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Claire Cox

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Everything posted by Claire Cox

  1. Content Article
    In 2017, The Point of Care Foundation made a film of a Schwartz round at Ashford and St Peter’s Hospitals NHS Trust. The full session lasted one hour – this is an edited version which aims to show what happens in a round. Schwartz rounds often tackle difficult emotional situations. This film deals with a particular case about a sick baby, which some viewers may find upsetting.
  2. Content Article
    The creation of a national network of medical examiners (MEs) was recommended in the Shipman inquiry and was alluded to in the Mid-Staffordshire and Morecambe Bay public inquiries. The Parliamentary Under-Secretary of State for Health, Lord O’Shaughnessy, confirmed in October 2017 that a national system of medical examiners will be introduced from April 2019. The ME reforms set out in the 2009 Coroners Act will be implemented nationally in two phases. By April 2019, NHS trusts should set up non-statutory schemes, based upon the national pilots (particularly in Leicester, Sheffield and Gloucester), funded in part from cremation form fees, in preparation for the commencement of a statutory scheme in 2020/21. A National Medical Examiner will be appointed, reporting directly to the National Director of Patient Safety.
  3. Content Article
    A team at South Tees Hospitals NHS Foundation Trust in Middlesbrough developed a programme to raise awareness of acute kidney injury (AKI) and to recognise and treat the condition promptly. Since the programme started there has been a sustained reduction (36%) in AKI cases within the surgical wards at Middlesbrough. This successful programme and pathway has been shared with seven other trusts in the North East of England. As a result of the AKI project and its links to CRAB Clinical Informatics Limited (C-Ci), other NHS Trusts (Imperial, Frimley Park, Wexham Park, North Devon, St Helen’s, Lincoln, Yeovil, Bartholomew’s, The Royal London and Southend) have now also been consulted, meaning this project has the potential for much wider spread. Commonly AKI starts in the community so the team is now focusing on strategies to support primary care to reduce AKI in the community and to harmonise AKI aftercare between hospital and community services. The South Tees Hospitals NHS Foundation Trust team was also highly commended in July 2017 at the national Patient Safety Awards.
  4. Content Article
    Pressure ulcers are an unwanted and often avoidable complication of care that affect over 700,000 UK patients per year. They are a common occurrence, particularly in patients whose mobility is limited due to illness, severe physical disability or increasing frailty. Pressure ulcers can lead to increased mortality, morbidity, and reduced quality of life for the patient. Pressure ulcers can also result in longer hospital stays, with hospital acquired pressure ulcers increasing length of stay by an average of 5-8 days per pressure ulcer. In addition, they represent a substantial financial cost to local NHS trusts and care providers. In 2015, the cost per pressure ulcer was estimated to vary between £1,214 and £14,108 depending on its severity. Given the often preventable nature of pressure ulcers, the occurrence of this harm to patients is a key indicator of nursing standards.
  5. Content Article
    Prescribing errors in general practice are an expensive, preventable cause of safety incidents, illness, hospitalisations and even deaths. Serious errors affect one in 550 prescription items, while hazardous prescribing in general practice contributes to around 1 in 25 hospital admissions. Outcomes of a trial published in the Lancet showed a reduction in error rates of up to 50% following adoption of PINCER. PINCER is a methodology for reducing medication errors and, thereby, improving medication safety. Using clinical audit tools alongside quality improvement methodology to review groups of patients taking high risk medicines/combinations of medicines, PINCER ensures that any risks are mitigated.
  6. Content Article
    Liverpool is leading the way in the use of smartphone technology to deliver and monitor care in people’s homes. The city is the first to introduce a digital system with almost all domiciliary care providers – giving instant information about 9,000 vulnerable residents to their families and professionals. The use of an app allows care providers and families to see when a visit is carried out by a carer, for how long and how the person responded.The effect is better informed families and care managers and improved care. Liverpool is the only authority in Europe to be using the technology across its city, with all but one of its 18 domiciliary care providers using everyLIFE PASSsystem. It was made possible through a grant of one million Euros of European Union funding secured through the EU STOPandGO programme of which the Innovation Agency, the Academic Health Science Network for the North West Coast was a key partner.
