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Content Article
NSW Government: Between the Flags
Patient Safety Learning posted an article in International patient safety
The Between the Flags (BTF) system is a 'deteriorating patient safety net system' for patients who are cared for in New South Wales (NSW) public health facilities in Australia. It is designed to assist clinicians to recognise when patients are deteriorating and to respond appropriately when they do. -
News ArticleLong Covid clinics across Australia are being inundated with requests for assessments from patients struggling with ongoing symptoms, an inquiry has heard. Doctors told the federal parliamentary inquiry into long and repeated coronavirus infections that they were struggling to keep up with demand as waitlists increased. At least 10 million Australians have been infected with Covid and it is estimated 3-5% will develop Long Covid at some point. “Our waitlist is increasing because what we’ve observed is that it can take some time for the recognition of post-Covid conditions, particularly with the fatigue-predominant types, to reach us,” Royal Children’s hospital Associate Prof Shidan Tosif told the inquiry on Wednesday. Patients are usually referred to specialist clinics through a GP and while there is no official cure, symptoms can sometimes be treated on a case-by-case basis. The inquiry by the House of Representatives health committee is investigating the economic, social, educational and health impacts of long Covid and repeat infections. Read full story Source: The Guardian, 12 October 2022
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Content ArticleIn this Guardian article, Sarah Kendell describes her experience of maternity care in Australia, highlighting the stark difference in care offered before and after a woman has given birth. She says "at the most difficult transition of our lives–after childbirth–the healthcare system leaves us to fend for ourselves," and argues that the impact this can have on the health and wellbeing of women and their babies needs to be considered. She asks whether reallocating some resource from antenatal care to postnatal care would produce health benefits for new mothers and babies.
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Content ArticleFatigue has increasingly been viewed by society as a safety hazard. This has lead to increased regulation of fatigue by governments. The most common control process has been compliance with prescriptive hours of service (HOS) rule sets. Despite the frequent use of prescriptive rule sets, there is an emerging consensus that they are an ineffective hazard control, based on poor scientific defensibility and lack of operational flexibility. In exploring potential alternatives, we propose a shift from prescriptive HOS limitations toward a broader Safety management system (SMS) approach. Rather than limiting HOS, this approach provides multiple layers of defence, whereby fatigue-related incidents are the final layer of many in an error trajectory. This review presents a conceptual basis for managing the first two levels of an error trajectory for fatigue.
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Content ArticleThis editorial in Anaesthesia looks at how the term 'human factors' has been applied to different aspects of anaesthesia over the past few years. The author calls for a deeper look at the application of human factors in the field of anaesthesia to ensure systems are designed to minimise the risk of human error and variation.
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Content Article
Queensland Health: Fatigue risk management systems
Patient Safety Learning posted an article in Good practice
This guideline has been developed to support all Australia's Queensland Health workplaces to identify and manage fatigue risks. It draws on lessons learnt from over a decade of implementing fatigue risk management systems (FRMSs) in Queensland Hospital and Health Services (HHSs) and from proven approaches to safety risk management. -
News ArticleIn September, Shine Lawyers won a $300 million settlement in two class actions over the failed mesh products by Johnson & Johnson Medical and Ethicon. However, the law firm is proposing to take up to $99.5 million from the payout in costs, just under a third of the total sum. Of 11,000 women involved in the class action, Janelle Gale is one of 200 who is not happy with Shine Lawyers' compensation proposal. Representatives of the group said there was mass confusion over what compensation they might be eligible for and how many hoops they would have to jump through to receive a payment. Despite having barely any leakage before her 2014 surgery, afterwards Janelle became heavily incontinent. She was a drag-racing champion, but that came to a halt. She said it destroyed her marriage, she couldn't have sex and she still can't work. Read more Source: ABC News, 3 December 2022
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Content ArticleEZDrugID is a campaign to improve the distinctiveness of medication packaging set up by a group of healthcare workers. Inadequate standards around medication packaging mean that medications with very different actions are sometimes packaged in a very similar way causing "look-alike drugs”. This can lead to errors and serious harm to patients if the wrong drug is mistakenly used. The EZDrugID website contains information about their campaigns to maximise distinctiveness of different medications as well as a "lookalikes" gallery. See also: the hub's error traps gallery The medication safety area of the hub
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Content ArticleSkin cancer is one of the most common cancers worldwide, with one in five people in the US expected to receive a skin cancer diagnosis during their lifetime. Detecting and treating skin cancers early is key to improving survival rates. This blog for The Medical Futurist looks at the emergence of skin-checking algorithms and how they will assist dermatologists in swift diagnosis. It reviews research into the effectiveness of algorithms in detecting cancer, and examines the issues of regulation, accessibility and the accuracy of smartphone apps.
