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Found 325 results
  1. Content Article
    The purpose of this document, from the Chartered Institute of Ergonomics and Human Factors, is to provide health and social care teams with advice and guidance on the human-centred design of work procedures such as written instructions, checklists or flow charts during this period of 'crisis management' in response to COVID-19 and to support the design and re-design of care services and new ways of working. Implementation of the guidance will contribute to safer and easier to use procedures, which better support how people work and reduce risks to themselves, patients, carers and others.
  2. Content Article
    London clinicians have shared their top 10 tips to help prepare NHS staff in other parts of the country facing the COVID-19 crisis. UCLPartners asked clinicians working in a range of specialties across its region, the first in the UK to deal with a major escalation in COVID-19, to share their practical advice to support NHS staff elsewhere in the country preparing for a large number of COVID-19 cases.
  3. 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.
  4. Content Article
    A tutor once told me that research means 'to search again'. I am always searching or, as someone told me recently, 'sleuthing' for knowledge to improve myself and then share with my colleagues. I would like to share with you my knowledge of hydrogen peroxide.
  5. Content Article
    ECRI Institute's Top 10 Patient Safety Concerns for 2020 features new topics, with an emphasis on concerns that have the biggest potential impact on patient health across all care settings. However, the number one topic on this year's list is one revisited from 2019: missed and delayed diagnoses.
  6. Content Article
    Rates of induction of labour have been increasing globally to up to one in three pregnancies in many high-income countries. Although guidelines around induction, and strength of the underlying evidence, vary considerably by indication, shared decision-making is increasingly recognised as key. The aim of this study, published in Women and birth, was to identify women’s mode of birth preferences and experiences of shared decision-making for induction of labour.
  7. Content Article
    Kathy Nabbie reflects on the recent flights caught up in Storm Dennis and how 'routine' quickly became 'out of the ordinary'. As with aviation, in surgery we must always do the safety checks for each patient to ensure that every journey for the patient is a safe one.
  8. Content Article
    When James Titcombe is hit by the biggest tragedy imaginable to any parent, he and his wife need to confront a tragedy on a bigger scale still: the structural learning disabilities of the organisation that robbed them of their child. The ‘complexity of failure’ video documents the struggle to get the largest employer of the land to account for what was lost. Behind the bureaucracy and posturing, the lies and denials, it discovers a humanity and a richly facetted suffering by many others. It drives a determined James Titcombe to change how we learn from failure forever.
  9. News Article
    The Streatham terrorist attack has again highlighted one of the most difficult decisions the emergency services face – deciding when it is safe to treat wounded people. In the aftermath of the stabbings by Sudesh Amman, a passer-by who helped a man lying on the pavement bleeding claimed ambulance crews took 30 minutes to arrive. The London Ambulance Service (LAS) said the first medics arrived in four minutes, but waited at the assigned rendezvous point until the Metropolitan police confirmed it was safe to move in. Last summer, the inquest into the London Bridge attack heard it took three hours for paramedics to reach some of the wounded. Prompt treatment might have saved the life of French chef Sebastian Belanger, who received CPR from members of the public and police officers for half an hour. A LAS debriefing revealed paramedics’ frustration at not being deployed sooner. A group of UK and international experts in delivering medical care during terrorist attacks have highlighted alternative approaches in the BMJ. In Paris in 2015, the integration of doctors with specialist police teams enabled about 100 wounded people in the Bataclan concert hall to be triaged and evacuated 30 minutes before the terrorists were killed. The experts writing in the BMJ believe the UK approach would have delayed any medical care reaching these victims for three hours. These are perilously hard judgment calls. Policymakers and commanders on the scene have to balance the likelihood that long delays in intervening will lead to more victims dying from their injuries against the increased risk to the lives of medical staff who are potentially putting themselves in the line of fire by entering the so-called 'hot zone'. First responders themselves need to be at the forefront of this debate. As the people who have the experience, face the risks and want more than anyone to save as many lives as possible, their leadership and insights are vital. In the wake of the Streatham attack the government is looking at everything from sentencing policy to deradicalisation. Deciding how best to save the wounded needs equal priority in the response to terrorism. Read full story Source: The Guardian, 7 February 2020
  10. Content Article
    In this chapter, Wilkinson and Savulescu describe the background to the Charlie Gard case and how it played out over the first half of 2017. They will look at how decisions about medical treatment are normally made and the role of the court in decisions. They outline some of the important ethical questions raised by the Gard case.
