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Showing results for tags 'Diagnosis'.
Found 477 results
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Content ArticleThis study, published in Human Factors in Healthcare, applied a human factors approach through the Systems Engineering Initiative for Patient Safety (SEIPS) model to inform the design of community cardiac diagnostic services, focusing on workforce design and the potential role of cardiac physiologists. The study setting was a cardiology department at a community hospital. Data were collected through observations, interviews and focus groups. Data were analysed using SEIPS and Thematic Analysis.The analysis revealed three overarching design considerations: (1) Promoting professional growth and autonomy for the cardiac workforce in the community. (2) Focusing on the needs of patients in the community, including accessibility and communication. (3) Facilitating communication across organisational boundaries, particularly between CDCs and General Practitioners (GPs).
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Content ArticleThis report commissioned by the US Agency for Healthcare Research and Quality aims to identify major themes related to the current state of diagnostic safety and highlight key gaps in knowledge. Through a rapid narrative review methodology to evaluate multiple resources in the literature and interviews with experts, it presents several findings that have implications for future resource investments to reduce harm from diagnostic errors. The report looks at the following key themes: Incidence and Contributing Factors Measurement: Data and Methods Cognitive Processes Culture, Workflow, and Work System Issues Disparities Health Information Technology Patients and Families Testing Interventions Implementation
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Content ArticleKerri Mothersole was a 44 year old woman who had a past medical history of asthma, labyrinthitis, depression and back pain. In May 2020 she was seen with symptoms of possible early menopause and blood tests requested. In October 2020 she was noted to be suffering from tiredness and had irregular periods and again blood tests were requested. Blood tests taken in January 2021 noted a low haemoglobin and ferritin so iron was prescribed as well as follow up in two months. In March 2021 she complained of having per vaginal bleeding for six weeks and she was referred for an ultrasound. Due to her underlying ill health, she had difficulty in attending appointments and missed a number of different appointments. She was seen in the surgery on 21 June 2021 by her General Practitioner who noted abdominal tenderness and weight loss and he again referred her for an ultrasound. An ultrasound was undertaken by a private firm HEM Clinical Ultrasound on 28 June 2021 but the report was never sent to her General Practitioner. A second ultrasound on the 1 July 2021suggested a diagnosis of adenomyosis but noting that serious pathology could not be ruled out. Only the second report was sent to the General Practitioner which led to a routine gynaecology referral, she had however already been referred to the colorectal team on the urgent two week wait pathway. Had the earlier scan report been seen this would have led to an urgent referral to gynaecology. There were a number of missed appointments and a colonoscopy took place on 20 October 2021. The procedure was negative but the endoscopist thought he could feel something in the pelvis and a CT scan was arranged. The CT scan on 28 October 2021 demonstrated a large pelvic mass and she was referred to the gynaecology team in early December and a multidisciplinary team meeting discussion on 17 December 2021 led to a request for an MRI scan. Appointments were made for 31 December 2021, 25 January 2022 and again in February but not attended and she eventually underwent an MRI on 1 May 2022 which revealed a large mass. She was again discussed at the multidisciplinary team meeting on 6 May 2022 and referred to the gynae-oncology surgeons at Maidstone hospital. She was seen on 1 June 2022 and booked for surgery on 27 June 2022. She was, however, far too unwell for surgery on 27 June 2022 and further investigations revealed brain metastases. She was admitted to hospital and treated with steroids and referred to the Oncologists as surgery was deemed no longer appropriate. She was prescribed hormone treatment but she was, by now, too unwell to receive even palliative radiotherapy. She was taken to Medway Maritime hospital on 19 August 2022 and was struggling as she had been so unwell at home. Whilst plans were being made to provide some care at home she remained overnight but sadly died on 20 August 2022 as she was so unwell she could not return home.