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Content ArticleWhen healthcare worker infections at The Royal Melbourne Hospital in Australia seemed to be spiralling out of control despite strict protocols being adhered to by expertly trained staff, Professor Kirsty Buising and her colleagues took action. To inform future responses in the Australian setting, Kirsty and her colleagues present in this paper a description of healthcare worker infections at their institution and the suite of interventions they used to control the outbreak.
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Content ArticleThe General Practice: Health of the Nation report gives a unique overview of Australian general practice. The report reflects the experience of more than 1300 RACGP Fellows from across Australia, and incorporates information from the Australian Bureau of Statistics (ABS), Medicare, the Australian Institute of Health and Welfare (AIHW) and various government publications. The report provides information at a specific point in time and identifies longer-term trends across the general practice sector. The 2021 Health of the Nation report also highlights a number of critical issues affecting GPs and their patients, including: treatment of multimorbidities in general practice the increasing mental health burden on general practice restrictions to GP involvement in aged care barriers to the use of video telehealth services the COVID-19 vaccine rollout.
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Content ArticleSubstantial evidence indicates that patient outcomes are more favourable in hospitals with better nurse staffing. One policy designed to achieve better staffing is minimum nurse-to-patient ratio mandates, but such policies have rarely been implemented or evaluated. In 2016, Queensland (Australia) implemented minimum nurse-to-patient ratios in selected hospitals. In a study published in the Lancet, McHugh et al. aimed to assess the effects of this policy on staffing levels and patient outcomes and whether both were associated.
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Content Article“Sunshine” policy, aimed at making financial ties between health professionals and industry publicly transparent, has gone global. Given that transparency is not the sole means of managing conflict of interest, and is unlikely to be effective on its own, it is important to understand why disclosure has emerged as a predominant public policy solution, and what the effects of this focus on transparency might be.
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Content ArticleThis survey tool from the Australian Commission on Safety and Quality in Health Care provides Australian health service organisations with a set of 14 principles supported by a variety of risk reduction strategies. The tool is intended for use in hospitals by all clinicians involved in the medication management pathway, including those with governance responsibilities within the health service. The survey tool is also intended to be applied within pharmacy and ward storage environments.
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Content ArticleThis is the recording of a webinar given on 19 January 2022 for the International Shared Decision Making Society by Professor Kirsten McCaffery from the University of Sydney and Marie Anne Durand from the University of Lausanne. It covers the following topics: What is health literacy and why does it matter Conceptualising health literacy and shared decision making Findings from recent health literacy and shared decision making reserach What can we do better?
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Content ArticleThis charter published by the Australian Commission on Safety and Quality in Healthcare describes the rights that consumers, or someone they care for, can expect when receiving health care. These rights apply to all people in all places where healthcare is provided in Australia. This includes public and private hospitals, day procedure services, general practice and other community health services. Topics covered include access, safety, respect, partnership, information, privacy and feedback.
