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Sam

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Everything posted by Sam

  1. News Article
    China has introduced a new law with the aim of preventing violence against medical workers. The announcement comes days after a female doctor was stabbed to death at a Beijing hospital. The law bans any organisation or individual from threatening or harming the personal safety or dignity of medical workers, according to state media. It will take effect on 1 June next year. Under the new law, those "disturbing the medical environment, or harming medical workers' safety and dignity" will be given administrative punishments such as detention or a fine. It will also punish people found illegally obtaining, using or disclosing people's private healthcare information. Read full story Source: BBC News, 29 December 2019
  2. News Article
    As part of the HTN Health Tech Trends Series, Health Tech Newspaper has researched a variety of health tech projects making a difference across health and care. Read full story Source: Health Tech Newspaper, 5 December
  3. Content Article
    Patient safety incidents are any unintended or unexpected incident which could have, or did, lead to harm for one or more patients receiving healthcare. Reporting them supports the NHS to learn from mistakes and to take action to keep patients safe. Both healthcare staff and the general public are encouraged to report any incidents, whether they result in harm or not, to the National Reporting and Learning System (NRLS). You can find out how to do this from the link below.
  4. Content Article
    Steve Highley looks at responding positively to error using a personal experience involving his car and highlights how to find and deal with error traps.
  5. News Article
    Machine learning algorithms can accurately assess the capabilities of neurosurgeons during virtual surgery before they step into an actual operating room, a new study shows. Researchers recruited 50 participants from four stages of neurosurgical training: neurosurgeons, fellows and senior residents, junior residents and medical students. The participants performed 250 complex tumour resections using NeuroVR, a virtual reality surgical simulator. Using the raw data, the machine learning algorithm developed performance measures that could predict the level of expertise of each participant with 90% accuracy. The top performing algorithm could classify participants using just six performance measures. As reported in the Journal of the American Medical Association, the findings show that the fusion of artificial intelligence (AI) and virtual reality neurosurgical simulators can accurately and efficiently assess the performance of surgeon trainees. This means that scientists can develop AI-assisted mentoring systems that focus on improving patient safety by guiding trainees through complex surgical procedures. These systems can determine areas that need improvement and how the trainee can develop these important skills before they operate on real patients. “Our study proves that we can design systems that deliver on-demand surgical assessments at the convenience of the learner and with less input from instructors. It may also lead to better patient safety by reducing the chance for human error both while assessing surgeons and in the operating room,” said leading author, Rolando Del Maestro of McGill University. Read full story Source: FUTURITY, 5 August 2019
  6. Content Article
    The successful implementation of clinical practice guidelines should improve quality of care by decreasing inappropriate variation and expediting the application of effective advances to practice. However, despite wide promulgation, practice guidelines have had limited effect on changing physician behavior. Cabana et al. conducted a systematic review of the barriers to physician adherence to clinical practice guidelines, practice parameters, clinical policies or national consensus statements. They found that physician adherence is dependent on physician awareness (31 examples), agreement (68 examples), self-efficacy (13 examples), outcome expectancy (12 examples), motivation (3 examples), and the absence of external barriers to perform guideline recommendations (62 examples). The findings suggest that studies describing interventions to improve physician adherence may not be generalisable, since barriers in one setting may not be present in another. Using this analysis, the authors propose a framework which describes the barriers that must be overcome to improve physician adherence. This framework can be used (1) as a method to profile barriers or sources of poor adherence and thus (2) as a diagnostic tool to standardise and select appropriate interventions to improve adherence. The selection of interventions to change physician behaviour has been haphazard in the past. This analysis offers a more rational approach towards improving physician adherence to practice guidelines as well as a framework for further research.
  7. News Article
    The Patient Safety Learning award winners have been announced today at our annual conference. You can see the winning entries and read more about their projects here.
