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Patient-Safety-Learning

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Everything posted by Patient-Safety-Learning

  1. Content Article
    Incident reports of medication errors are valuable learning resources for improving patient safety. However, key information is often contained within unstructured free text, which prevents automated analysis and limits the usefulness of these data. Natural language processing can be used to structure this free text automatically and retrieve relevant past incidents and learning materials, but this requires a large, fully annotated and validated set of incident reports. This study in Nature used a set of 58,658 machine-annotated incident reports of medication errors to test a natural language processing model. The authors provide access to the validation datasets and machine annotator for labelling future incident reports of medication errors.
  2. Content Article
    Surgical Site Infections (SSIs) can have subtle, early signs that are not readily identifiable. This study aimed to develop a machine learning algorithm that could identify early SSIs based on thermal images. Images were taken of surgical incisions on 193 patients who underwent a variety of surgical procedures, but only five of these patients developed SSIs, which limited testing of the models developed. However, the authors were able to generate two models to successfully segment wounds. This proof-of-concept demonstrates that computer vision has the potential to support future surgical applications.
  3. Event
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    Social innovation labs are innovative spaces that encourage creative thinking and experimentation. A recent evidence review undertaken by the Innovation Unit explores how labs can achieve greater impact. This session, jointly delivered by Q and Innovation, is an opportunity to hear more about the evidence review, hear from leading practitioners in the field and connect with others with an interest in social innovation. Register for the webinar
  4. Content Article
    As the NHS’s digital transformation journey enters a new phase, there are opportunities to improve the quality and productivity of the healthcare system. This phase is not just about advancing the maturity of electronic health records (EHRs) but also about embracing the vast potential of generative artificial intelligence tools. In this HSJ article, Robert Wachter and Harpreet Sood explore the reasons why EHRs have not yet delivered promised productivity improvements and look at how GenAI offers opportunities for the NHS to realise productivity benefits faster, cheaper and at a greater scale.
  5. Content Article
    In this report for Stat, technology correspondent Casey Ross looks at the dangers involved in using AI to predict patient outcomes, especially in life-or-death situations such as suspected sepsis. He looks at the recent case of US electronic health record provider Epic who were force to rewrite the algorithm being used by tens of thousands of US clinicians to predict sepsis.
  6. Content Article
    Despite widespread efforts to combat the opioid epidemic, post-operative opioid overprescribing by doctors remains an ongoing contributor to opioid misuse. This US study aimed to evaluate the impact of a low-cost, reproducible “just in time” intervention on opioid prescribing in dialysis access operations. Standardised opioid prescribing guidelines were emailed to residents on the vascular service on the first day of the rotation. Opioid prescriptions were reviewed for four years before and one year after this intervention. The results showed a decrease in patients discharged with opioids following the intervention, from 58% to 36%. For patients prescribed opioids, the median quantity decreased from 90 to 45 oral morphine equivalents.
  7. Content Article
    This Medscape article tells the story of Josephine Vest, who was diagnosed with endometriosis aged 19. Now 30, she describes how her symptoms were dismissed and belittled by GPs and gynaecologists before she received a diagnosis a year after her symptoms began. With an average diagnostic delay approaching nine years across the UK, Josephine counts herself fortunate to have been diagnosed in this time frame. She goes on to describe the obstacles she faced in getting effective treatment and the suspicious attitudes healthcare staff displayed towards her.
  8. Content Article
    Consumer perspectives enable a broader understanding of how harm occurs. This webpage by Te Tāhū Hauora, the Health Quality & Safety Commission of New Zealand, contains guidance on engaging patients and consumers who have experienced harm and wish to be involved in learning and improvement in the healthcare system. It describes how patients and family will be supported to work in partnership with health care workers.
