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Showing results for tags 'Decision making'.
Found 325 results
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Content ArticleThis review in Medical Decision Making looks at how healthcare organisations might successfully use patient decision aids (PtDAs) to support person-centred care. It aimed to develop context-specific program theories that explain why and how PtDAs are successfully implemented in routine healthcare settings. Based on the results of their review, the authors recommend the following strategies for organisations wishing to embed PtDAs: Co-production of PtDA content and processes (or local adaptation) Training the entire team Preparing and prompting patients to engage, Ensuring senior-level buy-in Measuring to improve
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EventuntilThis event will look at the Patients Association's recent report on shared decision making, and NICE guidelines on how we can all ensure that shared decision making is a reality. Hear from and ask questions of our panel members about their experiences and thoughts on shared decision making: Alexandra Freeman - Executive Director, Winton Centre for Risk and Evidence Communication Hameed Khan - Patient and carer representative Jonathan Berry - Policy Lead: Health Literacy & Shared Decision Making, NHS England & Improvement Rachel Power - CEO, Patients Association Ruby Bhatti OBE - Patient and carer representative Victoria Thomas - Head of Public Involvement, NICE Register
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Content ArticleFor many years the NHS has talked about the need to shift towards a more personalised approach to health and care so that people have the same choice and control over their mental and physical health that they have come to expect in every other part of their life. And as local health and care organisations work together more closely than ever before, they are recognising the power of individuals as the best integrators of their own care. This document sets out how the NHS Long Term Plan commitments for personalised care will be delivered. It introduces the comprehensive model for personalised care, comprising six, evidence-based standard components, intended to improve health and wellbeing outcomes and quality of care, whilst also enhancing value for money. Implementation will be guided by delivery partnerships with local government,
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Content ArticleShared decision making (SDM) is when patients and clinicians work together to make evidence-based decisions based on patient values and preferences. This may be to select a test or intervention, such as going ahead with surgery. SDM ensures individuals are supported to make decisions which are right for them. The Centre for Perioperative Care has a number of resources on their website on shared decision making.
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Content ArticleDiagnostic errors are the number one patient safety concern in healthcare today, inflicting harm on hundreds of thousands of patients in the USA annually. The problem is complex and involves the difficulties inherent in diagnosis generally, the known weaknesses of human cognition and the myriad breakdown points in our healthcare systems. In this BMJ Editorial, Mark Graber discusses the advantages of clinical decision support tools for diagnosis (CDS-Dx) and three promising trends regarding the uptake and potential use of CDS-Dx systems. Further reading: Co-development of OurDX - an online tool to facilitate patient and family engagement in the diagnostic process
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Content ArticleWhen the history of the COVID-19 pandemic is written, it is likely to show that the mental models held by scientists sometimes facilitated their thinking, thereby leading to lives saved, and at other times constrained their thinking, thereby leading to lives lost. This paper from Trisha Greenhalgh explores some competing mental models of how infectious diseases spread and shows how these models influenced the scientific process and the kinds of facts that were generated, legitimised and used to support policy.
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Content ArticleThis innovative educational initiative was developed as a direct and constructive response to the communication inadequacies exposed by the Montgomery case, and subsequent legislation. While it is not difficult to give ‘more information’ it is harder for surgeons and patients to achieve a decision partnership. The ICONS workshop content has been informed by internationally recognised experts in Shared Decision Making, by consensus among senior practising surgeons, by patients and by professional experts in risk management and risk communication. Delegates on the ICONS workshops will acquire skills and knowledge to implement best practice in sharing the complex decisions surrounding informed consent. By participating in a workshop, they will also contribute to the development of resources for future training in the important area of informed consent.
