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Showing results for tags 'Communication'.
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Content ArticleTrust is central to the therapeutic relationship, but the epistemic asymmetries between the expert healthcare provider and the patient make the patient, the trustor, vulnerable to the provider, the trustee. The narratives of pain sufferers provide helpful insights into the experience of pain at the juncture of trust, expert knowledge, and the therapeutic relationship. While stories of pain sufferers having their testimonies dismissed are well documented, pain sufferers continue to experience their testimonies as being epistemically downgraded. This kind of epistemic injustice has received limited treatment in bioethics. In this paper, Buchman and colleagues examine how a climate of distrust in pain management may facilitate what Fricker calls epistemic injustice. They critically interrogate the processes through which pain sufferers are vulnerable to specific kinds of epistemic injustice, such as testimonial injustice. They also examine how healthcare institutions and practices privilege some kinds of evidence and ways of knowing while excluding certain patient testimonies from epistemic consideration.
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Content ArticleDehydration can be a significant risk to people taking certain medicines. These Sick Day Rules cards aid patients in understanding the medicines they should stop taking temporarily during illness which can result in dehydration, such as vomiting, diarrhoea and fever. They are intended for use as a tool to support conversations between healthcare professionals and patients about their medicines and dehydration.
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Content ArticleOver time and across the world, the need to be transparent with patients and families when care has not gone well is now recognised as a key element of high-quality, safe and patient-centred healthcare. However, a significant gap still persists and some organisations have yet to welcome a transparent and accountable approach, while others fail to turn these principles into reliable actions. This editorial in BMJ Quality & Safety highlights the vulnerable position patient and families are in after error disclosure and looks at how data on processes around error disclosure are key to improvement. The authors call for healthcare organisations to redouble their engagement with patients and families who have been harmed by their healthcare and use the principles of accountability, compassion and transparency to drive their response.
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Adverse incidents arising from suboptimal healthcare are a major cause of worldwide morbidity and mortality. Arriving at an understanding of the conditions under which adverse incidents occur has the potential to improve the safety of healthcare provision. Staff working in the NHS have been contributing their experiences via a narrative data capture platform – SenseMaker – to help gain contextual insights on a wide range of topics under exploration by the NHS Horizons team. This blog by Rosanna Hunt (Senior Associate, NHS Horizons) in collaboration with Lizzy MacNamara (Junior Research Consultant, The Cynefin Co.) and Taj Nathan (Consultant Forensic Psychiatrist, Cheshire & the Wirral Partnership Foundation Trust) describes how the SenseMaker® platform could be used to extract staff experiences on the topic of patient safety incidents both reported and unreported by staff, and the facilitated conversations that would be needed to transform the data into actionable insights and commitment to change. -
Content ArticlePersonalised Care will benefit up to 2.5 million people by 2024. It aims to give people the same choice and control over their mental and physical health that they have come to expect in every other aspect of their life. Personalised care is based on ‘what matters’ to people and their individual strengths and needs. This webpage by NHS England contains information about the following aspects of personalised care: Patient choice Shared decision making Patient activation and supported self-management Social Prescribing and community based support Personalised care and support planning Personal health budgets
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Language Matters pocket guides (April 2023)
Patient-Safety-Learning posted an article in Diabetes
The language used by healthcare professionals can have a profound impact on how people living with diabetes, and those who care for them, experience their condition and feel about living with it day-to-day. At its best, good use of language; verbal, written and non-verbal (body language) which is more inclusive and values based, can lower anxiety, build confidence, educate and help to improve self-care. On the other hand, poor communication can be stigmatising, hurtful and undermining of self-care and have a detrimental effect on clinical outcomes. Language Matters Diabetes is a global movement that aims to improve the way in which healthcare professionals and wider society talks about and to people with diabetes. These three pocket guides for different groups aim to address use of language about diabetes and people with diabetes in order to improve experiences of care and tackle stigma. Language Matters pocket guide: Healthcare professionals Language Matters pocket guide: Parents and families Language Matters pocket guide: Media and social media -
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NHS Horizons: Complexity research
Patient Safety Learning posted an article in Techniques
NHS Horizons uses SenseMaker to gather and analyse stories of real-time, day-to-day experiences to facilitate improvement in complex environments. SenseMaker is the complexity research tool that enables not only the mass data collection of rich and deep descriptions of people’s experiences, but also uses a framework incorporating “triads” and “dyads” to allow participants to categorise what their stories mean to them. The process starts with a SenseMaker survey (or a series of surveys) and ends with a Sensemaking workshop. -
Content ArticleGaslighting at work can take many forms and is often subtle, causing the victim to question their perception. This blog gives some examples of gaslighting at work and suggests ways to deal with it if you believe you are experiencing gaslighting from a colleague.