  11. Content Article
    On 8 June 2017, the Supreme Court in the United Kingdom rejected a legal appeal in the high-profile case of Charlie Gard, a British infant with a severe genetic disorder whose parents had disagreed with medical professionals and were requesting treatment that the doctors believed was futile. The case was the latest in a series of UK legal cases where courts have authorised withdrawal of treatment against the wishes of parents. In such disputes, British judges have, with rare exception, sided with health professionals. In contrast, in North America when disputes have reached the court, the courts have invariably sided in favour of life-sustaining medical treatment requested by a loving family. Paris et al. discuss the case of Charlie Gard.
  12. News Article
    Up to half of all patients who suffer an acute aortic dissection may die before reaching crucial specialist care, according to a new Healthcare Safety Investigation Branch (HSIB) report. The report highlights the difficulty which can face hospital staff in recognising acute aortic dissection. The investigation was triggered by the case of Richard, a fit and healthy 54-year old man, who arrived at his local emergency department by ambulance after experiencing chest pain and nausea during exercise. It took four hours before the diagnosis of an acute aortic dissection was made, and he spent a further hour waiting for the results of a CT scan. Although Richard was then transferred urgently by ambulance to the nearest specialist care centre, he sadly died during the journey. The report has identified a number of risks in the diagnostic process which might result in the condition being missed. These include aortic dissection not being suspected because patients can initially appear quite well or because symptoms might be attributed to a heart or lung condition. It also highlighted that, once the diagnosis is suspected, an urgent CT scan is required to confirm that an acute aortic dissection is present. Gareth Owens, Chair of the national patient association Aortic Dissection Awareness UK & Ireland, welcomed the publication of HSIB’s report, saying: “HSIB’s investigation and report have highlighted that timely, accurate recognition of acute Aortic Dissection is a national patient safety issue. This is exactly what patients and bereaved relatives having been telling the NHS, Government and the Royal College of Emergency Medicine for several years." Read full story Source: HSIB, 23 January 2020
  13. Content Article
    'Hospitals should remove any barriers to doctors eating and drinking during the working day'. As healthcare providers, it’s easy to forget to look after ourselves at work. We know that taking breaks and eating and drinking regularly is a critical component of being “optimised,” helping to sustain our energy, concentration and performance, and reduce the risk of human error. Yet, for many, the realities of working in busy, modern hospitals get in the way. Medicine is a demanding profession, with days often starting early and finishing late and many fall into the habit of forgetting to take regular breaks, not drinking enough fluids, or missing meals. If we want to improve staff wellbeing and reduce the risk of errors, we need to change this.
  14. Content Article
    For eligible patients, prompt admission to the Intensive Care Unit (ICU) can increase their chance of survival by up to 23%. Yet those that do survive may experience lasting physical and emotional effects, and it is the job of the clinician to carefully weigh up the potential gains and risks of admission in what is often a time-pressured environment. There are currently no national guidelines to help the decision-making process, and evidence suggests it is influenced by a range of factors, with considerable variation between clinicians. In addition, patients and their families are not always fully informed or consulted. This study, published by Health Services and Delivery Research, explored current practice in order to create a decision support tool that could be used to help take some of the uncertainty out of the process, thereby improving decisions and, when possible, also informing the discussions with the patient and their family.
  15. News Article
    Hundreds of people with haemophilia in England and Wales could have avoided infection from HIV and hepatitis if officials had accepted help from Scotland, newly released documents suggest. A letter dated January 1990 said Scotland’s blood transfusion service could have supplied the NHS in England and Wales with the blood product factor VIII, but officials rejected the offer repeatedly. Large volumes of factor VIII were imported from the US instead, but it was far more contaminated with the HIV and hepatitis C viruses because US supplies often came from infected prison inmates, sex workers and drug addicts who were paid to give blood but not screened. The death of scores of people with haemophilia and blood transfusion patients and the infection of thousands of others across the UK in the contaminated blood scandal has been described as the worst health disaster to hit the NHS. The latest document was released under the Freedom of Information Act to campaigner Jason Evans, whose father died in 1993 having contracted hepatitis and HIV. In it, Prof John Cash, a former director of the Scottish Blood Transfusion Service, said the decision not to use Scotland's spare capacity to produce Factor VIII for England was "a grave error of judgement". Read full story Source: The Guardian, 3 January 2020
  16. Content Article
    NHS Resolution received 1,223 claims for incidents occurring between 2012 and 2017 that have cost the NHS £233 million so far. Of these cases, 728 claims are under review due to the complexities around consent. Consent can be a common contributing factor in many claims. This leaflet looks at examples of failure to provide adequate consent, a breakdown of these kinds of claims by clinical speciality, the importance of the Montgomery ruling and what supported decision making looks like.
