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Showing results for tags 'Decision making'.
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Content ArticleOrganisations expect to see consistency in the decisions of their employees, but humans are unreliable. Judgments can vary a great deal from one individual to the next, even when people are in the same role and supposedly following the same guidelines. And irrelevant factors, such as mood and the weather, can change one person’s decisions from occasion to occasion. This chance variability of decisions is called noise, and it is surprisingly costly to companies, which are usually completely unaware of it.
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Content ArticleThis guidance from the Chartered Institute of Ergonomics and Human Factors (CIEHF) is aimed at early career pharmacists, especially those in foundation pharmacist positions managing the transition from education to the workplace environment. Support in clinical decision-making is recognised as an educational development need for early career pharmacists, making the transition from a university education where there is very little exposure to the clinical environment into the work environment. This situation is compounded by a policy landscape which 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. The guidance will also be of use to those involved in the education and mentorship of early career pharmacist.
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Content Article
Surgical Outcome Risk Tool v2 (SORT)
Patient Safety Learning posted an article in Surgery
Some patients die after major surgery. Risk prediction tools can help shared decision making with the patient, aiding decisions on whether to operate, how to prepare and use of critical care. An international multi-centre prospective observational cohort study in 274 sites with 22,631 patients compared risk prediction with 30-day mortality. In 88.7% of cases clinicians exclusively used subjective assessment. The best predictions were from the SORT tool combined with clinical assessment. P-POSSUM Surgical Risk Scale, SRS and SORT all over-predicted risk, with SORT performing best. This 10-question SORT model has been updated including clinician assessment and provides an accurate means of predicting perioperative risk. -
Content Article
Keeping staff safe during COVID-19: Risk assessments
PatientSafetyLearning Team posted an article in Staff safety
Staff safety is fundamental to running an effective health service and delivering quality care. This year has highlighted how important risk assessments are in protecting the NHS workforce, as it continues to respond to the COVID-19 pandemic. We know that frontline healthcare staff are more at risk of becoming infected with COVID-19. We also know the virus has a disproportionate impact on staff from minority ethnic communities, and that many NHS workers are considered “clinically vulnerable” to COVID-19. There are also risk factors that relate to gender, age, weight and many more. This can understandably leave staff feeling confused about what they should and shouldn’t be doing to look after themselves and their colleagues. On 24 June, it became mandatory for all trusts to complete occupational risk assessments of vulnerable NHS workers. In this interview, Patient Safety Learning speaks to James Duez, CEO of Rainbird. James tells us how his company developed an automated decision-making tool, able to produce individualised risk assessments so that appropriate measures can be put in place quickly. -
EventThis conference focuses on delivering effective consent practice and ensuring adherence to the new 2020 guidance from the General Medical Council. This timely conference will focus on ensuring adherence to The Seven Principles as outlined by the New GMC Guidance. The conference will also update delegates on implications of recent legal developments. Further information and to book your place or email kate@hc-uk.org.uk Follow the conversation on Twitter #Consentpractice We are pleased to offer hub members a 10% discount. Email: info@pslhub.org for the code.
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Content ArticleDr. Donna Prosser is joined by Dr John James, a patient safety advocate, and the author of A New, Evidence-Based Estimate of Patient Harms Associated with Hospital Care. The team discusses the meaning of informed consent for clinicians and patients, the steps to a genuine shared decision making dialogue, and the components that should be addressed in the decision making process. Informed consent cannot be separated from the person-centeredness of an organization. While the shared decision making between clinicians and patients and loved ones does require time, attention, and attentiveness to the patient's wishes and goals, it should be a priority for all healthcare organisations.
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Event
Using human factors to support clinical decision making
Sam posted an event in Community Calendar
untilCoping with complexity: how a human factors systems approach can support competency development for pharmacists. Support 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. This session will act as the launch event for these resources and can support early career pharmacists and supervisors to navigate the CIEHF learning resources developed so far. Register -
Content ArticleThe COVID-19 Evidence Network to support Decision-making (COVID-END) helps: those supporting decision-making about COVID-19 to find and use the best available evidence (i.e. to support the evidence-demand side of the pandemic response) researchers to avoid waste by reducing duplication in and better coordinating the COVID-19 evidence syntheses, technology assessments and guidelines being produced (i.e., to support the evidence-supply side of the pandemic response). COVID-END is a time-limited network that brings together more than 50 of the world’s leading evidence-synthesis, technology-assessment and guideline-development groups around the world. It covers the full spectrum of the pandemic response, from public-health measures and clinical management to health-system arrangements and economic and social responses. It also covers the full spectrum of contexts where the pandemic response is playing out, including low-, middle- and high-income countries.
