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Showing results for tags 'Decision making'.
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Content ArticleThis article by the National Institute for Health Research (NIHR) summarises recent evidence about the information and support pregnant women need to make decisions about their maternity care, and any interventions they may need. It discusses the following areas: The importance of continuity of carer and personalised care in maternity services Women need clear information and better access to mental health care Helping women with complicated pregnancies make informed decisions about their care Supporting shared decision-making when there are problems with the baby
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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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- Patient
- Patient / family involvement
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Content ArticleThis patient decision aid from the National Institute for Health and Care Excellence (NICE) aims to help adults with type 2 diabetes understand the risks and benefits of taking a second medication, so that they can make an informed decision about their care.
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- Diabetes
- Decision making
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Content ArticleThis patient decision aid from the National Institute for Health and Care Excellence (NICE) aims to help family members and carers of severe stroke patients under 60 understand the risks and benefits of decompressive hemicraniectomy, so that they can make an informed decision about treatment.
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- Decision making
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Content ArticleThis patient decision aid from the National Institute for Health and Care Excellence (NICE) aims to help patients with high blood pressure understand the risks and benefits of different treatment options so that they can make an informed decision about their care.
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- Decision making
- Communication
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Content ArticleThese free e-learning courses about communicating the potential harms and benefits of treatment to patients have been produced by the Winton Centre for Risk & Evidence Communication, the Academy of Medical Royal Colleges in the UK and the Australian Commission on Safety & Quality in Healthcare.
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- Patient engagement
- Communication
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Content ArticleThere are many respects in which the modern medical system is not fit for purpose and poses a threat to human health. In so many situations, our superficial assumptions about medicine are wrong. Having more tests to identify disease is often not better than leaving those “well enough” alone, labelling people with a specific disease may not be helpful, and more medicine may not be better than less medicine or no medicine at all. In our eagerness to intervene, we can end up doing harm. This fits with the estimation that around 30% of medical care is ineffective and another 10% is harmful. But why do doctors recommend tests, or diagnose and prescribe treatments that don’t help people? Ian A Harris, an orthopaedic surgeon, and Rachelle Buchbinder, a professor of clinical epidemiology, discuss in this BMJ opinion article.
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- Doctor
- Patient harmed
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Content ArticleHigh Reliability Organisations (HRO), including healthcare and aviation, have a common focus on risk management. The human element is a ‘weak link’ which may result in accidents or adverse events taking place. Surgeons and other healthcare professionals can learn from aviation's rigorous approach to the role of human factors (HF) in such events, and how we can minimise them. Air Accident Investigation Branch (AAIB) reports show that fatal accidents are frequently caused by pilots flying outside their own personal limits, those of the aircraft or environment. Similarly, patient morbidity or mortality may occur if surgeons work outside personal their capability, with poor procedure selection and patient optimisation, or with a team or theatre environment not suited to the procedure. The authors of this study introduce the personal limitations checklist – a tool adapted from aviation that allows surgeons to define their limits in advance of any decision to operate, and develop critical self-reflection. It also allows management of patient expectations, shared decision making, and flattening of team hierarchy. The minimum skills, patient characteristics, team and theatre resources for any given procedure to proceed are defined. If the surgeon is ‘out of limits’, redressing these factors, seeking additional assistance, or thorough patient consenting may be required for the safe conduct of the procedure. The authors explore external pressures that could cause a surgeon to exceed both personal and organisational limits.
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- Human factors
- Aviation
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Content ArticleIn this video of a plenary session from the Guidelines International Network (GIN) Conference on 26 October 2021, James McCormack, Professor at the Faculty of Pharmaceutical Science, University of British Columbia, discusses issues with clinical practice guidelines and ways to overcome them.
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- Pharma / Life sciences
- Canada
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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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- Diagnosis
- Diagnostic error
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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 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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- Learning disabilities
- Medication
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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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- Data
- Information sharing
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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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- Investigation
- Confirmation bias
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Content ArticleIn 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.
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- Obstetrics and gynaecology/ Maternity
- Decision making
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Content ArticleThis is the recording of a webinar given on 19 January 2022 for the International Shared Decision Making Society by Professor Kirsten McCaffery from the University of Sydney and Marie Anne Durand from the University of Lausanne. It covers the following topics: What is health literacy and why does it matter Conceptualising health literacy and shared decision making Findings from recent health literacy and shared decision making reserach What can we do better?