  8. News Article

    National Medical Examiner update

    Sam

    Sam posted a news article in News

    Latest National Medical Examiner update on national and regional infrastructure, funding the medical examiner system, medical examiners and referrals to coroners, working with registrars, and face to face training. Read update
  9. Content Article
    There have been major healthcare failings in the UK NHS over many years. The persistent dysfunctional organisational culture, an inability to learn and the need for change has been identified within literature. The concept of organisational silence forms one aspect of the proposed model of organisational dysfunction in the NHS. Forty-three interviews and six focus groups have been conducted to test the model. From generalised evidence, it is suggested that the NHS is systemically and institutionally deaf, bullying, defensive and dishonest. There appears to be a culture of fear, lack of voice and silence. The cost of suppression of voice, reluctance to voice and the resulting ‘sea of silence’ is immense. There is a resistance to ‘knowing’ and the NHS appears to be hiding and retreating from reality. There is an urgent need for action to be taken to address this dysfunctional culture. The NHS needs to embrace the identity of being a listening, learning and honest organisation, with a culture of respect. It needs to choose to hear, see and speak for the benefit of patients and staff. There are implications for the wider UK society due to the apparent inability to learn and improve.
  10. Content Article
    This education and training guide is a resource for every Guardian’s self-development, whatever their experience in the role. Commissioned by the National Guardian’s Office and Health Education England in August 2017, the Guide was compiled by Louisa Hardman from the NHS Leadership Academy with invaluable contributions and guidance from an Advisory Group comprising Freedom to Speak Up Guardians and members of the National Guardian’s Office.
  11. Content Article
    Evidence highlights the intrinsic link between nurse staffing and expertise, and outcomes for service users of healthcare, and that workforce retention is linked to the clinical and organisational experiences of employees. However, this understanding is less well established in mental health. This study from Cook et al. comprises a retrospective observational study carried out on routinely collected data from a large mental healthcare provider. Two databases comprising nurse staffing levels and adverse events were modelled using latent variable methods to account for the presence of multiple underlying behaviours. The analysis reveals a strong dependence of the rate of adverse events on the location and perceived clinical demand of the wards, and a reduction in adverse events where registered nurses exceed ‘clinically required levels’. In the first study of its kind, these findings present significant implications for nursing workforce policy and present an opportunity to not only improve safety but potentially impact nurse retention.
  12. News Article
    Ambulance crews have been warned not to rely on satellite navigation systems after a spate of incidents where they were directed onto slower routes causing delays in reaching patients. Read full story (paywalled) Source: HSJ, 28 August 2019
  13. Event
    Behaviour change can be difficult to achieve. This workshop from the Improvement Academy we will help you to achieve behaviour change by applying tried and tested theories from psychology. This unique one-day workshop developed by the Yorkshire Quality and Safety Research Group provides an opportunity to learn from leading researchers in behaviour change. Interactive learning and discussion will lead to improved understanding and enhanced practice in improving patient safety through behaviour change. Further details and registration
  14. News Article
    Health leaders have written to Boris Johnson issuing new warnings on the impact of a no-deal Brexit. In a letter to the Prime Minister, the heads of 17 royal colleges and health charities across the UK say clinicians are "unable to reassure patients" their health and care will not be affected. They go on to say they have "significant concerns about shortages of medical supplies". Government said it was working with the health sector on "robust preparations". The letter, co-ordinated by the Royal College of Physicians, is signed by the heads of organisations including the British Dental Association, the Royal Pharmaceutical Society, Kidney Care UK and the Royal College of Emergency Medicine. It calls for the Health and Social Care Secretary Matt Hancock to be put on the EU exit strategy committee chaired by Michael Gove, who is in charge of no-deal planning. The signatories argue that - given the scale of the NHS - without sufficient planning, even the smallest of problems could have "huge consequences on the lives of millions of people". Read full story Source: BBC News, 21 August 2019
  15. News Article
