Investigations, risk management and legal issues

Articles in this category

1. Learning from incidents in healthcare: the journey, not the arrival, matters (1 April 2016)

   • Patient safety incident
   • Reporting
   • (and 1 more)

     Tagged with:

     • Patient safety incident
     • Reporting
     • Policies / Protocols / Procedures

   By Becky T, 29 September

   • 0 comments
   • 135 views
   • 
   • Added by Becky T
   • 29 September

2. Why error reporting systems should be voluntary (2000)

   • Human error
   • Reporting
   • (and 3 more)

     Tagged with:

     • Human error
     • Reporting
     • Doctor
     • Safety culture
     • Policies / Protocols / Procedures

   By Becky T, 26 September

   • 0 comments
   • 37 views
   • 
   • Added by Becky T
   • 26 September

3. Nursing Matters podcast: Patient safety – Learning from our mistakes (24 September 2021)

   • Patient safety incident
   • Organisational learning
   • (and 2 more)

     Tagged with:

     • Patient safety incident
     • Organisational learning
     • Nurse
     • Data

   By Patient Safety Learning, 24 September

   • 0 comments
   • 133 views
   • 
   • Added by Patient Safety Learning
   • 24 September

4. Confidential enquiry into the deaths of Asian and Asian British babies: joint letter to Nadine Dorries, MP (6 September 2021)

   • Investigation
   • Maternity
   • (and 4 more)

     Tagged with:

     • Investigation
     • Maternity
     • BAME
     • Baby
     • Patient death
     • Health inequalities

   By Patient Safety Learning, 10 September

   • 0 comments
   • 176 views
   • 
   • Added by Patient Safety Learning
   • 10 September

5. Robbie Powell: Time for Truth, Justice and Accountability (Sharon Hartles, August 2021)

   • Patient death
   • Duty of Candour
   • (and 2 more)

     Tagged with:

     • Patient death
     • Duty of Candour
     • Accountability
     • Transparency

   By Mark Hughes, 17 August

   • 1 comment
   • 7,609 views
   • 
   • Comment by Steve Turner
   • 2 September

6. Action Against Medical Accidents (AvMA): What you need to know about AvMA

   • Patient
   • Patient harmed
   • (and 4 more)

     Tagged with:

     • Patient
     • Patient harmed
     • Complaint
     • Investigation
     • Legal issue
     • Patient / family involvement

   By Mark Hughes, 15 July

   • 0 comments
   • 181 views
   • 
   • Added by Mark Hughes
   • 15 July

7. Causes and conditions in patient safety

   • Investigation
   • Just Culture

   By PatientSafetyLearning Team, 18 June

   • 0 comments
   • 277 views
   • 
   • Added by PatientSafetyLearning Team
   • 18 June

8. Systems-based models for investigating patient safety incidents (28 April 2021)

   • Investigation
   • System safety
   • (and 2 more)

     Tagged with:

     • Investigation
     • System safety
     • Patient safety incident
     • Systems modelling

   By Patient Safety Learning, 6 May

   • 1 comment
   • 576 views
   • 
   • Comment by Keith Bates
   • 6 May

9. Once for Wales Concerns Management System

   • Patient safety incident
   • Quality improvement
   • (and 5 more)

     Tagged with:

     • Patient safety incident
     • Quality improvement
     • Complaint
     • Digital health
     • Legal issue
     • Risk management
     • Reporting

   By Patient Safety Learning, 20 April

   • 0 comments
   • 202 views
   • 
   • Added by Patient Safety Learning
   • 20 April

10. First Global Patient Safety Network Webinar 2021 - Patient safety incident reporting and learning systems (5 March 2021)

    • Patient safety incident
    • Reporting
    • (and 2 more)

      Tagged with:

      • Patient safety incident
      • Reporting
      • Organisational learning
      • Quality improvement

    By Patient Safety Learning, 15 April

    • 0 comments
    • 209 views
    • 
    • Added by Patient Safety Learning
    • 15 April

11. English and Welsh Ombudsman set out the case for '... a proper public inquiry into the tragic death of Robbie Powell'

    • Police
    • Post mortem
    • (and 15 more)

      Tagged with:

      • Police
      • Post mortem
      • Harmed Care Pathway
      • Medicine - Diabetes and Endocrinology
      • Patient death
      • Competence
      • Criminal behaviour
      • System safety
      • Leadership
      • Organisational culture
      • Organisational learning
      • Whistleblowing
      • Transparency
      • Patient engagement
      • Children and Young People
      • Investigation
      • Coroner reports

    By Steve Turner, 17 November, 2020

    • 4 comments
    • 3,005 views
    • 
    • Comment by Dominic Stenning
    • 16 July

12. HSE: Reporting accidents, incidents and diseases (10 October 2015)

    • Reporting
    • Safety report
    • (and 1 more)

      Tagged with:

      • Reporting
      • Safety report
      • Legal issue

    By Becky T, 22 September, 2020

    • 0 comments
    • 33 views
    • 
    • Added by Becky T
    • 22 September, 2020

