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Found 124 results
  1. News Article
    One of the trusts worst affected by coronavirus has been issued with two warning notices and rated ‘inadequate’ for leadership, following a Care Quality Commission inspection. The regulator raised serious concerns about the safety of Countess of Chester Hospital Foundation Trust’s maternity services, as well as the oversight and learning from incidents. It also found staff were experiencing multiple problems with a newly installed electronic patient record, while systems for managing the elective waiting list were said to be unsuitable. In maternity services, the inspectors flagged severe staff shortages and a failure to properly investigate safety incidents. They said there were three occasions during the inspections when the antenatal and post-natal ward was served by only one midwife, despite the interim head of midwifery saying this would never happen. Inspectors also highlighted five incidents last year where women had suffered a major post-partum haemorrhage, involving the loss of more than two litres of blood and which resulted in an unplanned hysterectomy. The CQC said two were not reported as serious incidents, and where learning had been identified from the others, action plans were not being completed on time. The CQC said it was only made aware of the incidents by a whistleblower, while internal actions agreed in December 2021 had still not been implemented two months later. Read full story (paywalled) Source: HSJ, 15 June 2022
  2. Content Article
    Updatable estimates of COVID-19 onset, progression, and trajectories underpin pandemic mitigation efforts. To identify and characterise disease trajectories, Thygesen et al. aimed to define and validate ten COVID-19 phenotypes from nationwide linked electronic health records (EHR) using an extensible framework. Their analyses illustrate the wide spectrum of disease trajectories as shown by differences in incidence, survival, and clinical pathways. The authors have provided a modular analytical framework that can be used to monitor the impact of the pandemic and generate evidence of clinical and policy relevance using multiple EHR sources.
  3. Content Article
    Specialty referrals—when a clinician refers a patient to a specialist for evaluation or treatment—are on the rise in the US. Despite the introduction of electronic health records (EHRs), the referral process is often hindered by lack of clarity over roles, communication breakdowns, workloads and variations in requirements among specialists. These difficulties can lead to missed or delayed diagnoses, delays in treatment and other lapses in patient safety. This guide from the Institute for Healthcare Improvement offers recommendations that aim to help standardise how primary care practitioners activate referrals to specialists and then keep track of the information over time. It describes a nine-step, closed-loop process in which all relevant patient information is communicated to the correct person through the appropriate channels, in a timely manner.
  4. Content Article
    This mixed methods study in BMC Medical Informatics and Decision Making explored approaches to implementing Electronic Patient Record systems (EPRs) into NHS acute, mental health and community care hospitals throughout England. It also looked at the challenges and benefits of implementing EPRs. The authors conducted an online survey and semi-structured telephone interviews with chief information officers at NHS trusts. The study found that there was no single approach taken to implementing EPRs among participating English NHS trusts, who cited various benefits and challenges. The authors conclude that policymakers and researchers need to provide clearer guidance for trusts at various stages of implementation and ensure that intelligence is shared across England’s NHS trusts.
  5. Content Article
    Huge numbers of patients suffer avoidable harm in US hospitals each year as a result of unsafe care. In this blog, published in the Harvard Business Review, the authors argue that these numbers could be greatly reduced by taking four actions: Make patient safety a top priority in hospitals’ practices and cultures, establish a National Patient Safety Board, create a national patient and staff reporting mechanism, and turn on EHRs machine learning systems that can alert staff to risky conditions.
  6. Content Article
    The following questionnaire will take about 8 minutes to complete and is designed to explore your professional experience of using the electronic patient record (EPR) system(s) where you work.  By participating in this research, you will help the NHS understand how your EPR system is working for you, including where it is performing well and where more can be done to enhance your experience.
  7. Content Article
    In this blog for BJGP Life, GP and Public Health Specialty Registrar Richard Armitage looks at the patient safety implications of changes made to gender markers on patient records. Patients in the UK are able to change the gender marker on their NHS patient record on request at any time. This action triggers the creation of a new NHS number and imports the patient’s medical information into a new patient record, without any reference to the patient's previous gender identity or original NHS number. The author highlights that failure to transfer this information could inhibit high quality care for trans patients, especially with regard to population screening programmes which invite patients according to age and gender markers on their patient record. He argues that public health officials, in collaboration with their primary care colleagues, should: respectfully communicate sex-specific health risks with their trans patients encourage them to consider requesting and accessing the appropriate population screening programmes support them in accessing screening in a dignified manner.