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News Article
NHS England reinstates central control powers as covid risk rating is increased
Patient Safety Learning posted a news article in News
The NHS has been returned to the highest level of risk on its emergency preparedness framework, a move which allows national leaders tighter control over local resources and decision making. NHS England chief executive Sir Simon Stevens announced the decision at a press conference this morning. He said: “Unfortunately, again we are facing a serious situation [due to rising coronavirus infections and hospital admissions]. That is the reason why at midnight tonight the health service in England will be returning to its highest level of emergency preparedness, EPPR level 4, which of course we had to be at from the end of January to the end of July.” Placing the NHS on level 4 of Emergency Preparedness Reslience and Response framework allows system leaders to take control of decisions over mutual aid and other local priorities. Sir Simon was joined by NHSE/I medical director Steve Powis and Alison Pittard, dean of the Faculty of Intensive Care Medicine. They used the press conference to stress the threat the NHS faced from the second covid peak, but also set out more positive news on the covid vaccine programme. Read full story Source: HSJ, 4 November 2020 -
Content ArticleInvolving patients in decisions about their care is of fundamental importance to effectively managing long-term conditions and improving patient safety. In 2020, AbbVie brought together patient groups, health and social care services, national organisations, policymakers, and parliamentarians to a Showcase at Westminster celebrating exemplar projects that promote shared decision making practices from across the country. The link below contains the posters from the projects showcased on the day, showcasing the creative work taking place across the UK in the shared decision-making space.
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Content Article
Tim Stephens is a researcher at Queen Mary University of London and Barts Health NHS Trust and a qualified intensive care nurse. He is currently working with a large team of clinicians, patients and scientists to investigate how older people make decisions about having major surgery. In this blog, Tim talks about shared decision-making, individual impact and the need for better data to help clinicians quantify risk.- Posted
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Content Article
AbbVie: Shared decision making
Patient Safety Learning posted an article in Patient-centred care
The involvement of patients in decisions about their care is essential to help effectively manage long-term conditions and help achieve the best possible patient outcome. ‘Shared decision making’ ensures that individuals are supported, by their healthcare partners, to make decisions about their care or treatment, that are right for them. Shared decision making is included in the NHS Constitution, and AbbVie, a research-driven biopharmaceutical company. hopes to help continue raising the profile of patient involvement. AbbVie wants to see shared decision making be widely adopted across NHS services. To support this ambition, AbbVie held the Shared Decision Making Showcase in Parliament on the 10 March 2020. A year on from the publication of the NHS Long Term Plan, and Universalised Personalised Care Plan – which established ambitious targets to put shared decision making at the heart of patient care – the showcase provided a platform for patient groups, NHS Trusts, and healthcare providers to share their innovative work. The projects showcased ranged from MS, arthritis, Lymphoma, Autism, Hepatitis C, kidney dialysis and more—all focused on empowering patients to take an active part in decisions about their treatment and care. AbbVie has supported a number of organisations and projects to develop and enable shared decision making including two of the showcased initiatives: a survey of treatment decision experience amongst psoriasis patients and the work of the Patient Information Forum to develop and implement the Perfect Patient Information Journey. -
Content ArticleThe Patient Information Forum ran a survey on covid choices. It asked how people are balancing the need to have new or ongoing health conditions treated and managed versus the risks of contracting COVID-19. The aim of the survey was to identify the factors important to patients’ decision-making. This will help charities and the NHS produce the information patients need to make crucial decisions about health and well-being.
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Content ArticlePatients can play a distinct role in protecting their health, choosing appropriate treatments for episodes of ill health and managing chronic disease. Considerable evidence suggests that patient engagement can improve their experience and satisfaction and also can be effective clinically and economically. This policy brief outlines what the research evidence tells us about the effects of engaging patients in their clinical care, and it reviews policy interventions that have been (or could be) implemented in different health care systems across Europe. In particular, it focuses on strategies to improve: health literacy treatment decision-making self-management of chronic conditions.