  17. Content Article
    Each baby counts is the Royal College of Obstetricians and Gynaecologist's national quality improvement programme to reduce the number of babies who die or are left severely disabled as a result of incidents occurring during term labour. Watch the Each baby counts human factors video for information on how to address issues within your unit.
  18. Content Article
    This presentation written by Dr Gordon Caldwell, a Consultant Physician at Lorn and Islands Hospital, Oban, Argyll, Scotland, highlights the importance of surveillance and actions to be taken around prevention of infection of cannlula sites.
  19. Content Article
    This is a story of a patient in whom the emergency department missed the same diagnosis twice, four years apart. The first occasion (prior to his diagnosis of ankylosing spondylitis) was understandable. The second was not. As a result of this case, the hospital have changed their x-ray policy for non-traumatic back pain. They also want to share key learning points (the majority of which were due to lack of awareness about a relatively rare condition and its complications) as widely as possible, to help others avoid the same errors.  This reflective learning features guest educator, Mr Gareth Dwyer (the patient).
  20. Content Article
    In this blog published in the New York Times, Theresa Brown explains why American healthcare has become one giant workaround.  "The nurses were hiding drugs above a ceiling tile in the hospital — not because they were secreting away narcotics, but because the hospital pharmacy was slow, and they didn’t want patients to have to wait." These 'work arounds ' pose a significant patient safety risk. What work around problems do you have in your department? Theresa Brown is a clinical faculty member at the University of Pittsburgh School of Nursing.
  21. Content Article
    STOMP stands for: stopping over medication of people with a learning disability, autism or both with psychotropic medicines. It is a national project involving many different organisations which are helping to stop the over use of these medicines. STOMP is about helping people to stay well and have a good quality of life. Psychotropic medicines can cause problems if people take them for too long. Or take too high a dose. Or take them for the wrong reason. This can cause side effects like: putting on weight feeling tired or ‘drugged up’ serious problems with physical health.
  22. Content Article
    A blog from Dr Linda Dykes. "Bryn was my patient. He died. He may have stood a better chance of survival had I been aware of the risk of small bowel volvulus in an adult.  I produced this reflective learning resource with some colleagues - and with Bryn's widow, whom we call Fiona.  Please read it... it may help you save a life one day."
  23. Content Article
    The Cynefin framework is a conceptual framework used to aid decision-making. Created in 1999 by Dave Snowden when he worked for IBM Global Services, it has been described as a "sense-making device". Cynefin is a Welsh word for habitat. The Cynefin Framework allows executives to see things from new viewpoints, assimilate complex concepts, and address real-world problems and opportunities. Using the Cynefin framework can help executives sense which context they are in so that they can not only make better decisions but also avoid the problems that arise when their preferred management style causes them to make mistakes. In this video, Dave Snowden introduces the Cynefin Framework with a brief explanation of its origin and evolution and a detailed discussion of its architecture and function.
  24. Content Article
    How we treat each other at work has an enormous impact on how teams perform – with potentially fatal consequences if you work in healthcare. In this TEDx talk, Chris Turner reveals the shocking impact of rudeness in the workplace, arguing that civility saves lives.
  25. News Article
    Women are having their appendixes removed wrongly in nearly a third of cases, British research suggests. Researchers said too many female patients were being put under the knife when they should have undergone investigations for period pain, ovarian cysts or urinary tract infections. They said the study, which compared practices in 154 UK hospitals with those of 120 in Europe, suggests that Britain may have the highest rate of needless appendectomies in the world. Surgeons said they were particularly concerned by the high rates among women, with 28% of operations found to be unnecessary. They said the NHS was too quick to book patients in for surgery, when further scans and investigations should have been ordered. Researchers warned that such operations put patients at risk of complications, as well as fuelling NHS costs. Read full story Source: The Telegraph, 4 December 2019
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