  7. Content Article
    University Hospitals of Leicester NHS Trust (UHL), IBSL (UK) Limited and Santa Lucia Pharma Apps SrL (SLPA), with support from EMAHSN and Loughborough University, have deployed a unit dose closed loop medicines management solution in four wards at UHL and undertaken an 18-month evaluation of the project (OptiMed-ID) in preparation for a Trust-wide rollout.
  8. Content Article
    The Tookie Vest is a patient and clinician driven innovation, designed to support patients fitted with a Central Venous Catheter (CVC) undergoing haemodialysis (HD) to provide enhanced line security. The Tookie Vest is designed to help prevent catheter displacement but also to aid the patients to continue to live ‘#ALifeMoreNormal’ as the vest helps to discretely secure the lines, offering modesty and dignity, freedom, independence and reassurance. The Tookie Vest was originally designed to prevent inadvertent catheter fallout in paediatric oncology patients, a product that was supported by the Yorkshire & Humber AHSN through funding and access to specialist clinical and design advice. The AHSN for the North East and North Cumbria (AHSN NENC) have since provided support and advice via ‘The Innovation Pathway’ for the development of the adult HD vest.
  9. Content Article
    Urinary tract infection (UTI) was identified as the main reason to call a GP out-of-hours or to result in an unplanned admission to hospital from residential and nursing homes. Care home staff were using a urine dipstick to diagnose a urinary tract infection then calling a health care professional (HCP) for antibiotics, resulting in inappropriate use of antibiotics and over-treating what is perceived as a UTI in the absence of clinical symptoms.
  10. Content Article
    Nationally, it is estimated that nearly 1.4 million people in the UK are affected by atrial fibrillation (AF), and a quarter of these people are unaware that they have AF. AF causes an irregular or abnormally fast heart rate. It increases the risk of stroke by up to five times, with about 12,500 strokes per year directly attributed to AF. Recognising and receiving proper treatment for AF is important because the strokes due to AF are often more severe, with a survival rate of only 50 per cent and a risk of increased disability among those who do survive, compared to those who have a non-AF related stroke. At the age of 40, we all have a one in four lifetime risk of developing AF. Eleven AHSNs have contributed to the detection of 365 patients with undiagnosed atrial fibrillation, in one year. This means that the equivalent of one stroke per day has been prevented by this work, saving lives, reducing disability, and saving almost £8.5 million to the NHS and social care.
  11. Content Article
    A digital tablet intervention to record and communicate data on the health of residents was used in care homes in Sunderland. Between April 2017 and March 2018, a small-scale evaluation compared data between eight of the care homes routinely using the intervention with eight similar care homes who weren’t. The evaluation found that the eight care homes using the intervention made an estimated saving of around £756,144 in A&E attendances and ambulance services during this period.
  12. Content Article
    The South West Patient Safety Collaborative has introduced a validated assessment tool for safety culture in England, using a survey called SCORE (safety, communication, operational risk, resilience and reliability, and engagement). As part of the ‘Safer Culture, Better Care’ programme, this anonymous survey gives individuals and teams a fresh perspective on their current patient safety culture. Over 10,000 staff in 122 teams have taken part in the programme, leading to improved patient safety and new ways of working.
  13. Content Article
    An adverse clinical event, patient safety incident or medical error can have a far-reaching impact not only for the patient and their families, the 'first victims', but also the healthcare professionals involved. These are sometimes referred to as ‘second victims’. Often there are few opportunities for second victim healthcare professionals to discuss the details of incidents or events and share how this has affected them personally. The East Midlands Patient Safety Collaborative (EMPSC) funded the University of Leicester as part of their National Safety Culture workstream to develop a Second Victim Support Unit within the Children’s Hospital at University Hospitals Leicester to test whether models of support established in the US could be successfully transferred to UK health settings.
  14. Content Article
    UCLPartners delivered two breakthrough series collaboratives with 13 acute hospital trusts in the north Thames region to transform the care provided to patients with acute kidney injury (AKI) and sepsis. The aims for the AKI and sepsis collaboratives were to achieve improvements in the recognition and treatment of patients admitted to hospital with AKI or sepsis, as well as to increase NHS staff quality improvement capability across the region. The analysis of over 2,000 AKI and sepsis cases throughout the programme showed that both collaboratives exceeded their aims, and reduced AKI mortality by 47%, and sepsis mortality by 24%.