    Two million pensioners are taking at least seven types of prescription drugs - putting them at risk of potentially lethal side-effects, a major report warns. Age UK said the rise of “polypharmacy” was putting lives at risk, with three quarters likely to suffer adverse reactions to at least one of their drugs. The research found that the number of emergency hospital admissions linked to such side-effects has risen by 53 per cent in seven years, with some cases proving fatal. Experts said GPs were doling out too many drugs because they were too busy to properly consider complex health problems, and the risk of side-effects, and interactions between different drugs. Caroline Abrahams, Charity Director at Age UK, said: "We are incredibly fortunate to live at a time when there are so many effective drugs available to treat older people’s health conditions, but it’s a big potential problem if singly or in combination these drugs produce side effects that ultimately do an older person more harm than good.” Read full story Source: The Telegraph, 22 August 2019
  16. News Article
    After two decades of keeping the public in the dark about millions of medical device malfunctions and injuries, the US Food and Drug Administration (FDA) has published the once hidden database online, revealing 5.7 million incidents publicly for the first time. The newfound transparency follows a Kaiser Health News investigation that revealed device manufacturers, for the past two decades, had been sending reports of injuries or malfunctions to the little-known database, bypassing the public FDA database that’s pored over by doctors, researchers and patients. Millions of reports, related to everything from breast implants to surgical staplers, were sent to the agency as “alternative summary” reports instead. Read full story Source: Kaiser Health News, June 27 2019
  17. News Article
    Registrars at an Australian hospital have launched legal action against its management amid claims that they are being worked beyond exhaustion while being denied their mandatory clinical training. The alleged plight of the doctors at Melbourne’s Sunshine Hospital has become the latest instalment in a growing list of complaints among doctors in training over excessive workload pressures, exploitation, harassment, and bullying across the country’s public hospital system. Read full story Source: BMJ, 12 August 2019
  18. News Article
    NHS England has declared a national emergency over shortage of feed for babies and disabled patients, with some patients being told to go to Accident & Emergency (A&E) departments. Hundreds of NHS patients, including children, who depend on intravenous (IV) nutrition, have been experiencing delays in deliveries. It follows an inspection by watchdogs which found manufacturers were failing to meet safety standards, and the presence of potentially fatal bacteria. The NHS National Patient Safety Director, Aiden Fowler, has written to all NHS hospital trusts, and affected patients, warning that the incident has been designated as an emergency incident, under the Civil Contingencies Act, at the highest level. British manufacturer Calea had already said the shortages could last up to four weeks. But the letter warns that the crisis could last far longer, outlining plans to ration the product to those most in need. Parents said the situation was “terrifying” with some told to go to A&E if vulnerable children were left too long without being fed. Hospitals have now been asked to review all patients receiving such IV feed to ensure only those deemed at high-risk are allocated the supplies, which are tailored to meet specific individual needs. Others will be allocated standard bags of nutrition, with extra supplements. In the letters from Dr Fowler, disclosed by the Health Service Journal, he warns that the NHS is facing a “difficult balance” between the risks caused by the shortages, and the dangers of allowing production to continue, without safety improvements. Read full story Source: The Telegraph, 13 August 2019
  19. News Article
    Medical leaders need to prevent and tackle “problematic subcultures”, which can include groups of “divas” who are viewed as “untouchable”, new General Medical Council research has concluded. Read full story (paywalled) Source: HSJ, 14 August 2019
  20. News Article
    Nearly 2 million NHS patients are to be given access to video consultations with doctors employed by a digital healthcare supplier as a result of a series of deals signed with NHS commissioners.Nearly 2 million NHS patients are to be given access to video consultations with doctors employed by a digital healthcare supplier as a result of a series of deals signed with NHS commissioners. Read full story (paywalled) Source: HSJ, 12 August 2019
  21. News Article
    Whitehall investigators have launched an inquiry into allegations of serious misconduct during the official review of the Gosport hospital scandal. They are examining claims that civil servants working on the £13m inquiry bullied staff, buried evidence and went on taxpayer-funded “working retreats” to Spain. An independent panel last year linked Dr Jane Barton to the premature deaths of up to 656 elderly people given opiate overdoses at Gosport War Memorial Hospital between 1989 and 2000. Whistleblowers have alleged that the panel ignored concerns about the hospital’s culture and use of faulty medical equipment to deliver a “clean hit” and “draw a line under it all”. The Department of Health said last night: “We take all and any allegations of wrongdoing very seriously. An investigation is being undertaken and it would be inappropriate to comment further until it is concluded.” Read full story Source: The Sunday Times, 11 August 2019