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Content Article
Diagnostic error in mental health: a review (4 April 2024)
Mark Hughes posted an article in Diagnostic error
Diagnostic errors are associated with patient harm and suboptimal outcomes. However, despite efforts to advance definition, measurement and interventions for diagnostic error, diagnosis in mental health is not well represented in this ongoing work. The authors of this article, published in BMJ Safety & Quality, summarise the current state of research on diagnostic errors in mental health and identify opportunities to align future research with the emerging science of diagnostic safety. -
Content ArticleDespite growing awareness of diagnostic error, most healthcare systems do not track or record diagnostic quality, and many diagnostic safety events are not recognised. Without methods to identify, measure, investigate and analyse events, healthcare organisations cannot understand causes of diagnostic errors, identify contributing factors or create solutions. One of the best ways to collect information about diagnostic errors is through self-reporting by patients and healthcare professionals. This issue brief from the Agency for Healthcare Research and Quality looks at how to foster psychological safety and organisational safety culture in order to reduce harm from diagnostic error.
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News Article
Cost of dementia to UK could almost double to £91bn by 2040, study finds
Patient_Safety_Learning posted a news article in News
Dementia could cost the UK almost £91bn a year by 2040, as the number of people affected rises inexorably, a study has found. The “colossal” costs of the disease are likely to more than double from an already “staggering” £42.5bn today to £90.6bn, according to research undertaken for the Alzheimer’s Society. That projected rise will happen in line with an expected increase in the number of diagnosed cases from 981,575 to 1,402,010, related to an ageing and growing population. Read full story Source: Guardian, 13 May 2024 -
Content ArticleIt’s well known that diagnosis at an early stage of cancer dramatically increases chances of survival. Current NHS policy is focused on diagnosing cancer at an earlier stage and improving the speed with which patients receive a definitive diagnosis. This article from the Nuffield Trust and The Health Foundation presents graphical data illustrating that the NHS is seriously off course in achieving these aims. It examines the reasons for delays to diagnosis including difficulties patients face in getting their concerns and symptoms taken seriously, the role of deprivation in increasing diagnostic inequalities and pressures due to increasing numbers of referrals. It also looks at the role screening has to play in achieving earlier diagnosis and highlights issues with patients understanding the information they are given.
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Content ArticleThis article tells the story of 61 year-old Susannah Constantine who was diagnosed with a rare neurological condition after her MRI was not looked at by her GP surgery for over a year. Susannah decided to have a private MRI when doctors couldn't diagnose why she’d been suffering from tinnitus and pins and needles in the fingers of her left hand. The results were sent to her GP, and Susannah heard no more, so struggled on for another year—she gradually became weaker and her muscles atrophied. She called her GP surgery to check if the MRI held any clues and learnt no one there had ever looked at the results—they had just been sat there for a year. She was told she needed to see a neurosurgeon immediately and was diagnosed with arteriovenous malformation (AVM), a rare neurological condition that disrupts the flow of blood and oxygen to the brain. If not spotted and treated in good time there is a one in three chance of suffering a brain haemorrhage, paralysis or stroke.
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Content Article
On 17 and 18 April 2024, government ministers, high-level representatives and health experts from all over the world gathered in Santiago, Chile for the Sixth Global Ministerial Summit on Patient Safety. In this long-read article, Patient Safety Learning’s Chief Executive Helen Hughes reflects on the key themes and issues discussed at the event. -
Content Article
Improving diagnosis in health care (2015)
Patient-Safety-Learning posted an article in Diagnosis
This report is a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001). It finds that diagnosis, and in particular the occurrence of diagnostic errors, has been largely unappreciated in efforts to improve the quality and safety of healthcare. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, healthcare organisations, patients and their families, researchers and policy makers. The report's recommendations contribute to the growing momentum for change in this crucial area of healthcare quality and safety. -
News Article
Ethnic minorities in England ‘need more GP visits’ before cancer diagnosis
Patient Safety Learning posted a news article in News
