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Found 1,203 results
  1. Content Article
    Disease-modifying antirheumatic drugs (DMARDs) are a group of medications commonly used in people with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and systemic lupus erythematosus (SLE). They work by work suppressing the body's overactive immune and/or inflammatory systems and take effect over weeks or months. This information guide gives information for patients on conventional and biologic DMARDS, including how they work, the different kinds available and their side effects.
  2. Content Article
    In this blog, a woman who has suffered from severe pain and complications for 17 years due to transvaginal mesh shares her experience. She talks about how the device has changed her life, how her symptoms have been repeatedly dismissed by surgeons, and the variation she has witnessed between different specialist mesh centres.
  3. Content Article
    In a previous blog, 'What is a Whistleblower',[1] Hugh drew attention to negative perceptions of whistleblowers in the eyes of some people. A crossword and clues were published on the hub to emphasise how wrong such perceptions are and how damaging they can be, with serious patient safety implications.[2] This follow-up outlines the nature of the journey travelled by some NHS staff who have spoken up and the problems which still exist with NHS whistleblowing culture. It provides a link to an attached file which contains the answers to each clue. The attachment also shows the completed crossword in larger, easier-to-read, format than the small illustration in this blog. There is a further link to companion notes which expand on the answer to each clue. These notes contain more detail about the realities of speaking up. They reinforce the link between hostility towards those who speak up and an ongoing series of patient safety scandals.[7-21]
  4. Content Article
    The spread of the Covid-19 pandemic presented significant challenges in the management of patients with chronic diseases like multiple sclerosis (MS). This article in Frontiers in Neurology looks at how telemedicine was used as an alternative to face-to-face consultations with MS patients during the pandemic. Recognising the variation in care that occurred as different centres adopted telemedicine, they make a series of recommendations for the use of telemedicine in managing MS patients.
  5. Content Article
    Epistemic injustice occurs when a person is not given authority and credibility as a 'knower' in a conversation, due to negative stereotypes associated with their identity. These stereotypes might relate to their age, gender, ethnicity, social class, education, sexual orientation or health. Young people with unusual experiences and beliefs are particularly at risk of experiencing epistemic injustice, and this can have a negative impact on their health outcomes. In this blog Joe Houlders, Matthew Broome and Lisa Bortolotti from the University of Birmingham talk about the risks of young people with unusual experiences and beliefs experiencing epistemic injustice in clinical encounters. This is the first in a series of blogs reporting outcomes from a project on Agency in Youth Mental Health, led by Rose McCabe at City University.
  6. Content Article
    This is part of our new series of Patient Safety Spotlight interviews, where we talk to people about their role and what motivates them to make health and social care safer. Ehi talks to us about how building a connection with patients makes their care safer, the safety issues caused by lack of regulation, accountability and transparency, and the moral responsibility each of us has to speak up when we spot safety risks or see a patient harmed.
  7. Content Article
    An increasing number of cancer patients are using the internet to better understand their disease and connect with others facing the same challenges. Online cancer communities have developed into resources that highlight new research and evolving treatments. Combined with increasing health literacy and social media, they have enabled some patients to become experts in their cancer. This article in the journal JCO Oncology Practice examines the role of expert patients (e-patients) in advancing cancer medicine, and looks at opportunities available to those who wish to become more involved in research advocacy. The authors found that e-patients play a greater role in their own care and in larger conversations regarding practice, research, and policy. They highlight that clinicians can engage e-patients as partners in cancer care to work together towards improving healthcare access and outcomes for people with cancer.
  8. Content Article
    Annegret Hannawa investigated communication during Covid-19. She asked the questions: to what extent did communication by the Swiss traditional news media and by the Swiss Government, communication in the social media, and interpersonal communication affect Swiss residents' (1) trust, (2) willingness to vaccinate, (3) engagement in conspiracy theories, and (4) mental health? This video gives a short summary of the first results.
  9. Content Article
    This blog by GP Dr Abbie Brooks examines rising patient demand for GP services and the need to manage patient expectations around appointment waiting times. It looks at the impact of the pandemic, and how patients can help primary care cope with increased demand by ensuring they are using the appropriate NHS service for their needs and being patient while waiting for initial and follow up appointments.
  10. Content Article
    For many people, improving their health and wellbeing requires a holistic approach and support by professionals who can help them focus on what matters to them to live well. Social prescribing supports people to understand their needs and connects them to local community (non-clinical) often voluntary services which can provide the help they need.
  11. Content Article
    This study in the International Journal for Quality in Health Care aimed to develop and test a handover performance tool (HPT) able to help clinicians to systematically assess the quality and safety of shift handovers. The study was conducted in the paediatrics, obstetrics and gynaecology wards of a UK district hospital. 30 human factor experts participated in the development phase and 62 doctors from various disciplines were asked to validate the tool. The authors found that, according to the HPT, communication determined the majority of handover quality, with teamwork and situation awareness also important factors in the overall quality rating. They found that the HPT demonstrated good validity and reliability and can be easily used by raters with different backgrounds and in several clinical settings.
  12. Content Article
    This article in the journal Archives of Disease in Childhood examines patient safety theories and suggests principles to tackle safety challenges specific to paediatric care. The authors provide an overview of the evolution of patient safety theories and tools such as huddles and electronic prescribing. They look at the example of Paediatric Early Warning Systems (PEWS), highlighting that the organisational context and culture in which PEWS is used will dramatically affect its effectiveness as a tool. They conclude that approaches to patient safety must see it as a complex interconnected whole, rooted in the culture and environment in which safety interventions act. They also argue that paediatricians must take a lead in improving the safety of the care they deliver on a systems basis.