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EventuntilTe Ngāpara Centre for Restorative Practice invites you to attend the virtual symposium Restorative Health Systems: Healing, learning, and improving after harm. This free event is being held in association with the Health Quality & Safety Commission in Aotearoa New Zealand. The symposium will provide a virtual space for knowledge sharing and exchange among the growing international community of clinicians, researchers, consumers, investigators policymakers, and practitioners working in health settings. We aim to share what is happening globally in this emerging field and to reflect on the future of restorative initiatives in the health system context. The symposium will incorporate a series of different sessions, including interactive dialogues with international critical thinkers and advocates, presentations on key issues relevant for the field and research relating to restorative initiatives. View the programme (PDF) This is the first of a symposium series as part of the Te Ngāpara Centre for Restorative Practice’s commitment to supporting the development of restorative knowledge. The symposium will take place on Zoom on Wednesday 29 March, 8am - 12pm (NZDT) 0600 Australia (AEDT) 2000 London UK (BST) 1200 Vancouver (PDT) 1500 Montréal (EDT) Register for the symposium
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Community PostAbout 1000 angry nurses and doctors have rallied outside Perth Children’s Hospital in Australia following the death of seven-year-old Aishwarya Aswath, demanding vital improvements to the state’s struggling health system. The Australian Nurses Federation was joined by the Australian Medical Association for the rally, with staff from hospitals across Perth attending. Many people held signs that read “We care about Aishwarya”, “Listen to frontline staff”, “Report the executive — not us” and “Please don’t throw me under the bus”. Aishwarya developed a fever on Good Friday and was taken to Perth Children’s Hospital the next day, but had to wait about two hours in the emergency department before she received treatment. She died soon after from a bacterial infection. An internal report into the tragedy made 11 recommendations — including improvement to the triage process, a clear way for parents to escalate concerns and a review of cultural awareness for staff — but Aishwarya’s parents said the report raised more questions than it answered. The family wants a broader independent inquiry to look at all 21 near-misses in the past 15 months – not just their daughter’s case. Some people have been referred to medical authorities, while Child and Adolescent Health Service chair Debbie Karasinski resigned after the report.' I am encouraged to see the way healthcare staff reacted to this tragedy. Imagine a similar event in England, would nurses protest outside the hospital and stand up to authority like this? I doubt it very much, which is very sad reflection on the prevailing culture and health leadership in England. What do others think? Source: The Australian. 9 July 2021 Picture: Picture: 9 News
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Content ArticleThis study aimed to operationalise and use the World Health Organization's International Classification for Patient Safety (ICPS) to identify incident characteristics and contributing factors of deaths involving complications of medical or surgical care in Australia. A sample of 500 coronial findings related to patient deaths following complications of surgical or medical care in Australia were reviewed using a modified-ICPS (mICPS). This study demonstrated that the ICPS was able to be modified for practical use as a human factors taxonomy to identify sequences of incident types and contributing factors for patient deaths.
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Content ArticleIn Australia, as in many other countries, the harms caused by transvaginal mesh surgery have prompted individual and collective attempts to achieve redress. Media outlets covered aspects of the rise of mesh surgery as a procedure, the experience of mesh-affected women and the formal inquiries and legal actions that followed, The authors of this article in the journal Health Expectations conducted a media analysis of the ten most read Australian newspapers and online news media platforms, focusing on how mesh and the interaction of stakeholders in mesh stories were presented to the Australian public. They found that mass media reporting, combined with medicolegal action and an Australian Senate Inquiry, appears to have provided women with greater epistemic justice, with powerful actors considering their stories. They argue that although medical reporting is not recognised in the hierarchy of evidence embedded in the medical knowledge system, in this case, media reporting has contributed to shaping medical knowledge in significant ways.
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Content ArticleThe aim of this Australian study was to assess the impact of adding assistants in nursing to acute care hospital ward nurse staffing on adverse patient outcomes using administrative health data. The results suggest that the introduction of assistants in nursing into ward staffing in an additive role should be done under a protocol which clearly defines their role, scope of practice, and working relationship with registered nurses, and the impact on patient care should be monitored.
