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Showing results for tags 'Decision making'.
Found 323 results
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Content ArticleRecently, there has been a concerning increase in the number of deaths of pregnant women, especially from Black, Asian and deprived backgrounds. In addition, there have been several investigations into safety issues in maternity services, such as the Ockenden, East Kent, and Shrewsbury and Telford report. This National Institute for Health and Care Research (NIHR) Collection highlights evidence in priority areas, identified in the East Kent report, to support high-quality care and avoid safety issues in maternity services.
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Content ArticleTo support patients to understand the risks of taking sodium valproate during pregnancy, NHS England has launched two new shared decision-making tools. This is part of an NHS-wide effort to reduce the use of valproate in people who can get pregnant, and to help those that do continue with valproate to prevent pregnancies.
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Content ArticleThis webinar shares the findings of a co-production project in Nottingham and Nottinghamshire Integrated Care Board (ICB) to remove barriers to shared decision making. The partners in the project were the ICB’s Personalised Care Team, the My Life Choices lived experience panel, the Patient Information Forum (PIF) and the Patients Association. Over the course of six co-production meetings, they developed simple resources to support patients and professionals to have better shared decision making conversations. Speakers discuss practical solutions to help patients and professionals get the most from limited appointment times which can be applied nationally.
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Content ArticleThis article looks at the experience of Tammy Dobbs, who has cerebral palsy and requires extensive support from home carers to carry out daily tasks. In 2016, Tammy's care needs were reassessed by the state of Arkansas where she lives, and the hours of support she was eligible to receive were cut in half. The change in eligibility was due to a new state-approved algorithm that had calculated her support needs in a new way, in spite of the fact that there was no change to her level of need. The situation caused Tammy much distress and resulted in drastic life changes. The article highlights the issues associated with the use of algorithms to determine need and allocate resources in health and social care. It also raises questions about what transparency means in an automated age and highlights concerns about people’s ability to contest decisions made by machines.
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Content Article
Infopool prostate cancer patient resource
Patient-Safety-Learning posted an article in Cancers
This patient resource created by Prostate Cancer Research aims to equip patients and the public with information about prostate cancer. It contains information on: testing and diagnosis treatment choices living with side effects clinical trials. -
Content ArticleGuidance needs to be applied in a careful, caring and person-centred way to ensure that patients benefit from, and are not harmed by, healthcare. In this blog, Dr Sam Finnikin, an academic GP in Sutton Coldfield, uses the story of 86 year-old Joan to illustrate the importance of shared decision-making in ensuring patients receive the most appropriate care. Joan was prescribed multiple medications by the hospital cardiology team after being diagnosed with acute coronary syndrome and a severely impaired left ventricle, but the medications made her feel very unwell and inhibited her quality of life. Joan then reached out to her GP surgery as she wanted to stop taking them, and Dr Finnikin realised that she and her family were unaware of the the reason each medication had been prescribed and the potential benefits and side effects of each one. After a long conversation about her priorities, Joan stopped the medications that were not benefitting her symptoms and died in peace and comfort at home a few weeks later. Dr Finnikin argues that shared decision-making is not an optional extra, but must be considered a vital part of healthcare, stating that "omitting shared decision making can be just as harmful to patients as being ignorant of clinical recommendations."
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Content ArticleThe nature of patient needs and ward activity is changing. Inpatients tend to be more ill than they used to be, many with complex needs often arising from multiple long-term conditions. At the same time, hospitals face the challenges of a shortage and high turnover of registered nurses. This review presents recent evidence from National Institute for Health Research (NIHR)-funded research, including studies on the number of staff needed, the support workforce and the organisation of care on the wards. While few research studies have explored the similar pressures that occur in community and social care, the learning from hospitals may be useful to decision makers in these areas.
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Content ArticleThe Dutch Hospital Patient Safety Program started in 2008. It initially ran for five years, and its aim was to decrease adverse events by 50% in all Dutch hospitals. A second National Safety Program launched in 2020. This focuses on reflection, interprofessional collaboration and explaining process variation in daily practice. It also looks to foster more patient involvement and shared decision making. The ultimate aim is to reach a significant reduction in preventable patient harm. This webinar provides an overview of patient safety in the Netherlands and discusses these two initiatives and their implementation, outcomes and ongoing impact.