  13. Content Article
    Hot debriefs are interactive, structured team conversations that take place immediately or very shortly after a clinical case. They are designed to help the whole team learn from the experience, reflect on what went well, identify team strengths or difficulties and to consider ways to improve future performance. In this blog, the authors describe how a multidisciplinary focus group at Edinburgh Emergency Medicine, alongside staff from the Scottish Centre for Simulation and Clinical Human Factors (SCSCHF), developed “STOP5: STOP for 5 Minutes”, a new tool to facilitate hot debriefs.
  14. Content Article
    Debriefing is a process of communication that takes place between a team following a clinical case. It identifies errors as well as areas of excellence for both teams and individuals. This article in BMJ Open Quality describes a quality improvement project in an emergency department in Ireland, which aimed to introduce hot debriefing following all cardiac arrests.
  15. Content Article
    Debriefing after a patient death or serious incident is important for staff wellbeing, especially in the emergency medicine environment. While on placement in an emergency department, medical student Max Sugarman realised there was no debrief for staff or students involved in critical incidents. This led him to develop the TAKE STOCK hot debrief tool, which is an adaption of the STOP5 model created by Edinburgh EM and the Scottish Centre for Simulation and Clinical Human Factors. In this blog, Max talks about how critical incidents affect staff, how to make time for debriefs and how the TAKE STOCK tool works in practice.
  16. Content Article
    NHS Providers provide a selection of example questions boards should ask themselves in relation to their role in improvement. These aim to help guide personal reflection, conversations between board members and in quality committees, with staff and with partners locally. This list does not cover everything you may wish to or need to ask, but is intended to help provide a starting point and overview of important aspects to consider.
  17. Content Article
    This book interrogates the assumption that evidence means the same thing to different constituencies and in different contexts by outlining a more nuanced and socially responsive approach to medical expertise that incorporates scientific and lay processes of making sense of the world and deciding how to act in it. In so doing, it provides a point of orientation for clinicians working at the coalface, whose experience is sometimes at odds with the type of rationality that underpins evidence-based medicine and that guides researchers conducting randomised controlled trials. The argument elaborated also has implications for policy makers in the healthcare system, who have to navigate similar pressures and contradictions between scientific and lay rationality to produce meaningful guidelines in the midst of a runaway pandemic. Debates within and beyond the medical establishment on the efficacy of measures such as mandatory face masks and lockdowns are examined in detail, as are various degrees of hesitancy towards vaccines and other pharmaceutical interventions. The authors demonstrate that it is ultimately through narratives that knowledge about medical and other phenomena is communicated to others, enters the public space, and provokes discussion and disagreements. Importantly, effective narratives can enhance the reception of that knowledge and reduce some of the sources of resistance and misunderstanding that continue to plague public communication about important medical issues such as pandemics. Access the introduction and excerpts from each chapter from the link below.
  18. Content Article
    This duty of candour animation offers guidance on the importance of being open and honest. Being open and honest with patients and those close to them is always the right thing to do and is often referred to as the duty of candour. NHS Resolution have produced a short animation to help those working in health and social care to better understand the similarities and differences that exist between the professional and statutory duties of candour. The 8-minute animation also offers guidance on how they can be fulfilled effectively.
  19. Content Article
    This long read by the Health Foundation examines the challenges of discharging people from hospital, and looks at 'discharge to assess' (D2A) an approach to reducing the incidence of delayed discharge. It outlines priorities for policymakers and the NHS and suggests next steps for managing hospital discharge.
  20. Content Article
    The Patient Safety Movement are looking for patients, family members, health workers and administrators to reach out if they have an experience related to harm or death due to a medication error in the operating room. While the specific numbers may be debated, that medication errors, while rare in the operating, could have catastrophic consequences. The Patient Safety Movement are interested in hearing your perspective concerning this issue. Please email events@patientsafetymovement.org if you have a story that you’d like to share. If you are worried about anonymity please submit your story at the link below.
  21. Content Article
    When people already negatively affected by unfavourable social determinants of health seek care, healthcare itself may make health inequalities worse, rather than tackling them. This is seen in certain demographic groups experiencing disproportionate levels of harm. This article in The BMJ argues that focusing on patient safety in terms of specific health inequalities will help make healthcare more equally safe. It looks at interpersonal and structural factors that shape care experiences for people from marginalised backgrounds, including poor communication, basing treatment on models built around majority norms and healthcare worker bias. It highlights the importance of having a clear line of accountability for unequal harms so that individuals and organisations are given responsibility for taking action to overcome issues.
  22. Content Article
    In this article in the journal Health Expectations, the authors explore how current investigative responses can increase the harm for all those affected by failing to acknowledge and respond to the human impacts. They argue that when investigations respond to the need for healing alongside learning, it can reduce the level of harm for everyone involved, including including patients, families, health professionals and organisations.
  23. Content Article
    This study in the British Journal of General Practice aimed to identify cardiovascular disease-related Prevention of Future Deaths reports (PFDs) involving anticoagulants, and to highlight issues raised and responses received. The authors highlight that nearly two-thirds (60%) of PFDs had not received responses from the organisations they were sent to, including NHS trusts, hospitals and general practices. They call for national organisations, healthcare professionals and prescribers to take actions that address concerns raised by coroners in PFDs, in order to improve the safe use of anticoagulants in treating cardiovascular disease.
  24. Content Article
    Although leaders might say they value inquisitive minds, in reality most stifle curiosity, fearing it will increase risk and inefficiency. Harvard Business School’s Francesca Gino elaborates on the benefits of and common barriers to curiosity in the workplace and offers five strategies for bolstering it.
  25. Content Article
    Civility Saves Lives have created a number of infographic each with a key message of civility. A selection are shown below and more can be found through the link at the bottom of the page.
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