  9. Content Article
    Throughout 2023, the Arthritis and Musculoskeletal Alliance (ARMA) carried out the first ever national inquiry into musculoskeletal (MSK) health inequalities. The inquiry found that the prevalence and impact of musculoskeletal conditions are not experienced equally across the population. Musculoskeletal conditions are linked to deprivation and age, are more prevalent in women and disproportionately affect some ethnic groups. Deprivation is a significant driver of inequalities in MSK health. People in deprived areas experience more chronic pain, are more likely to have a long term MSK condition and experience worse clinical outcomes and quality of life. These inequalities are avoidable through changes in the design and delivery of MSK services, and actions to address wider determinants of health and prevention. The report makes recommendations to reduce health inequalities in MSK care, treatment and outcomes.
  10. Content Article
    In this blog, Peter Provonost MD, Chief Quality and Transformation Officer at University Hospitals Cleveland Medical Center, offers advice about what patients and their families can do to prevent health risks associated with hospital stays. He looks ways to mitigate against medication errors, surgical errors, infections, blood clots and other medical complications.
  11. Content Article
    This study aimed to assess perceptions of Covid-19 vaccines amongst pregnant or recently pregnant women in the US over two different time periods between November 2021 and February 2023. The results highlighted decreasing confidence in Covid-19 vaccine safety in a large, diverse pregnant and recently pregnant insured population, and the authors see this as a public health concern.
  12. Content Article
    This National Paediatric Diabetes Audit (NPDA) report on care and outcomes 2022/23 found that the prevalence of children and young people cared for in Paediatric Diabetes Units (PDUs) in England and Wales has increased from 33,251 in 2021/22 to 34,371 in 2022/23, despite a fall in the incidence of new cases. It also found that the percentages of children and young people with Type 1 and Type 2 diabetes receiving all six key annual healthcare checks have increased, but there remains much variability between PDUs (and completion rates for those with Type 2 remain lower than for those with Type 1). Other findings include: Percentages of young people with early signs of micro and macrovascular complications for both Type 1 and Type 2 diabetes show very little change in 2022/23 compared to the previous audit year Use of diabetes related technology has increased in 2022/23, with around half of children and young people with Type 1 diabetes using insulin pumps and half using a real time continuous glucose monitor (rtCGM) Around a quarter of all new cases of Type 1 diabetes had diabetic ketoacidosis (DKA) at diagnosis, compared to 25.6% in 2021/22. The report also states that, despite improvements in outcomes and use of technologies across different ethnicities and areas of deprivation, inequalities remain evident. In terms of rtCGM use, the inequality gap by deprivation has reduced, however the difference in use between Black and White children with Type 1 diabetes has widened from 8.6% in 2021/22 to 14% in 2022/23.
  13. Content Article
    Currently, surgical site infection surveillance relies on labour-intensive manual chart review. Recently suggested solutions involve machine learning to identify surgical site infections directly from the medical record. Deep learning is a form of machine learning that has historically performed better than traditional methods, while being harder to interpret. This study proposed a deep learning model—an explainable long short-term memory network—for the identification of surgical site infection from the medical record. The study found that the model had greater sensitivity when compared to traditional machine learning methods.
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    The Patients Association is running a webinar to support Future Health’s campaign, The Forgotten Majority. This campaign aims to raise awareness among policy representatives from Government and other political parties, as well as other key stakeholders, about the real life every day challenges faced by people with long-term health conditions and advocate for meaningful policy change as we approach the General Election. This webinar will provide patient experience to bring to life policies and initiatives aimed at addressing gaps in care for people with long-term health conditions. We hope this will raise awareness among policymakers and key stakeholders about the challenges faced by the ‘forgotten majority’ and the urgency of addressing their treatment and care. Rachel Power, Chief Executive of the Patients Association, will be chairing this webinar. The panel will share their insights on the importance of addressing the needs of people with long-term health conditions, and will advocate for improved care and support services. Hopefully this will increase awareness and understanding among policymakers and key stakeholders about the challenges faced by individuals with long-term health conditions, and drive systemic change. Register for the webinar
  15. Content Article
    This cohort study in JAMA Network Open explored whether the empathy displayed by doctors has an impact on the outcomes of patients with chronic pain. 1470 adults with chronic low back pain were included in the study, in which empathy was more strongly associated with favourable outcomes than nonpharmacological treatments, opioid therapy and lumbar spine surgery. The findings suggest that empathy is an important aspect of the patient-doctor relationship and is associated with better outcomes among patients with chronic pain.
