Breaking bad news, funding culture not tech – and size isn’t everything when it comes to tokens of affection…

Breaking bad news – could lighting help?

The most harrowing news most of us will ever hear will be delivered in a consulting room or a hospital ward – Experiences and views of receiving and delivering information about recovery in acquired neurological conditions: a systematic review of qualitative literature.

Breaking bad news is tough on the clinical staff, too – one large-scale review found a significant link between a sense of isolation and burn-out as a result of breaking bad news, with those staff who felt most connected with their patients suffering the most. The authors urge a greater awareness among managers, a culture of collective care and space for reflective practice to mitigate the effects – Healthcare practitioners’ experiences of breaking bad news: A critical interpretative meta synthesis.

Another literature review noted that Serenity Rooms – low-sensory spaces – for nurses improved compassion and retention and reduced the risk of burn-out – Using Serenity Rooms and Similar Tools to Improve the Workplace during COVID-19: A Rapid Review, with higher risks among nurses with sensory processing sensitivity – The impact of sensory processing sensitivity on stress and burnout in nurses. Simply placing the nurses’ station next to a window reduces stress and increases positive communication and laughter. Given a shortage of over 4.5 million nurses worldwide, offering a dedicated space to recover could be a small price to pay – Nursing and midwifery.

It’s worth extending that attention to consulting rooms too, as stress shifts the dial on the way your brain processes light. 

1. Extreme photosensitivity – choose low-glare sources and enhanced control. Your pupils tend to dilate in response to stress – a useful reaction in the wild when you want to gather as much information as you can – Attenuation of visual exploration following stress. But an open pupil lets in more light than you need so you’re more sensitive to glare and cooler ‘blue’ wavelengths that we tend to perceive as brighter.
2. Tunnel vision – invite a more balanced view. You tend to focus on a small zone in the centre of your visual field, with lots of short, tight jumps or saccades. A view out to nature, or simply an image of a natural scene slows that activity down, linked to a relaxation and restoration response – The Perceived Restorative Quality of Viewing Various Types of Urban and Rural Scenes: Based on Psychological and Physiological Responses.
3. Hypervigilance – daylight or high colour rendering. You will be acutely alert to the subtle shifts in blood flow to the face that signal shifts in emotion, especially anger or fear. Choosing a light source that delivers a spectrum as close to daylight as possible will reduce heart rate and other signs of stress, improve visual comfort and can help with diagnosis too – Influence of full-spectrum lighting on blood pressure, heart rate and visual comfort on young adults, The Impact of Color Fidelity on Evaluation of Patients in the Outpatient Dermatologic Setting.

We can’t avoid getting – or giving – bad news. But taking care of the visual environment just might help to soften the blow.

The NHS – A whale or a shoal? 

An analogy shared by Katya Masconi-Yule as we waited in line to enter the cavernous belly of Portcullis House last week. I stepped out into the chilly drizzle four hours later, realising it was about right.

Some of my takeaways- and a gap –  from a fascinating afternoon, skillfully chaired by Dame Barbara Hakin. 

• Money is not the problem.  The UK government announced £3.4 billion funding for NHS Technology and Transformation – With a return to basics, is the spring Budget a game changer for NHS technology? Having the courage to fast will enable a transparent evaluation of return on investment for NICE protocols and local decison makers – and the confidence to challenge marketing hype, ensuring we don’t throw good money after bad.
• Suppliers have to pitch the same product hundreds of times:  90% of HealthTech is developed and funded locally, with few clear pathways to scale, leading to duplicated effort and frustration with the UK market trailing far behind the USA and the EU as an attractive and supportive place to do business – THE PULSE OF HEALTHTECH: 2023 BUSINESS SURVEY.  The Catapult programme, a current redesign of the mammoth product catalogue, and  ‘passport’ system to pre-qualify products in multiple categories might just help.
• The nascent HealthTech sector lacks transparent protocols for NICE evaluation and the established marketing and distribution networks of the global Pharmaceuticals sector that has shaped models of care for over 70 years. At the same time, billions have already been spent on kit that has never been used – whether through lack of integration, training or support for the inevitable risk and disruption that comes from trying something new. To quote Tim Morton of the Hospitals Foundation, we need to fund the culture, not the technology.

And a big gap – 

The conversation was all about kit and software. 

But nothing about the smart infrastructure embedded in the buildings themselves that can enable and optimise the operational efficiency of that technology – lighting and dynamic shading systems that track occupancy and assets, maintain temperature and humidity, improve visual comfort and accuracy of diagnostic teams, reduce medical errors and falls…

–  I’m glad the NHS is not a monolithic whale: we need the wisdom and agility of community-led care. But we do need to invest in ways to encourage greater trust and transparency between the minnows so we can all move faster together.

Valentine’s day 

While millions choose the classic chocolates and flowers, this fascinating analysis of online shopping habits on Alibaba suggest that everyday objects and creative/DIY items that indicate commitment to daily life together are more attractive – Chinese E-Romance: Analyzing and Visualizing 7.92 Million Alibaba Valentine’s Day Purchases.

So showing how much you care with with (home-grown) love. While you may feel you need to spend a lot, the object of your affection is likely to find a small home-made offering at least as attractive as an expensive one – More Expensive, More Attractive? The Effect of Pricing on Gift Evaluation: Differences Between Giver and Receiver.