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- Decision making
- Health inequalities
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Communication is key to building patient trust in ‘the system’
Lotty posted an article in Patient-centred care
In this blog, Lotty Tizzard, Patient Safety Learning's Content and Engagement Manager, looks at how positive, proactive communication improves patient trust in health services. She highlights that negative past experiences can prevent patients accessing the support and treatment they need, and looks at possible ways to build patient trust in the health system.- Posted
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- Patient engagement
- Communication
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Content ArticleThis article, published in Mayo Clinic Proceedings, looks at how outsourcing in health care has become increasingly common as health system administrators seek to enhance profitability and efficiency while maintaining clinical excellence. However, outsourcing clinical services often results in lower quality patient care, including patient harm, and compromises the values of the organisation.
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- Patient harmed
- Evaluation
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A series of failures: a relative's story
Patient Safety Learning posted an article in Keeping patients safe
At the first Patient Safety Management Network (PSMN)* meeting of 2022, we were privileged to hear from a bereaved relative about her shocking experience, which reminded us all of why we do what we do. Claire Cox, one of the PSMN founders, invited Susan (not her real name to protect her confidentiality) to share with us the causes of her relative’s untimely death and the poor and shameful experience when she and her GP started to ask questions. This kicked off a valuable and insightful discussion about how patients are responded to when things go wrong and about honesty and blame, patient and family engagement in decision making when patients are terminally ill, and how we need to ensure that the new Patient Safety Incident Response Framework (PSIRF) guidance embeds good practice informed by the real-life experience of patients and staff.- Posted
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- Patient safety incident
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Content ArticleWomen are entitled to clear information on the risks and benefits of different options in order to make informed decisions about the birth of their babies. Rates of induction are rising. One in three pregnancies is induced in Great Britain, according to most recent data. Earlier this year Patient Information Fortum (PIF) members raised concerns about availability of information to support decision-making on induction of labour. PIF responded by collaborating on a survey with maternity charities including Tommy’s, Bliss and Birthrights. The results are sobering and show there is much to do to put personalised care and shared decision making into practice in maternity care.
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Content ArticleThis decision aid is for women who have complications caused by pelvic mesh that was used to treat their stress urinary incontinence. Pelvic mesh has also been called ‘tape’, ‘net’ or a ‘sling’. Stress urinary incontinence is when you leak urine accidentally, especially during exercise or when you cough, laugh or sneeze. This decision aid has been written for women who have been referred to a specialist centre to treat complications from mesh used for stress urinary incontinence.
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- Womens health
- Surgery - Urology
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Content Article
The Health Literacy Place toolkit
Patient-Safety-Learning posted an article in Health inequalities
It is easy to underestimate people’s health literacy needs, because those needs can be hidden or people can be reluctant to admit that they haven’t understood the information they have been given. This toolkit by The Health Literacy Place contains a range of resources to help healthcare professionals better understand and meet the health literacy needs of their patients.- Posted
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- Health literacy
- Health inequalities
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Content ArticleThe tinnitus decision aid is designed to help clinicians and patients work together to choose the right treatment option for each individual. People with tinnitus vary in their preferences, for example, some like to use sound, others prefer a talking therapy approach. The decision aid provides information on key points that patients need to know to make a decision. The decision aid was developed through a systematic process of reviewing evidence, gathering key questions from patients and refining the information to be readable and useable. All the approaches listed are available everywhere but may require some travel or cost to access them. This should be discussed in consultations.
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- Medicine - Audiology
- Decision making
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Content ArticleCOVID-19 has meant people have died the ultimate medicalised deaths, often alone in hospitals with little communication with their families. But in other settings, including in some lower income countries, many people remain undertreated, dying of preventable conditions and without access to basic pain relief. The unbalanced and contradictory picture of death and dying is the basis for the Lancet Commission on the Value of Death. Drawing on multidisciplinary perspectives from around the globe, the Commissioners argue that death and life are bound together: without death there would be no life. The Commission proposes a new vision for death and dying, with greater community involvement alongside health and social care services, and increased bereavement support.
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- Patient death
- Medicine - Palliative
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