  16. Event
    This webinar organised by WHO Europe will explore the access gaps in rural areas and the role that PHC plays in tackling this issue. Panellists from diverse backgrounds will delve into the multifaceted factors influencing access in rural, isolated and dispersed population areas. Register for the webinar
  17. Content Article
    In this article for the Lancet, Richard Horton reflects on the failure of medical education systems around to look after their students. He highlights reports of large proportions of medical students reporting burnout and feeling unappreciated and calls for an overhaul of the medical education system.
  18. Content Article
    Integrated Care Boards (ICBs) are responsible for commissioning and funding care provided by the various healthcare providers in its area, such as hospital trusts and community trusts. This blog offers patients practical advice on how to hold their ICB to account, for example, by raising questions at their ICB's monthly or bimonthly meeting.
  19. Content Article
    The UK is suffering from a chronic shortage of midwives, a shortage that has had an inevitable impact on maternity safety. While services in Scotland, Wales and Northern Ireland certainly have their challenges, it is England where the problems have been most severe, with a current estimated shortage of 2,500 midwives. The result is that midwives and working an estimated 100,000 hours’ unpaid overtime every week— burnout is widespread and the NHS is struggling to retain staff. This report by the Royal College of Midwives makes several suggestions to recruit and retain midwives in our maternity services. These include improving the quality of midwifery education. paying student tuition fees and employers developing more flexible working practices.
  20. News Article
    Rishi Sunak has failed to deliver on his key promise to cut NHS waits, the health secretary has admitted, as new figures show that the overall waiting list now stands at 7.5 million. An extra 300,000 patients are waiting for hospital care compared with January last year, when the prime minister pledged that, under his government, “NHS waiting lists will fall and people will get the care they need more quickly” . Victoria Atkins, the health secretary, admitted that Sunak had failed to deliver on his promise but argued: “I don’t think anyone could have thought that it was an easy promise to make and it was going to be easy to achieve.” Read full story (paywalled) Source: The Times, 11 April 2024
  21. News Article
    The headline A&E target was missed in March despite NHS England’s controversial last-ditch attempts to deliver it. Four hours A&E performance was 74.2 per cent in March—1.8 percentage points lower than NHSE’s 76 per cent threshold—but up from 71.5 per cent in the same month last year. NHSE’s attempts to improve four hours performance ahead of a year-end deadline—which included new cash incentives, asking directors to sign personal commitments, and encouraging trusts to focus on less sick patients—saw March performance 3.3 percentage points higher than 70.9 per cent in February. Around a third of acute trusts (38 of 119) met the 76 per cent target in March–more than double the number of trusts above the threshold in February (15). An interim ambulance response time for category 2 incidents, set at 30 minutes, was also missed in 2023-14—despite some improvement, and despite the government providing significant extra funding. The average response time across the year was 36m 23s—better than 2022-23 when it was 50m—but much worse than the pre-covid average of 21m 47s in 2018-19 and 23m 50s in 2019-20. Many ambulance trusts have continued to struggle with delays in handovers to A&E departments and South Western Ambulance Service Foundation Trust – which has seen some of the worst delays over the winter—averaged 45m 54s for category 2 incidents in March. Read full story (paywalled) Source: HSJ, 11 April 2024
  22. News Article