Ethnic minorities and young people require more visits than other people to the GP before being diagnosed with cancer, according to new analysis. On average, one in five people across England require three or more GP interactions before being diagnosed with cancer. But for people from ethnic minority backgrounds, the figure rises to one in three, according to analysis of the NHS cancer patient experience 2022 survey by QualityWatch, a joint programme from the Nuffield Trust and the Health Foundation. For young people aged between 16 and 24, about half needed at least three GP visits before being diagnosed, with 20% needing at least five visits. Despite this, young people were still more likely to be diagnosed at an early stage in their cancer. Prof Kamila Hawthorne, the chair of the Royal College of GPs, said that identifying cancer symptoms in young people could be challenging as the risk for the group was generally much smaller. Hawthorne said: “Ensuring patients receive timely and appropriate referrals for suspected cancers is a priority for GPs – and to this end, they are doing a good job, making more urgent referrals and ensuring more cancers are being diagnosed at an early stage than ever. “Whilst GPs are highly trained to identify cancers, this remains challenging in primary care, not least and particularly with some cancers, because the symptoms are often vague and typical of other, more common conditions.” Dr Liz Fisher, senior fellow at the Nuffield Trust, said: “Delays to a cancer diagnosis pose real risks for people and an early diagnosis plays a pivotal role in determining the treatments available to people and determining outcomes. “The NHS has set an ambitious goal to dramatically increase early detection of cancer, but performance in this area has stubbornly stalled in recent years. Everyone’s experience of cancer diagnosis is different but the risks to delays aren’t felt equally, with younger people and those from minority ethnic groups requiring more visits to health professionals to secure a diagnosis.” Read full story Source: The Guardian, 24 April 2024 -
News Article
How Covid is pushing up waiting lists for cancer treatment
Patient-Safety-Learning posted a news article in News
New figures have quantified what the pandemic has meant for cancer waiting lists—and the impact is stark. Official data show that 15,971 cancer patients in the UK have had to wait more than 124 days, or four months, after diagnosis for their treatment to start since 2020 as the pandemic sends waiting lists soaring. The statistics show that the number of untreated patients has more than doubled since Covid began, with one patient waiting for more than two years, according to data released following a freedom of information request from the Liberal Democrats. This is despite an NHS target for patients to receive cancer treatments within two months of an urgent referral. Last year, 6,334 patients waited more than 124 days, compared to 2,922 in 2022, the figures show. Data was received from 69 out of 137 acute health trusts in the UK, meaning the true number of people waiting long periods for treatment is likely to be much higher. Over 1,100 cancer patients last year were left waiting more than six months to receive treatment, triple the NHS target time. Liberal Democrat Leader, Ed Davey, said: “Every single one of these figures is a tragedy. Long delays for treatment can have a devastating impact on cancer patients and their families, and in certain cases can even cost lives." Read full story Source: inews, 22 April 2024 -
Content ArticleThe use of checklists as a tool to improve performance has proven successful in a variety of healthcare settings. For instance, checklists have been successful in preventing hospital-acquired infections and preventing errors in the surgical process. The use of checklists has also been recommended as a tool to reduce diagnostic errors. Diagnostic errors are frequent and often have severe consequences but have received little attention in the field of patient safety. Checklists are considered a promising intervention for the area of diagnosis because they can support clinicians in their diagnostic decision making by helping them take correct diagnostic steps and ensuring that possible diagnoses are not overlooked. This Agency for Health Research and Quality (AHRQ) issue brief summarises current evidence on using checklists to improve diagnostic reasoning.
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Content ArticleDiagnostic errors cause substantial preventable harms worldwide, but rigorous estimates for total burden are lacking. Newman-Toker and colleague previously estimated diagnostic error and serious harm rates for key dangerous diseases in major disease categories and validated plausible ranges using clinical experts. In this study they estimated the annual US burden of serious misdiagnosis-related harms (permanent morbidity, mortality) by combining prior results with rigorous estimates of disease incidence. They found that an estimated 795 000 Americans become permanently disabled or die annually across care settings because dangerous diseases are misdiagnosed. Just 15 diseases account for about half of all serious harms, so the problem may be more tractable than previously imagined.