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News Article
Electronic decision support ‘to be the norm for all clinicians’ under NHSE plan
Patient Safety Learning posted a news article in News
Electronic systems and clinical decision support software must become “the norm” for all NHS clinicians, under plans being drawn up by NHS England’s new transformation directorate, HSJ has revealed. The massive increase in clinicians’ use of technology forms a major part of the draft plans, seen by HSJ, with the new directorate set to launch ambitious targets for the health service. Other targets include every integrated care system creating virtual wards which are the equivalent size of a district general hospital — around 500 beds each — and installing electronic patient records at every NHS trust. The proposals are led by former US healthcare chief Tim Ferris, NHSE’s new transformation director, who was appointed last year. According to the plans, NHSE’s ambition is to increase the “safe and effective use” of computer assisted processes and clinical decision support so it becomes the “expected norm for all clinicians”. NHS leaders have welcomed the use of virtual wards to improve home care and reduce hospital occupancy, but clinicians have warned of safety issues within virtual wards, with some prominent doctors calling for a careful implementation of the policy. Read full story (paywalled) Source: HSJ, 2 February 2022 -
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 -
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 -
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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EventuntilAt this Bevan Brittan webinar, Dr Bell, a Consultant in Intensive Care and Anaesthesia will cover the following: 1. Background on scenarios in which consideration is given to treatment limitations. 2. Factors influencing decision-making. 3. The evolution of conflict. 4. Clinical perspective on the role of the courts. Register
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EventThis innovative educational initiative from the Royal College of Surgeons of Edinburgh 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. Register
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EventThis innovative educational initiative from the Royal College of Surgeons of Edinburgh 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. Register
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EventuntilHealthwatch is hosting this event to launch the Your Care, Your Way campaign, which calls for improved accountability and implementation of the Accessible Information Standard (AIS). Healthwatch England has joined forces with a coalition of user-led national organisations to highlight how the NHS and social care fail to support people's accessible communication needs. By law, all publicly funded health and social care providers must fully comply with the AIS and ensure people are given information about their health and care in accessible formats. New research by Healthwatch England and partner organisations has shown this is not happening, with many services overlooking people's needs and failing to provide the right support. At this webinar, you will hear: A summary of Healthwatch England's recent research findings on accessible information, drawing on Freedom of Information requests submitted to 200 NHS provider trusts and over 6,000 people's experiences shared with Healthwatch Survey data on staff and public experiences of the AIS from a coalition of user-led charities, including RNIB, SignHealth and RNID, and user-led perspectives on how to improve implementation Information about NHS England's ongoing review of the AIS, developing conclusions from the review, and opportunities to contribute A perspective from an NHS Trust on the barriers to implementing the AIS and overcoming them We welcome questions from the audience and contributions towards the end of the webinar, as well as a discussion about how you and your organisations can get involved in supporting the campaign. This event is for staff working in NHS and social care services, service providers, ICS leaders, voluntary sector and professionals. Register This event is being run by: Urte Macikene, Policy and External Affairs Manager, Healthwatch England. Healthwatch England sits on the Accessible Information Standard Review Programme Board. Malcolm Pearce, Senior Manager, North of England Commissioning Support, Malcolm led the Rapid Review of British Sign Language on behalf of NHS E/I and is currently supporting the review of the Accessible Information Standard Mike Wordingham, Policy and Campaigns Officer, RNIB (Royal National Institute of Blind People) A speaker from an NHS Trust about their experience of implementing the AIS (TBC)
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EventuntilThis is the third in a series of online lectures organised by the International Shared Decision Making Society (ISDM). This lecture will be hosted by Kristen Pecanac, UW-Madison School of Nursing. Join the webinar
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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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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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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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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 ArticleIn this presentation Paula Goss, the founding member of Rectopexy Mesh Victims and Support, shares her experience of having a mesh implant. She describes the absence of informed consent during the procedure and the pain and complications she experienced following her surgery. This was shared at a Bristol Biomedical Research Centre workshop aimed at improving shared decision making for surgical innovation.
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Content ArticleIt is important that patients understand the risks, benefits and alternatives associated with their treatment, but there is often a gap in patients' actual understanding of these issues. There is now substantial evidence showing that patient decision aids (PDAs) and shared decision making can bridge the gap between the theory and practice of informed consent. However, in spite of the evidence, PDAs are still rarely used in clinical settings. This article in the journal Maine Law Review looks at how the monetary incentive of a professional liability insurance premium reduction could encourage doctors in the USA to increase the use of PDAs.
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Content ArticleThe government has published a draft Mental Health Bill for pre-legislative scrutiny. The bill aims to modernise the Mental Health Act for the 21st century.
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Content ArticleJunior doctors can struggle with decision-making in emergency departments because they worry about “looking silly” in front of senior colleagues, a study has found. A team from the Healthcare Safety Investigation Branch (HSIB) looked at missed or delayed diagnosis of conditions in A&E. They specifically examined cases of pulmonary embolism and focused on diagnostic decision-making using applied cognitive task analysis. Interviews with medical staff found a number of factors which were common among expert level doctors. These included being aware of life-threatening conditions and seeking to rule them out, being comfortable in expressing doubt and seeking out peers to challenge their diagnosis. Junior staff on the other hand often tried to fit symptoms to specific conditions and had a fear of making wrong a diagnosis. Some said they were afraid of “looking silly in front of a senior”. The study, presented at an online session at the Ergonomics & Human Factors 2022 conference, suggested looking at how younger staff can be supported in improving their decision-making. HSIB investigator Nick Woodier, who presented the study, said: “Decision-making is a skill, commonly developed in healthcare through experience without formal training or opportunities to practise it.” You can view the presentation from the link below.