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Age-Friendly Health Systems (AFHS) is an initiative that aims to follow evidence-based practices while minimising harm in older patients. The evidence-based elements of high-quality care are known as the 4Ms: What Matters Medication Mentation Mobility During the early days of the Covid-19 pandemic, a team from the Oregon Health & Science University (OHSU) decided to examine the equity of their care for older adults. The resulting study published about the age-friendly work at OHSU is the first to include data about health equity as part of AFHS outcomes and illustrates the importance of creating equitable care at clinical and institutional policy levels. This blog looks at the process the team went through to assess and collect data about age-related equity. -
Content ArticleGetting a GP appointment is often a challenge at the moment, but for many disabled people, access to their GP has long been a problem. The King's Fund explored disabled people’s experiences of involvement in health and care design, their experiences accessing health and care, as well as of involvement in service design. Some participants described the significant difference a GP could make: those who made someone feel listened to and validated, compared with GPs who dismissed concerns or spoke to a person’s personal assistants rather than directly to them.
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Content ArticleThe Royal United Hospital Bath NHS Trust project tested different ways to communicate with staff about patient safety, to encourage the reporting of incidents and to promote a learning culture.
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Content ArticleGood patient communication strategies are an essential prerequisite for developing an effective NHS patient safety culture and the NHS needs to improve on its efforts, writes John Tingle in an article for the British Journal of Nursing.
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Content ArticleData from NHS Resolution indicates that the number of claims with a primary cause of ‘Fail to warn - Informed consent’ have increased from 128 to 248 claims per year in 2011–2012 and 2021–2022 respectively. This letter in the British Journal of Surgery highlights the impact of failures in both the process and documentation of informed consent. The writers call for further research to investigate unwarranted variation in claims and develop processes to standardise and improve the quality of consent.
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This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Paul talks to us about how AvMA helps people who have suffered direct or indirect medical harm and to help them to seek justice, why upcoming changes to the legal system could restrict access to clinical negligence claims and the importance of compassionate engagement in improving harmed patients’ experiences of the healthcare system. -
Content ArticlePublished in BMC Health Services Research, this is the first review to theorise how open disclosure (OD) works, for whom, in what circumstances, and why. Authors identify and examine from the secondary data the five key mechanisms for successful OD and the three contextual factors that influence this. The next study stage will use interview and ethnographic data to test, deepen, or overturn their five hypothesised programme theories to explain what is required to strengthen OD in maternity services.
