Search the hub
Showing results for tags 'Decision making'.
Found 325 results
-
Content ArticleFor 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.
-
Content ArticleRates 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.
-
Content Article
Misuse of hydrogen peroxide in a theatre environment
Kathy Nabbie posted an article in Good practice
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. -
Content Article
James Titcombe: The complexity of failure (2 October 2018)
PatientSafetyLearning Team posted an article in Culture
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. -
Content Article
'Storm in a Checklist'
Kathy Nabbie posted an article in Surgery
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. -
Content Article
ECRI - Top 10 Patient Safety Concerns 2020
Claire Cox posted an article in International patient safety
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. -
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.
-
Content ArticleLondon 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.
-
Content ArticleThe 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.
-
Content ArticleThere has been little applied learning from organisations engaged in making evidence useful for decision makers. More focus has been given either to the work of individuals as knowledge brokers or to theoretical frameworks on embedding evidence. More intelligence is needed on the practice of knowledge intermediation. This paper from Tara Lamont and Elaine Maxwell describes the evolution of approaches by one UK Centre to promote and embed evidence in health and care services.
-
Content ArticleIn this article for The Guardian, psychiatrist Rebecca Thomas talks about the benefits and problems related to electroconvulsive therapy (ECT) treatments, which are used in cases of severe depression. Having had 70 individual ECT treatments for depression herself, Rebecca highlights that although the therapy can be very effective, doctors need to acknowledge the issues it can cause for patients. She talks about the memory issues ECT can cause, and highlights that as a therapy it has been stigmatised, which spreads fear about a treatment that can be necessary and life-saving. Concluding that decisions around ECT therapy should be clinical and not moral, she urges doctors not to be complacent about the risks, and patients to be careful about stigmatising an effective treatment.
-
Content ArticleThe word 'controversy' almost always accompanies any reference to electroconvulsive therapy (ECT). It has a dark history and remains a deeply contentious practice. For many, ECT is seen as outdated, forever linked with frightening images of medical abuse, cruelty and even punishment. In this programme for BBC Radio 4, Professor Sally Marlow met her friend Dr Tania Gergel at King’s College London, which forced her to reassess everything she thought she knew about ECT. Tania told Sally that ECT had saved her life on numerous occasions and that ECT is the only treatment that can bring her back to health after episodes of severe depression, psychosis and mania. Tania is Director of Research at Bipolar UK. She’s a philosopher and an internationally respected medical ethicist. She also lives with a serious mental illness; an unusual mixed type of bipolar disorder. During her last period of illness a year ago, Tania kept an audio diary., which she shares extracts from throughout the programme in order to break down stigma around both mental illness and ECT.
-
Content ArticleSelf-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having the potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, the views of service users on self-binding directives have not been seriously investigated. This study in The Lancet Psychiatry aimed to explore whether reasons for endorsement, ambivalence or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity and human rights.
-
Content ArticlePublic and patient expectations of treatment influence health behaviours and decision-making. This study aimed to understand how the media has portrayed the therapeutic use of ketamine in psychiatry. It found that ketamine treatment was portrayed in an extremely positive light, with significant contributions of positive testimony from key opinion leaders (e.g. clinicians). Positive research results and ketamine's rapid antidepressant effec were frequently emphasised, with little reference to longer-term safety and efficacy. The study concluded that information pertinent to patient help-seeking and treatment expectations is being communicated through the media and supported by key opinion leaders, although some quotes go well beyond the evidence base. Clinicians should be aware of this and may need to address their patients’ beliefs directly.
-
Content Article
Mandy Anderton is a Clinical Nurse specialising in learning disability and a hub Topic Leader. In this new blog, Mandy explains how they are using shared decision making and reasonable adjustments to implement a new care pathway, where patients with a learning disability needing to undergo a medical investigation can receive deep sedation within their own home. Working with patients, carers, relatives, anaesthetists and others, the aim is to improve access to important medical investigations with minimal distress, where other avenues have been exhausted. -
Content ArticleThe Accessible Information Standard gives disabled people and people with sensory loss the right to get healthcare information they can understand and communications support if needed. A survey conducted by HealthWatch between February and May 2022 aimed to investigate whether the standard is being delivered by health services, and whether it offers enough support to patients. While the survey participants were self-selected, their views are likely to reflect those of a significant group of people who need communications support. HealthWatch hopes that the survey's findings will help NHS and social care decision-makers hear what is working and what could be better from the public's perspective.
-
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.
-
Content Article
The sepsis song
Claire Cox posted an article in Learning disabilities
Sepsis can be difficult to spot or articulate. This short video by MiXiT days, a theatre company made up of people with and without learning difficulties, describes the symptoms of sepsis in song format. -
Content ArticleSTOMP 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.
-
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.
-
Content ArticleThe Patients Association's Patient Partnership Week brought together patients, carers and healthcare professionals to talk about patient partnership.
-
Content ArticleIn this blog for The Patients Association, Patient Safety Commissioner Henrietta Hughes looks at the importance of patient involvement in improving patient safety. She argues that patient voices should be embedded in the design and delivery of healthcare, and highlights that services and organisations need to seek feedback from patients from a wide variety of backgrounds. She also outlines why shared decision making and consent are vital to ensure patients are safe and have more control over their care and treatment.
-
Content ArticleWhat Matters to You? (WMTY) is an international person-centred care movement. It is based on the principle that healthcare workers should 'Ask, listen, do', in order to shift the power to the person who knows best about the help or support needed - whether that be the person with a medical issue or the clinicians providing care. WMTY conversations help healthcare teams understand what is “most important” to patients, leading to better care partnerships and improved patient experience. This website contains information about organisations involved in the movement as well as resources to help healthcare professionals and services implement WMTY.
-
Content ArticleSpeaking to patients about what matters to them helps healthcare teams understand individuals' priorities, leading to better care partnerships and improved patient experience. This toolkit developed by the Montefiore Medical Center in New York provides an outline of how to implement "what matters to you?" (WMTY) conversations in healthcare settings.
-
Content ArticleShared decision making is a collaborative process in which clinicians and patients consider treatment options based on evidence about their potential benefits and harms, to enable the patient to decide the best course for themselves. The person’s priorities and concerns, wishes, preferences and goals should inform the conversation and the decision made. The Professional Records Standards Body (PRSB) produced this draft standard on shared decision making following widespread consultation and a series of role plays which tested the standard’s usability in practice. It was was developed to align with the GMC guidance on shared decision-making and consent, as well as the NICE guidelines on shared decision-making. The final version of the PRSB standard is due to be released in Summer 2022.