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Content ArticleThis research letter in JAMA Internal Medicine describes a multicentre retrospective cohort study that investigated associations between stigmatising language, errors in the diagnostic process and demographics for hospitalised patients. The study found that stigmatising language in patient documentation was associated with diagnostic error and multiple diagnostic process errors. The prevalence of stigmatising language was higher in documentation relating to Black patients and patients with housing instability. The authors argue that this may be indicative of clinician biases that interfere with data gathering, communication and clinical reasoning. They call for further research to explore the mechanisms behind this and to understand how clinician use of stigmatising language can be reduced.
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Content ArticleThe US Leapfrog Group has released Recognizing excellence in diagnosis: Leapfrog’s national pilot survey report, which analyses responses from 95 hospitals on their implementation of recommended practices to address diagnostic errors, defined as delayed, wrong or missed diagnoses or diagnoses not effectively communicated to the patient or family. The National Academy of Medicine has warned that virtually every American will suffer the consequences of a diagnostic error at least once in their lifetime and noted that 250,000 hospital inpatients will experience a diagnostic error every year. While progress varies considerably, more than 60% of hospitals responded that they were either already implementing or preparing to implement each of 29 evidence-based practices known to prevent harm from diagnostic error. The practices were identified in an earlier Leapfrog report, Recognizing excellence in diagnosis: Recommended practices for hospitals. The hospitals reported barriers to putting the practices in place that include staffing shortages and budgetary pressure.
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News Article
Report suggests people with breast cancer are being ‘systematically left behind’
Patient Safety Learning posted a news article in News
Many people with breast cancer are being “systematically left behind” due to inaction on inequities and hidden suffering, experts have said. A new global report suggests people with the condition are continuing to face glaring inequalities and significant adversity, much of which remains unacknowledged by wider society and policymakers. The Lancet Breast Cancer Commission highlights a need for better communication between medical staff and patients, and stresses the importance of early detection. It also highlights the need for improved awareness of breast cancer risk factors, with almost one in four cases (23%) of the disease estimated to be preventable. The Lancet Commission’s lead author, Professor Charlotte Coles, department of oncology, University of Cambridge, said: “Recent improvements in breast cancer survival represent a great success of modern medicine. “However, we can’t ignore how many patients are being systematically left behind. “Our commission builds on previous evidence, presents new data and integrates patient voices to shed light on a large unseen burden. “We hope that by highlighting these inequities and hidden costs and suffering in breast cancer, they can be better recognised and addressed by healthcare professionals and policymakers in partnership with patients and the public around the world.” Read full story Source: The Independent, 15 April 2024 -
Content Article
The Lancet Breast Cancer Commission (15 April 2024)
Patient Safety Learning posted an article in Cancers
Despite tremendous advances in breast cancer research and treatment over the past three decades—leading to a reduction in breast cancer mortality of over 40% in some high-income countries—gross inequities remain, with many groups being systematically left behind, ignored, and even forgotten. The work of the Lancet Breast Cancer Commission highlights crucial groups, such as those living with metastatic breast cancer, and identifies how the hidden costs of breast cancer and associated suffering are considerable, varied, and have far-reaching effects. The Commission offers a forward-looking and optimistic road map for how the health community can course correct to address these urgent challenges in breast cancer. -
Content Article
World Patient Safety Day 2024
Patient Safety Learning posted an article in WHO
This year’s World Patient Safety Day on 17 September 2024 is focused on the theme “Improving diagnosis for patient safety”. This article explains the aims of the event and the areas it will cover. -
Content Article
Endometriosis: A patient's journey (10 April 2024)
Patient-Safety-Learning posted an article in Women's health
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. -
News Article
England falls short on early cancer diagnosis goals
Patient-Safety-Learning posted a news article in News