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In this interview, we speak to sociologist Dr Marieke Bigg about why she decided to write her debut non-fiction This won’t hurt: How medicine fails women. Marieke discusses how societal ideas about the female body have restricted the healthcare system’s approach to women’s health and describes the impact this has had on health outcomes. She also highlights areas where the health system is reframing its approach by listening to the needs of women and describes how simple changes, such as allowing women to carry out their own cervical screening at home, can make a big difference. -
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 ArticleIn England, the NHS National Breast Screening Programme (NHSBSP) offers routine breast screening to all women, some trans men and non-binary people, between the ages of 50 years and up to their 71st birthday, every 3 years. The unfolding Covid-19 pandemic in early 2020 was understandably a time of great anxiety and concern. Culturally we were seeing strong behavioural shifts such as social distancing and a general change in all our daily life patterns. Conceptually, and as leaders, we understood the vulnerability we observed, but felt that we did not have the 'right language' and in fact lacked the relevant experience of how to address and communicate with staff and clients during this crisis. A semiotic, observational research project was utilised that aimed at providing insight how cultural behaviour was being shaped and expressed during the early onset of the Covid-19 pandemic in England. The recommendations of the project were then integrated and implemented into an action plan and subsequent practice. Semiotic analysis revealed that several factors (positive and negative) impacted on peoples' confidence and had practical and emotional implications. Eleven main codes which are belief systems about oneself and others were identified and expressed in a multitude of different ways revealing three main themes or needs i.e. Reassurance, Trust and Clarity. An action plan was developed in response to the project findings and recommendation were implemented. Effective leadership relies on situational awareness. This semiotic project enabled the authors to find the 'right' language and communication style so that they could connect with staff at the time of crisis.
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This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Maureen discusses the important role of professional standards in building a patient safety infrastructure, the need to reframe safety as a positive idea and her experience of implementing learning processes during her time as a GP. -
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D1abasics campaign resources (UHS, May 2023)
Patient-Safety-Learning posted an article in Diabetes
People with diabetes account for one in three hospital inpatients, and this is projected to increase to one in five in the next few years. Often, people are in hospital for reasons other than their diabetes, so it is important that staff across all specialties understand the basics of diabetes care in order to ensure patient safety. D1abasics is an innovative project that aims to equip all healthcare professionals to support the basic diabetes healthcare needs of their patients. Developed by the diabetes team at University Hospital Southampton with funding and support from the charity Diabetes UK, the campaign includes resources such as posters, lanyards and prompt cards. The diabetes team is supporting learning across the hospital by making visits to all wards and specialties to promote D1abasics. You can download the D1abasics poster below. -
Content ArticleHospital command and control centres (CCCs) are central locations within a hospital where staff can coordinate and manage the response to emergencies, disasters and other critical events. They are also often used to track and monitor the location and status of hospital staff and resources, such as beds, equipment and supplies, in order to ensure that they are used efficiently and effectively. This blog by Sukhmeet Panesar, Chief Health Officer at Monstar Labs, acts as an introduction to CCCs in healthcare. It includes information on the different types of CCC, the benefits of CCCs and the challenges they may face.
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Content ArticleIn this blog, After Action Review (AAR) specialist Judy Walker shares an account of a successful AAR that took place amongst a surgical team. The AAR was called after a near-miss where the anaesthetist was prevented from injecting spinal block medication into the wrong side of a patient's spine by an operating department practitioner (ODP). The story demonstrates the benefits of AAR, including accelerated learning, a no-blame approach, flattening staff hierarchy and a significant reduction in the time it takes to investigate an incident.
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Content ArticleIn 2002, a dedicated group from Pennsylvania passed the Medical Care Availability and Reduction of Error (MCARE) Act, the most robust state-level legislation of its kind. Its legacy remains 21 years later. In this interview with the journal Patient Safety, Pennsylvania's Patient Safety Authority chair, Dr Nirmal Joshi, discusses ways care has improved, what challenges persist, and how to achieve the unachievable—true culture change.
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Content Article
Complications after private surgery: where to turn to?
Anonymous posted an article in Patient stories
A patient shares her experience of life-changing complications after a hysterectomy she had at a private hospital and the lack of follow up and help she's received since. She highlights the actions she would like to see in place for private hospitals around informed consent, follow up and support after surgery, and accountability. The patient wishes to remain anonymous. -
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RNIB: My info my way
Patient Safety Learning posted an article in Other conditions and diseases
Blind and partially sighted people have a legal right to receive accessible health and care information. The RNIB has launched the #MyInfoMyWay campaign, and how to request information in a format you can read. Accessible health and care information allows people with sight loss to manage their health and care with the same level of independence and privacy as everyone else.