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EventA recent report published by the BMJ found that many doctors have difficulty in DNACPR discussions. Chaired by Davina Hehir Director of Policy & Legal Strategy Compassion in Dying, conference will focus on the important issue of effective person centred practice in CPR decisions and communication. By attending you will have the opportunity to hear from Rosie Benneyworth Chief Inspector of Primary Medical Services and Integrated Care Care Quality Commission who will discuss what we've learnt from the pandemic, including: the rapid review of how cardiopulmonary resuscitation decisions were used during the coronavirus pandemic; improving involvement of people using services, record keeping, and oversight and scrutiny of the decisions being made. Register 20% Discount now available with code HCUK20CPR when booking
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Content ArticleThis report from the Patients Association describes shared decision making and its benefits, before going on to assess how it has been formally embedded in NHS programmes and practice. It identifies the barriers preventing shared decision making becoming a reality for patients as a matter of course, and possible solutions.
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Content ArticleThe Patient-Centered Outcomes Research Institute (PCORI) is an independent, non-profit research organisation that seeks to empower patients and others with actionable information about their health and healthcare choices. It funds comparative clinical effectiveness research (CER), which compares two or more medical treatments, services, or health practices to help patients and other stakeholders make better informed decisions. The PCORI Strategic Plan provides a roadmap for its activities in the years ahead as they pursue their vision and mission. Developed with extensive stakeholder input, the Plan articulates a refined focus on generating patient-centered evidence that has the greatest positive impact on health outcomes.
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Content Article
In this blog, Farrah Pradhan, Project Manager for Clinical Quality, Education and Projects at RCOG, describes her work with maternity professionals, namely obstetricians, and through undertaking an MSc in Patient safety. Farrah’s focus was on their 'work as done' to see if the concepts of Safety-II (capability mindfulness and resilience engineering) helped them to work more safely. -
Content ArticleThis guideline covers how to make shared decision making part of everyday care in all healthcare settings. It promotes ways for healthcare professionals and people using services to work together to make decisions about treatment and care. It includes recommendations on training, communicating risks, benefits and consequences, using decision aids, and how to embed shared decision making in organisational culture and practices.
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EventuntilThis session presented by AfPP, aims to help attendees understand more about patient informed consent and shared decision-making. Learning outcomes: Understanding management, around issues of consent. Recognise the importance and relevance of the Montgomery legislation in the model of shared decision making. Gain insight around empowerment of the patient in informed consent. Be able to explore issues around extended roles in shared decision making. Register
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Content ArticleNICE guidance on the management of chronic pain no longer recommends the initiation of many medications (e.g. NSAID’s, gabapentinoids etc) for primary chronic pain. However, there are many patients in the community who are already using these medications and it is important that when implementing this guideline, the recommendations are not used out of context. This joint statement aims to provide information that will help doctors and patients when reviewing medications.
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Content ArticleIn my tweets and posts I have suggested that patients themselves need to take more responsibility for the medicines they are prescribed. But what about vulnerable groups who may depend on decisions being made for them, and in their best interests? Whilst there are circumstances where antipsychotic (psychotropic) medicines are an appropriate option for people with autism and learning disabilities, these occasions are limited. In all cases the patient matters most, and any decision to prescribe must be part of a team based, patient-led decision, which is regularly reviewed.
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Content ArticleRichard Armstrong, head of health registries for Northgate Public Services, explains why collecting more data is not a cure-all in a health crisis.
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Content ArticleIn the previous blog in the 'Why investigate' series, we heard from Professor Martin Langham about the error trap being an error trap in itself, and about changing our focus in investigations to look wider than simplistic ideas and models of causation. In this blog, Professor Alex Stedmon considers how we might make the wrong decision when we think it’s the right decision.
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Content Article
Medicines and prescribing are highly risky areas of health care. It is estimated that more than 200 million medication errors occur in NHS every year, and that avoidable adverse drug reactions (ADRs) cause 712 deaths per year, at a financial cost of at least £98.5 million every year.[1] Many medicines and prescribing issues have been highlighted in reports and investigations into patient deaths over the years, yet the issues around prescribing competency are yet to be fully addressed. It is time this omission was rectified. This blog explains why I believe patients, the public and healthcare practitioners, need to be aware of the Prescribing Competency Framework.[2] It outlines why the framework must be applied in practice, used in clinical supervision and CPD, and why we must all speak out of it is not being followed. The benefits of this will include prevention of unnecessary medicines being prescribed, avoidance of drug related harm, and lives saved.- Posted
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Content ArticleThis study in AIDS and Behavior looked at patient-provider communication in HIV care and the role of shared decision making in improving health outcomes. The authors found that good quality engagement between patients and their healthcare providers was associated with better health-related outcomes. A substantial proportion of patients did not report having good quality engagement and this was associated with significantly poorer outcomes.