13. What Never Events on PHIN's website can tell you about hospitals (2 September 2020)

    • Never event
    • Checklists
    • (and 2 more)

      Tagged with:

      • Never event
      • Checklists
      • Patient
      • Private sector

    By Patient Safety Learning, 9 September, 2020

    • 0 comments
    • 342 views
    • 
    • Added by Patient Safety Learning
    • 9 September, 2020

14. “I’m going to Datix you”

    • Patient safety incident
    • Reporting
    • (and 3 more)

      Tagged with:

      • Patient safety incident
      • Reporting
      • Software
      • Culture of fear
      • Organisational culture

    By Jonathan, 7 September, 2020

    • 2 comments
    • 8,460 views
    • 
    • Comment by Patient-Safety-Learning
    • 25 September, 2020

15. The history of Duty Of Candour and why Robbie's Law matters

    • Patient death
    • Patient harmed
    • (and 4 more)

      Tagged with:

      • Patient death
      • Patient harmed
      • Duty of Candour
      • Patient safety / risk management leads
      • Clinical governance
      • Ethics

    By Steve Turner, 6 September, 2020

    • 0 comments
    • 1,061 views
    • 
    • Added by Steve Turner
    • 6 September, 2020

16. Private Healthcare Information Network: Publication of provisional Never Events for the reporting period 1st January 2019 and 31st December 2019

    • Never event
    • Private sector

    By Patient Safety Learning, 3 September, 2020

    • 0 comments
    • 399 views
    • 
    • Added by Patient Safety Learning
    • 3 September, 2020

17. Patient Safety Learning: Confusion over PPE guidance poses a patient safety risk (27 August 2020)

    • PPE (personal Protective Equipment)
    • Virus
    • (and 3 more)

      Tagged with:

      • PPE (personal Protective Equipment)
      • Virus
      • Pandemic
      • Care home
      • Recommendations

    By Patient Safety Learning, 1 September, 2020

    • 0 comments
    • 293 views
    • 
    • Added by Patient Safety Learning
    • 1 September, 2020

18. RCN: Top 10 tips for statement writing

    • Staff support
    • Investigation
    • (and 2 more)

      Tagged with:

      • Staff support
      • Investigation
      • Reporting
      • Nurse

    By PatientSafetyLearning Team, 26 August, 2020

    • 0 comments
    • 787 views
    • 
    • Added by PatientSafetyLearning Team
    • 26 August, 2020

19. The importance of near miss reporting

    • Reporting
    • Near miss

    By Claire Cox, 4 August, 2020

    • 0 comments
    • 220 views
    • 
    • Added by Claire Cox
    • 4 August, 2020

20. The Duty of Candour – where are we now? (30 January 2020)

    • Duty of Candour
    • Accountability
    • (and 3 more)

      Tagged with:

      • Duty of Candour
      • Accountability
      • Organisational culture
      • Organisational learning
      • Transparency

    By Patient Safety Learning, 2 June, 2020

    • 0 comments
    • 700 views
    • 
    • Added by Patient Safety Learning
    • 2 June, 2020

21. Healthcare Quality Quest: Root Cause Analysis (2019)

    • Root cause anaylsis
    • Risk assessment
    • (and 2 more)

      Tagged with:

      • Root cause anaylsis
      • Risk assessment
      • Investigation
      • Quality improvement

    By Patient Safety Learning, 11 May, 2020

    • 0 comments
    • 171 views
    • 
    • Added by Patient Safety Learning
    • 11 May, 2020

22. BMJ: Government’s response to £239m worth of inquiries has been “opaque,” says NAO (24 May 2018)

    • Investigation
    • Research

    By Patient Safety Learning, 7 May, 2020

    • 0 comments
    • 177 views
    • 
    • Added by Patient Safety Learning
    • 7 May, 2020

23. Peter Duffy podcast: safety critical issues remain at UHMBT

    • Investigation
    • Patient death
    • (and 4 more)

      Tagged with:

      • Investigation
      • Patient death
      • Whistleblowing
      • Bullying
      • Culture of fear
      • Accountability

    By PatientSafetyLearning Team, 7 February, 2020

    • 0 comments
    • 610 views
    • 
    • Added by PatientSafetyLearning Team
    • 7 February, 2020

24. The problem with incident reporting by Carl Macrae (7 September 2015)

    • Investigation
    • Reporting
    • (and 1 more)

      Tagged with:

      • Investigation
      • Reporting
      • Patient safety / risk management leads

    By Claire Cox, 4 February, 2020

    • 0 comments
    • 387 views
    • 
    • Added by Claire Cox
    • 4 February, 2020

25. Ely Hospital, Cardiff: Inquiry findings (1969)

    • Investigation
    • Staff factors
    • (and 3 more)

      Tagged with:

      • Investigation
      • Staff factors
      • Nurse
      • Standards
      • Patient safety incident

    By PatientSafetyLearning Team, 5 January, 2020

    • 0 comments
    • 384 views
    • 
    • Added by PatientSafetyLearning Team
    • 5 January, 2020