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News ArticleTwo years of the pandemic have meant drops in essential screening and detection in Australia, while cancer patients undergo treatments alone and isolate to avoid Covid risks. When Claire Simpson turned 50 in early 2020, she received a letter telling her to get a mammogram. Then the pandemic hit, and Victoria went into lockdown. “Like many people, I put it off until we were coming out of that lockdown, but by then it was September and I couldn’t get an appointment until December,” she says. In February 2021 she was diagnosed with breast cancer and had a mastectomy. Tests showed she was positive for the aggressive HER2 receptor, so she began 12 weeks of chemotherapy as well as a treatment called Herceptin, which she received an IV infusion of every three weeks. Simpson says the delay in screening “really, really delayed diagnosis for me, by a good six months”. “I can’t help but feel that [an earlier screening] could have probably saved me from having to have chemotherapy and this Herceptin infusion therapy that I’m having,” she says. Her last Herceptin treatment was last Wednesday. She has been living in self-imposed lockdown, terrified as the Omicron wave built that she would have to isolate due to Covid and disrupt her treatment. That self-imposed isolation will continue until her final surgery, an elective operation scheduled for mid-year. Cancer screening dropped by 10% in Victoria alone in the first year of the pandemic. In 2021, referrals to the Peter MacCallum Cancer Centre, a leading treatment and research facility in Melbourne, were down 40%. “That is certainly going to bounce back at some point,” says Prof Sherene Loi, an oncologist and researcher at Peter MacCallum. “It is potentially going to be a real problem in a few years’ time. At the moment we have a lot of very young cancer diagnoses, a lot of breast cancer … we are just flat chat.” Read full Source: The Guardian, 13 February 2022
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News ArticleAlmost three out of five GPs reported managing patient expectations about vaccinations to be one of the most challenging issues of the pandemic, with multiple changes to vaccine eligibility requirements leaving many people confused and overwhelmed, the president of the Royal Australian College of General Practitioners, Dr Karen Price, said. In her foreword to the college’s Health of the Nation report, published on Thursday, Price said: “Unfortunately, some of these patients took their frustrations out on general practice staff”. “Differing eligibility requirements across jurisdictions added to the strain.” Schools should stay open as greatest risk of Covid transmission is in households, research finds The report is published annually and provides an insight into the state of general practice in Australia. It includes the findings of a survey of 1,386 GPs between April and May, of which 70% were in major cities, 20% inner-regional, 8% outer‐regional, and 2% remote and very remote. Read full story Source: Guardian, 21 October 2021
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News ArticleOn Tuesday, there were 356 COVID-19 patients being treated in intensive care wards throughout Australia. Of those, 25 were fully vaccinated. While the data points to the extraordinary efficacy of COVID-19 vaccines in preventing people from becoming severely unwell, being hospitalised and dying, it does raise the question: why do a small number of people become seriously ill and, in rare cases, die, despite being fully vaccinated? An intensive care unit staff specialist at Nepean hospital in Sydney, Dr Nhi Nguyen, said those who are fully vaccinated and die tend to have significant underlying health conditions. Being treated in intensive care, where people may be on a ventilator and unable to move, added to any existing frailty, especially in elderly people, she said. “If we think about intensive care patients in general, whether they are there due to COVID-19, pneumonia or any other infection, we know that those who have underlying disorders, those who are frail, and those with co-morbidities will have a higher risk of dying from whatever the cause of being in intensive care is,” she said. “Being fully vaccinated against Covid protects you from getting severe disease, yes, but it doesn’t completely protect you from getting Covid. So if you are someone with chronic health conditions, what might be a mild disease or mild infection in a young person or a person who is in good health, will have a greater impact on you.” She said this was why the Australian Technical Advisory Group for Immunisation (Atagi) had recommended boosters for those people who are severely immunocompromised. On Wednesday the government said it intended booster shots to be rolled out to the aged care sector within weeks, and to be available to the whole population by the end of the year. Read full story Source: The Guardian, 20 October 2021
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News ArticleDeborah Stanford is one of many women who have received a Boston Scientific implant and suffered complications. She has joined Shine Lawyers’ class action, which was filed today in the Australian Federal Court, to hold the manufacturers to account for the continuous pain she has endured since the Obtryx sling was implanted on 12 September 2012. Ms Stanford’s bladder was sitting in the birth canal and the sling was placed, on medical advice, to reposition her bladder. “It has been 9 years of suffering." “If I knew how hard this was going to be, I never would have gone through it,” said Ms. Stanford. Boston Scientific is the third pelvic mesh manufacturer to face a class action over their range of prolapse mesh and incontinence sling implants. Shine Lawyers has filed all three actions against Johnson & Johnson, Ethicon and American Medical Systems (AMS). Read full story Source: Shine Lawyers, 22 March 2021