  15. Content Article Comment
    Thanks so much @Judy Walker we use AAR's in out Trust. I was last part of an AAR when there was an unusual and distressing incident that happened. All staff involved got together and had an AAR that day to discuss what had happened using the framework. It isn't just about learning opportunities, its about how we communicate to each other, its about understanding and listening to how others have experienced the event. Not only did we all see from others perspectives, were were able to talk to each other on the same level. We had all gone through a very harrowing experience and were able to open up as human beings rather than 'the nurse ', 'the doctor' or 'the healthcare assistant'. Everyone has a chance to say how it was, the way they experienced it. After this , it made working with these people again so much more enjoyable and easier. We had respect for each other and were able to communicate better. Yes, they can be time consuming. I truly believe it we didn't have an AAR that day, at least 2 staff members would have gone off sick with stress. Investing in staff well-being is crucial.
  16. Content Article
    INQUEST's groundbreaking evidence-based report is based on our work with families of those who have died in mental health settings and related policy work. It identifies three key themes:  1. The number of deaths and issues relating to their reporting and monitoring. 2. The lack of an independent system of pre-inquest investigation as compared to other deaths in detention. 3. The lack of a robust mechanism for ensuring post-death accountability and learning.
  17. Content Article
    ThinkSAFE is developed by Newcastle University, in partnership with NHS staff and patients.  Research has shown that by encouraging patients and their families to work together with hospital staff, safety can be improved during the patient’s stay in hospital.
  18. Content Article
    Sleep is fundamental to good health. Healthcare professionals receive little teaching on the importance of sleep, particularly with respect to their own health when working night shifts. Knowledge of basic sleep physiology, together with simple strategies to improve core sleep and the ability to cope with working nights, can result in significant improvements both for healthcare professionals and for the patients they care for. This article by Dr Mike Farquhar, published in the Archives of Disease in Childhood: Education & Practice, gives practical advice for night shift workers and, generally, how to improve your quality of sleep.
  19. Content Article
    Information for the Public pre-hospital emergency medicine (PHEM) feedback is a collaboration between the Princess Alexandra Hospital and the services who bring patients to them (ambulances and air ambulance teams) and provide pre-hospital care to those patients.
  20. Content Article
    Healthcare isn’t the only industry that’s working to protect people in dangerous environments. Each year at the Institute for Healthcare Improvement (IHI) National Forum, the IHI faculty leads excursions to organisations outside of healthcare to learn about how they do their work. Kathy Duncan, IHI Faculty, leads a trip to the Central Florida Zoo, which has one of North America’s largest collections of venomous snakes. In this video, Duncan goes behind the scenes to learn about the staff’s safety procedures for handling snakes when they need to be moved from their enclosures.
  21. Content Article
    Quality 2020 is a 10 year quality strategy for health and social care developed by the Department of Health, Social Services and Public Safety for Northern Ireland.
  22. Content Article
    Listening to patients is hugely important as they are at the very the heart of what we do. We need to listen to them more, as they help us all move the conversation on safety forward. This short video from the Health Service Journal includes patients, relatives and patient advocates and staff who speak about their experiences from being in the healthcare system.
  23. Content Article
    Charles Vincent and René Amalberti set out a system of safety strategies and interventions for managing patient safety on a day-to-day basis and improving safety over the long term. These strategies are applicable at all levels of the healthcare system from the frontline to the regulation and governance of the system. There have been many advances in patient safety, but we now need a new and broader vision that encompasses care throughout the patient’s journey. The authors argue that we need to see safety through the patient’s eyes, to consider how safety is managed in different contexts and to develop a wider strategic and practical vision in which patient safety is recast as the management of risk over time. Most safety improvement strategies aim to improve reliability and move closer toward optimal care. However, healthcare will always be under pressure and we also require ways of managing safety when conditions are difficult. We need to make more use of strategies concerned with detecting, controlling, managing and responding to risk. Strategies for managing safety in highly standardised and controlled environments are necessarily different from those in which clinicians constantly have to adapt and respond to changing circumstances.
  24. Content Article
    Staff at C.S. Mott Children’s Hospital and Von Voigtlander Women’s Hospital, Michigan are adopting a new approach to safety. By picking up near misses, close calls, deviation off protocol and investigating each one via a daily huddle, they are able to enable change system wide.
  25. Community Post
    Thanks Neal - I'm going to pop these on the hub!
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