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Content ArticleThe General Medical Council has published an updated guide on Decision making and consent, which comes into effect on 9 November 2020. The guidance aims to support doctors to practise shared decision making and help their patients to make healthcare decisions that are right for them. New features include: a focus on taking a proportionate approach, acknowledging not every paragraph of the guidance will be relevant to every decision seven key principles which summarise the guidance a new section to help doctors find out what matters to patients so they can share relevant information to help them decide between viable options suggestions for how other members of the healthcare team can support decision making.
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News ArticleDelays at the Great Ormond Street Hospital led to a boy dying an agonising death, a health watchdog has found. Arvind Jain, 13, who had Duchenne Muscular Dystrophy, died in August 2009 after waiting months for an operation. The ombudsman's report found he had "suffered considerable distress" and criticised referral procedures as "chaotic and substandard". The Great Ormond Street Hospital said there were "failings in clinical care". Arvind's sister Shushma said: "To read that he was suffering all the time, that was disgusting. He had been asking us repeatedly if he would get the operation and we would be constantly reassuring him that he would not die." The degenerative disease Arvind, who lived in Cricklewood, north London, suffered from was not immediately life threatening but in January 2009 his condition had become acute enough for him to struggle with swallowing and feeding. He had a temporary medical solution where a tube was inserted through his nose to help him get the required nutrition. He also experienced a number of other medical complications although none of these was considered life-threatening. The permanent solution recommended by his consultant paediatric neurologist was a gastrostomy insertion which would allow Arvind to feed through his stomach. The Great Ormond Street Hospital Trust (GOSH) excels in such procedures, however, a series of communication errors meant despite repeated and urgent requests from his neurological consultant, proper investigations were not carried out into Arvind's suitability for the operation. After five months of delays he and his family were reassured that as soon as he got the operation he would be much more comfortable. Another hospital also offered to carry out the operation in the event that the delays continued. But the surgical team that was due to carry out the operation never managed to assess Arvind. His condition deteriorated to the point where he was not well enough to be operated on and Arvind died on 9 August 2009. The Parliamentary and Health Service Ombudsman's report said he "suffered considerable distress and discomfort". It also describes a series of basic shortcomings in Arvind's care. The report said: "The standard of care provided for Arvind fell so far below the applicable standards as to amount to service failure." Read full story Source: BBC News, 23 September 2020
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Content ArticleWhy is it hard for a highly trained professional to speak or report about mistakes made by him or her? Jean-Pierre Kahlmann, a retired Military and Airline Pilot, and now Co-owner and CEO of Yes Human Factors Ltd, believes that every staff member in an organisation should feel safe to use her or his voice to speak about safety issues, mistakes and how to learn and improve. In this TEDx presentation, Jean-Pierre takes you on a trip through his Airforce and civil aviation career to show the added value of Just Culture in high reliability organisations. He talks about his, initial, internal resistance against speaking about his mistakes and he sees the same resistance within the culture of health care professionals.
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Content Article
Canadian Institute for Health Information
Patient Safety Learning posted an article in International patient safety
The Canadian Institute for Health Information (CIHI) provides comparable and actionable data and information that are used to accelerate improvements in health care, health system performance and population health across Canada. Stakeholders use the broad range of health system databases, measurements and standards, together with the evidence-based reports and analyses, in their decision-making processes. -
Content ArticleThe OSIRIS programme is a major project of research, to understand and improve the shared decision making process for patients at high risk of medical complications as they contemplate major surgery. Led by Barts Health NHS Trust & Queen Mary University London and funded by the National Institute for Health Research (NIHR), research will be conducted with patients, doctors and carers to understand the surgical decision making process. The OSIRIS team aim to understand the values and beliefs about long-term outcomes amongst high-risk patients contemplating major surgery, how these differ from doctors’ opinions, how these affect decisions about surgical treatments, and whether patients’ opinions change once they experience surgery. They will co-design with patients and doctors, a decision support intervention, to provide an accurate and individualised forecast of the risks and benefits of surgery for each high-risk patient. You can find out more about the research methodology and the aims of the project through the link below.
