Programmes. As part of the Transformation Team within the Royal Surrey we work closely with our Quality Improvement (QI) colleagues to provide a different perspective on how to implement and sustain changes - both in the clinical and non-clinical environments.


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Our latest project


The TEACUP Framework: This project was part of a larger intervention looking at the culture and timely escalation of concern in our maternity unit. Based on user-centred design methodology we carried out observations, interviews, used ‘user stories’, and shadowed staff, to capture the Work-As-Done (WAD) on our maternity unit. We worked closely with our colleagues in maternity to create a framework that reflected what they need from a good escalation.

The Framework, called TEACUP, underlined the need to recognise escalation as a two-way process, not just the responsibility of the person escalating but also that of the recipient. It emphasised the importance of closing the communication loop to ensure both parties are aware of the plan, and it highlighted the importance of managing expectations to ensure all parties know what's expected of them.

As a result of the framework, 6 system-based interventions were identified as needing to be changed in order to support staff to work as they outlined in the TEACUP.

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