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Content ArticleChoosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.By having discussions that are informed by the doctor, but take into account what’s important to the patient too, both sides can be supported to make better decisions about care. Often, this will help to avoid tests, treatments or procedures that are unlikely to be of benefit.
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Content Article
Informed consent: what is it?
Julie EIDO Healthcare posted an article in Consent and privacy
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Julie Smith is Content Director for EIDO Healthcare, an organisation that provides health professionals with resources and support around informed consent. In this blog, Julie explains what it means to give your ‘informed consent’ as a patient, and why it is so important to read the information given to you. -
News Article
Shortages of staff and equipment weigh on doctors’ decisions, survey reveals
Patient Safety Learning posted a news article in News
Staff shortages and a lack of equipment are affecting the day-to-day decisions about patient care by doctors and nurses, a new YouGov survey has revealed. The representative survey of NHS clinicians revealed more than half, 54%, admitted that factors such as a lack of staff played a role in their decisions about patients beyond what was in their best interests. Almost a third of staff, 31%, said staffing levels were the top factor affecting decisions about patients. A fifth said the availability of services such as key tests were a significant factor; 16% cited a lack of equipment; and 12% cited beds. 10% of clinicians said a fear of being sued was part of their decision-making. YouGov carried out the research for JMW Solicitors and weighted the responses to be representative of the NHS workforce population. It also revealed more than two-fifths of clinicians, 42%, believe a “blame culture” in the NHS plays a top role in preventing staff admitting to mistakes in care. In maternity services specifically, 68% of nurses and midwives said at least one factor other than what was in patients’ best interest played a role in their decisions. Read full story Source: The Independent, 20 December 2020 -
Content Article
NICE guidance on shared decision making
PatientSafetyLearning Team posted an article in Consent and privacy
Shared decision making is when health professionals and patients work together. This puts people at the centre of decisions about their own treatment and care. When making decisions together, it's important that: care or treatment options are fully explored, along with their risks and benefits different choices available to the patient are discussed a decision is reached together with a health and social care professional. The link below includes guidance and tools to support patients and healthcare staff with shared decision making. -
Content ArticleAs winter pressures combined with COVID-19 create more stress for the NHS, hospitals could look at reducing exacerbating factors such as acute kidney injury, says Dr Mark Ratnarajah, managing director, UK, of digital health company C2-Ai. A study by researchers at University Hospital Southampton NHS Foundation Trust, found that Acute Kidney Infection (AKI) was a significant factor for COVID-19 admissions to Intensive Care Units (ICU) and deaths. AKI was present in 31 per cent of Covid-19 hospital patients, and the condition was associated with 27 per cent of admissions to ICU. The findings also showed that more than twice the number of COVID-19 patients with AKI died, compared to those without it. As AKI can commonly be acquired in hospital, it would be beneficial to both patients and hospitals if clinicians are able to consider the likelihood of anyone contracting the condition. For this, an individualised risk-assessment of a patient is needed, rather than a generalised catch-all approach. Click on the link below to read the full article, published in the Journal of mHealth.
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Content ArticleSupport in clinical decision making is recognised as an educational development need for pharmacists. The health policy landscape puts the pharmacist in a central role for clinical management of long-term complex morbidities, making clinical decision making and taking responsibility for patient outcomes increasingly important. This is compounded by the COVID-19 pandemic, where healthcare environments have become more complex and challenging to navigate. In this environment, foundation pharmacists were unable to sit the GPhC registration assessment during the summer of 2020 but provisionally the registration assessment is due to take place online during the first quarter of 2021. In response to this, a suite of resources has been developed with collaboration between Chartered Institute of Ergonomics and Human Factors (CIEHF) and Health Education England (HEE). These resources are aimed in particular at early career pharmacists and their supervisors, especially those in foundation pharmacist positions managing the transition from education to the workplace environment.
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