    A woman who feared she was having a heart attack said she spent nine days in a hospital staff room because of a shortage of beds. Zoe Carlin, 23, was admitted to Altnagelvin Hospital in Londonderry in March after experiencing severe chest pain. She said she spent more than a week in a “locker room” where she had to use a hand bell to call staff during what she described as a “dehumanising” ordeal. The Western Health and Social Care Trust (WHSCT) said it faced "extreme pressures" in its hospital emergency departments but could not comment on individual cases due to confidentiality. “For the full nine days I was in this alcove,” she told BBC Radio Foyle’s North West Today programme. “It’s basically the nurses' locker room. You can see the nurses’ lockers with their names on them. They [staff] just said there’s not enough beds,” she added. A privacy screen did not fully cover the room’s doorway and she had no access to a private bathroom. She said she was forgotten about at meal times on three occasions. A spokesperson for WHSCT said, "We are acutely aware of the continuing challenges and extreme pressures not just in our emergency departments but across both of our acute hospital sites with full escalation of beds on all wards and departments. In the Western Trust, when we learn of examples where care falls below the standard we expect, we review the circumstances and explore ways to improve care in the future." Read full story Source: BBC News, 11 April 2024
  23. News Article
    Adult transgender clinics in England are facing a Cass-style inquiry into how they treat patients after whistleblowers raised concerns about the care they provide. NHS England has announced that it is setting up a review of how the seven specialist services operate and deliver care after past and present staff shared misgivings privately during a previous investigation. As a first step, NHS England will send “external quality improvement experts” into each of the clinics to gather evidence about how they care for patients, to help guide the inquiry’s direction. The move follows the publication on Wednesday of a landmark review by Dr Hilary Cass, a former president of the Royal College of Paediatrics and Child Health, which recommended sweeping changes in the way that the health service treats under-18s who are unsure about their gender identity. In a letter responding to Cass’s report, which NHS England sent on Tuesday to the seven trusts that host adult gender dysphoria clinics (GDCs), it told them: “We will be launching a review into the operation and delivery of the adult GDCs, alongside the planned review of the adult gender dysphoria service specification.” Robbie de Santos, director of campaigns and human rights at Stonewall, an LGBT rights charity, said: “Gender healthcare for adults in the UK is, simply put, not fit for purpose. Many trans adults are being forced to go private at great personal expense to avoid waiting lists in excess of half a decade. We would welcome a review aimed at tackling this unacceptable state of affairs and building capacity into the system.” Read full story Source: Guardian, 10 April 2024
  24. News Article
    A statutory inquiry into deaths of mental health patients will now cover fatalities that took place as late as December 2023. The inquiry’s investigations are focused “on the trusts which provide NHS mental health inpatient care in Essex”. This includes: “Essex Partnership University Foundation Trust, and the North East London Foundation Trust and their predecessor organisations, where relevant.” NELFT was not specifically mentioned in the original terms of reference although the inquiry told HSJ it had been within the original scope. The inquiry will also now cover deaths of NHS patients from Essex who died when under the care of private sector providers. The inquiry’s previous terms of reference covered a period ending in 2020. However, the inquiry’s chair, Baroness Kate Lampard, proposed extending the inquiry’s scope last year due to “ongoing concerns” over services at EPUFT. Read full story (paywalled) Lampard Inquiry: Terms of reference Source: HSJ, 11 April 2024
  25. Event
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    The federal Patient Safety and Quality Improvement Act was created in 2005 and established a national patient safety database and a system of Patient Safety Organizations (PSOs) in the US. Although PSOs have existed for more than 15 years, healthcare organisations still struggle to identify the best reporting structure and how to most effectively utilise protections in relation to patient safety work. In this ECRI webinar, Partner and Owner of Bolin Law Group, Andrew Bolin, will discuss: The establishment of a Patient Safety Evaluation System and how it relates to PSOs The differences between state protections and federal protections How to work with surveyors who request information protected under the Act Register for the webinar The webinar will take place at 13:00 ET (18:00 BST)
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