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News Article
Maternity unit death 'lessons not learned'
Patient Safety Learning posted a news article in News
High-risk women at a maternity unit were not monitored closely enough and there was a "lack of learning" from a mother's death, inspectors found. A Care Qualtiy Commission (CQC) report rated the unit at Basildon University Hospital as inadequate with "failings" found in six other serious cases. Inspectors carried out unannounced checks in June after a whistleblower voiced fears about patient safety. The unit was criticised following the deaths of baby Ennis Pecaku in September 2018 and mother Gabriela Pintilie, 36, in February 2019. The CQC previously carried out an inspection of the department the month Mrs Pintilie died and said the unit, which had once been rated outstanding, required improvement. Inspectors returned for the surprise "focused" inspection after being contacted by an anonymous whistleblower. The report found babies were born in a poor condition and then transferred for cooling therapy, which can be offered for newborn babies with brain injury caused by oxygen shortage during birth. During their visit, inspectors found: High-risk women giving birth in a low-risk area. Not enough staff with the right skills and experience. "Dysfunctional" working between midwives, doctors and consultants, which had an impact on the "increased number of safety incidents reported". Concerns over foetal heart monitoring. Women being referred to by room numbers instead of their names. A "lack of response by consultants to emergencies" resulting in delays The CQC also referred to issues relating to the death of Mrs Pintilie, who was not named in the report, and said five serious incidents "identified the same failings of care". Read full story Source: BBC News, 18 August 2020 "This demonstrated there had been a lack of learning from previous incidents and actions put in place were not embedded." -
Content ArticlePresentation from Steve Turner at a NICE Associates Meeting on over prescribing of medication to patients with learning disabilities and reasonable adjustments. He highlights the death of Oliver McGowan and the lessons learnt.
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Content ArticleStress urinary incontinence is when you leak urine accidentally, especially during exercise or when you cough, laugh or sneeze. The National Institute for Health and Care Excellence (NICE) has produced a diagram that shows what treatments NICE recommends as options for managing stress urinary incontinence. If you have tried to manage your condition without surgery, but this hasn’t worked, you might like to think about surgery. This decision aid can help you and your surgeon decide together which type of surgery is best for you. You might also decide that you don’t want to have any surgery. It is important to make the choice that you feel is right for you. This will depend on your individual circumstances and how you feel about each type of surgery. Every woman is different, so this decision aid is only a guide. Information about how this decision aid was produced and the evidence on which it is based is available on the NICE website.
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Content ArticleThe call for meaningful patient and family engagement in healthcare and research is gaining impetus. Healthcare institutions and research funding agencies increasingly encourage clinicians and researchers to work actively with patients and their families to advance clinical care and research. Engagement is increasingly mandated by healthcare organizations and is becoming a prerequisite for research funding. In this article, Burns et al. review the rationale and the current state of patient and family engagement in patient care and research in the ICU. The authors identify opportunities to strengthen engagement in patient care by promoting greater patient and family involvement in care delivery and supporting their participation in shared decision-making. They also identify challenges related to patient willingness to engage, barriers to participation, participant risks, and participant expectations. To advance engagement, clinicians and researchers can develop the science behind engagement in the ICU context and demonstrate its impact on patient- and process-related outcomes. In addition, the authors provide practical guidance on how to engage, highlight features of successful engagement strategies, and identify areas for future research. At present, enormous opportunities remain to enhance engagement across the continuum of ICU care and research.
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Content ArticleOn 24 July 2017, the long-running, deeply tragic and emotionally fraught case of Charlie Gard reached its sad conclusion. Following further medical assessment of the infant, Charlie’s parents and doctors finally reached agreement that continuing medical treatment was not in Charlie’s best interests. Life support was subsequently withdrawn and Charlie died on 28 July 2017. This paper from Dominic Wilkinson and Julian Savulescu summarises the case and looks at the key factual and ethical questions arising from the Charlie Gard case, and parents’ role in decision-making for children.
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Content ArticleStress urinary incontinence (SUI) is the loss of urine when coughing, laughing, sneezing or exercising. It is a common and distressing condition, with negative impact on quality of life. If conservative treatment, e.g. pelvic floor muscle training, is not successful, the most successful surgical procedures are mid-urethral mesh tape, colposuspension, autologous fascial sling and urethral bulking agent injections.
