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Deep dive into patient safety: Communicating under water …?

The water-sports season on Anglesey has firmly restarted and people are on their way to the beaches of Ynys Mon to take their boards and boats to the water. At the same time  life is also getting more busy under water with recreational divers admiring the nature and wrecks around Anglsey’s cost. The serene silence under water is occasionally broken by passing ship. Most communication has to stop. But safety is critical for diving. So how do you communicate safely without a voice? While there is an increasing number of electronic systems that support under water communication most people have probably heard about the Recreational Scuba Training Council and its sign language. Going up is a thumb up, going down is a thumb down. Running out of air a movement with the flat hand across the neck. These signs signal to other divers in the group safety critical information. It allows divers to look after each other even if speech is limited. The basic knowledge for the communication under water can be trained in a few hours. So while most divers are trained at a basic level they are not specialists or instructors when they receive the manual distress signals. An intriguing model of how lay people are able to look after lay people.

So let’s translate this into healthcare: John Launer ( is associate editor of the Post-graduate Journal. In a recent editorial he describes his experience in hospital ….. as a patient ( ! He happens to be admitted at the same time as a colleagues and together they decide to use their time to observe what other patients and staff members are doing in their environment. They want to take it beyond being bored and nosy and re-frame their new role as ‘ethnographers’, skilled and unprejudiced observers of their new exotic environment. They are charting some important findings. The time of communication with healthcare professionals is short and frighteningly fragmented. They conclude that ‘our own experience indicates that patient-led ethnography could be a rich source of information for improving healthcare.’

Beyond the obvious legal and ethical concerns such an experiment might be quite similar to what is already happening under water. Lay people using their observation to help lay people. And it is possibly starting to invade the health and social care sector: In the Swiss App-store ‘Reachout’ ( can be found that claims to link people with mental health problems and in the UK ‘Howz’ ( allows family and friends to connect with elderly loved ones – while at the same time tracking their electricity use and pattern of daily activities. Patients are therefore able to be monitored by lay people who know and understand their movements in social care.

Time to find out  more about the safety functions of patient groups in hospital? Who would like to help us and establish a PADI type course for patients to stop them from going under in plain sight?

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