  22. News Article
    Documents released in an Ohio court case last month, in a landmark, multi-district opioid lawsuit, gave new insight into an unparalleled opioid epidemic in the United States. It revealed that between 2006 and 2012, some 76 billion opioid pills were distributed in the United States — more than 200 pills for every man, woman and child. It paints a damning picture of the tension between drug company profits and patient safety during the time opioid sales were climbing dramatically. In one 2009 exchange, a pharmaceutical company representative emailed a colleague at another company to alert him to a pill shipment. “Keep ’em comin’!” was the response. “Flyin’ out of there. It’s like people are addicted to these things or something. Oh, wait, people are.” According to Charles L. Bennett et al. in an editorial published in the Los Angeles Times, the failings are at every point in the system, starting with drug approvals. But the authors believe there is a particularly serious problem with the mechanisms for identifying, monitoring and disseminating information about issues with a drug after its release. They suggest a good starting point for reforming the system would be increased transparency about drugs already recognised as particularly dangerous. These drugs, currently numbering about 70 (including opioids), carry the FDA’s so-called 'black box warning,' intended to alert patients and their doctors to the high risks associated with the drugs. But that is not enough. The authors propose a 'black box' database or 'registry,' publicly available and simple to use, that would contain extensive information about where, by whom and for what purpose black box drugs are prescribed, as well as where and in what quantities such drugs are being distributed and sold. Information about adverse side effects, culled from the myriad of government databases that now collect them, would also be consolidated in an open form and format. Read full story Source: Los Angeles Times, 8 August 2019
  23. News Article
    Appropriate methods and standards around artificial intelligence (AI) need to be created to protect patient safety, experts have said. Responding to the Government’s pledge of £250 million for a National Artificial Intelligence (AI) Lab, Matthew Honeyman, researcher at The Kings Fund, said the NHS workforce needs to be equipped with digital skills for the benefits of new technologies to be realised. “AI applications are in development for many different use cases – from screening, to treatment, to admin work – there needs to be appropriate methods and standards developed for safe deployment and evaluation of these solutions as they enter the health system,” he told Digital Health. Adam Steventon, Director of Data Analytics at the Health Foundation, said the commitment was a “positive step” but that technology needs to be driven by patient need and “not just for technology’s sake”. “Robust evaluation therefore needs to be at the heart of any drive towards greater use of technology in the NHS, so that technologies that are shown to be effective can be spread further, and patients protected from any potential harm,” he said. Read full story Source: Digital Health, 9 August 2019
  24. News Article
    A judge has backed a decision by the Care Quality Commission to block the opening of an “institutional” care home for people with learning disabilities, concluding that the setting would have created “unacceptable and serious risks” for residents. Read full story (paywalled) Source: Nursing Times, 9 August 2019
  25. News Article
    The past year has seen wide concern about the safety of medical implants. Some of the worst scandals have involved devices for women, such as textured breast implants with links to cancer, and transvaginal mesh implants, which were the subject of the asenate inquiry. But women are harmed not only by 'women's devices' such as breast implants and vaginal mesh. Women are also more likely to be harmed by apparently gender-neutral devices, like joint replacements and heart implants according to Katrina Hutchison in a recent MENAFN article. Bias starts with design and then lab testing: biological and social factors can affect how women present when injured or ill, and how well treatments work. Often, device designers do not take these differences into account. The lab tests used to make sure implants are safe often ignore the possibility women could have different reactions to materials, or their activities could place different loads on implants. Bias continues with clinical trials. And then there's the doctor-patient relationship; the gender of the doctor and patient can make a difference to what women learn about their implant. Read full story Source: MENAFN, 11 August 2019
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