The ambition to diagnose cancer in its earliest stages in England is “seriously off target”, according to a new report by QualityWatch, a research programme by the Nuffield Trust and The Health Foundation A rise in urgent referrals in recent years has contributed to delays, along with patients finding it difficult to raise concerns about cancer with GPs. Inequalities in diagnosis, particularly among young people, those in deprived areas, and patients from ethnic minorities, was also highlighted by researchers. Experts said that while family doctors are “highly trained” to identify cancers, the issue remains a challenge in primary care because some symptoms can be vague. The NHS Long Term Plan said the health service is aiming to diagnose 75% of cancer patients when the disease is in its early stages by 2028. However, analysis of NHS data by QualityWatch said “our current course shows we are seriously off target”. More than 320,000 people in England were diagnosed with cancer in 2021 – the equivalent of some 900 a day – the report said, with the number of urgent cancer referrals rising since 2009 to more than two million in 2020/21. Read full story Source: Medscape, 24 April 2024 -
News Article
Black people who spot cancer symptoms are taking twice as long to be diagnosed
Patient Safety Learning posted a news article in News
Black and Asian people who spot cancer symptoms are taking twice as long to be diagnosed as white people, a shocking new study shows. Research by Bristol Myers Squibb (BMS) and Shine Cancer Support shows that people from minority ethnic backgrounds face an average of a year’s delay between first noticing symptoms and receiving a diagnosis of cancer. These groups report more negative experiences of cancer care than white people, limited knowledge about the diseases and lack of awareness of support services, which all contribute to later diagnostic rates. “In a year that’s revealed that the UK’s cancer survival lags behind comparable countries, I am saddened but unsurprised that people from minority ethnic groups face additional hurdles that delay their diagnosis.” said Ceinwen Giles, co-ceo of Shine Cancer Support. “We know that catching cancer earlier saves lives, yet with year long waits for some people, collaborative efforts between health leadership, advocacy groups and the pharmaceutical industry are required.” Read full story Source: The Independent, 9 April 2024 -
Content ArticleCancer Equals is a campaign launched by Bristol Myers Squibb, to understand and help address the many factors that lead to delays in cancer diagnosis and variations in cancer experiences between people from different backgrounds. Cancer Equals research shows that people from minority ethnic groups experience seven months longer delays between noticing cancer symptoms and diagnosis compared to white individuals. Many factors lead to these delays in diagnosis and differences in people’s experience of cancer – no one’s story is the same. Delays to diagnosis will and do impact prognosis, changing the course of peoples’ lives. Health disparities and inequalities are an ongoing and pressing issue, with the UK government, NHS and patient groups committed to increasing earlier diagnosis and improving outcomes for people living with cancer.
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News Article
NHS faces ‘avalanche’ of demand for autism and ADHD services, thinktank warns
Patient Safety Learning posted a news article in News
The NHS is experiencing an “avalanche of need” over autism and attention deficit hyperactivity disorder (ADHD), but the system in place to cope with surging demand for assessments and treatments is “obsolete”, a health thinktank has warned. There must be a “radical rethink” of how people with the conditions are cared for in England if the health service is to meet the rapidly expanding need for services, according to the Nuffield Trust. The thinktank is calling for a “whole-system approach” across education, society and the NHS, amid changing social attitudes and better awareness of the conditions. It comes days after the NHS announced a major review of ADHD services. Thea Stein, the chief executive of the Nuffield Trust, said: “The extraordinary, unpredicted and unprecedented rise in demand for autism assessments and ADHD treatments have completely overtaken the NHS’s capacity to meet them. It is frankly impossible to imagine how the system can grow fast enough to fulfil this demand. “We shouldn’t underestimate what this means for children in particular: many schools expect an assessment and formal diagnosis to access support – and children and their families suffer while they wait.” Read full story Source: The Guardian, 4 April 2024 -
Content ArticleLong waiting times for autism and attention deficit hyperactivity disorder (ADHD) assessments can prevent people from getting the vital care and medication they need. Health and education support often relies on a formal diagnosis, without which there can be severe negative consequences. Estimates show that there might be as many as 1.2 million autistic people and 2.2 million people with ADHD in England, and providing them with the right support is no small task. Recent news reports have highlighted a huge rise in demand for autism and ADHD diagnoses amid increased awareness and understanding of neurodiversity. Exploring referrals and waits for autism and ADHD assessments is a key first step to understanding the scale of the issue, which can then be used to drive improvements and change. This blog from the Nuffield Trust looks at what the data is telling us.