  8. News Article
    Electronic patient record (EPR) systems must be implemented in at least 90% of NHS trusts by the end of next year, the health secretary has announced at HSJ’s Digital Transformation Summit. Speaking at the event with digital healthcare leaders in Birmingham, Mr Javid said an estimated one in five trusts are currently without EPR systems implemented. He said: “We have seen some brilliant progress {on digital transformation] but it’s not always been consistent across the board.” He said: “We must see these disparities as just as unjust as disparities in access to education and employment.” And added: “Electronic patient records are the essential prerequisite for a modern, digital NHS." Mr Javid said 40% of social care providers were grappling with entirely paper based records, and he also wanted them to all adopt electronic records. He also outlined the intended future of the NHS App, and the government’s ambition for this to be used by 75 per cent of adults in England by March 2024. Currently it is just over half of all adults. Mr Javid said he wanted the app to be the “future front door for interaction with the NHS”, and will be used by patients to directly communicate with their healthcare providers, to receive personalised health advice and to access test results. Read full story (paywalled) Source: HSJ, 24 February 2022
  9. Content Article
    The Healthy Data e-consultation is a joint initiative run by the Belgian project 'Towards the development of a national health data platform' (AHEAD) and the European initiative 'Towards a European Health Data Space' (TEHDAS). Its aims are: to listen to citizens and patients’ views on health data secondary use and sharing, and on the role that they would like to play in the management and use of their health data. to increase citizen awareness, engagement and empowerment on the topic, so that everyone can develop informed opinions and take an active role in the use of their health data.  Anyone can sign up and share their views on the following questions: What should your health data be used for? Under which conditions should your health data be used? How would you like to be informed and involved in the reuse of your health data? What other ideas do you have on health data reuse?
  10. Content Article
    This blog in the Health Services Journal (HSJ) looks at the risk posed to clinical care by cyberattacks. A recent HSJ webinar in association with Sophos argued cybersecurity should be the business of everyone in the NHS, and looked at how NHS organisations can tackle the issue. Cyberattacks can cause delays and compromise patient safety and are therefore something that all healthcare staff need to consider. Using helpful language to explain the implications of cyberattacks is key to getting involvement right across the spectrum of management and frontline staff, so that it is not seen as 'an IT issue'.
  11. News Article
    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
  12. Event
    This conference from the Westminster forum will examine the next steps for the use of patient records and data within the NHS and clinical research. The agenda also looks at the opportunities for improved patient engagement in their care, including through the NHS app which enables easily to access their own records. Speakers and other delegates will share experience, latest thinking on best practice, and views on the way forward for addressing key issues. Areas for discussion include: patient data use in healthcare delivery - the current landscape, and priorities for the future electronic health records - including their role in supporting integrated care systems clinical research - the next steps for utilising patient data, and developing best practice digital health - patient data collection, use and quality, and innovation priorities population health - achieving the potential of data collection to improve outcomes security - including transparency on patient data use public trust - digital health literacy and patient control of their own care plans the NHS app - its role in the future of patient-centred healthcare. Register
  13. Content Article
    In this article in Inforisk Today, Marianne McGee looks at warnings from patient safety experts and federal authorities around cyberattacks on the public health sector. She looks at emerging trends in the way that cybercriminals target healthcare, recent work to bring down cybercriminal gangs and the impact of ransomware attacks on healthcare systems.
  14. Content Article
    This International Patient Summary roadmap (G7-IPS) supports the G7 commitment to deliver on the rights of patients to have access to their health information, and through using open and interoperable standards it enables this information to be used at the point of treatment or care. The roadmap outlines the component parts required for implementation and the standards which will be used to ensure alignment and interoperability across the G7 community. Although developed by the G7 countries, other countries, should they wish to, will be able to adopt the same principles and use the open and interoperable resources.
  15. Content Article
    This article in BMC Health Services Research looks at a range of macro, meso and micro factors influencing eHealth innovation in the English NHS. eHealth is a broad term which encompasses e-health, m-health, telemedicine and telecare, public health surveillance, personalised medicine/patient engagement, health and medical platforms, self-tracking, medical imaging, healthcare information systems, mobile connectivity, social networking, sensors and wearables, gamification, electronic health records, big data, health information technology, health analytics, digitised health systems, robotics and active assistive living. The study found that the fragmentation of the NHS is the most significant factor limiting the adoption of eHealth innovations, arguing that national policy has intensified the digital divide. It states that the NHS Long Term Plan places great emphasis on the role of digital transformation in aiding communication and enabling people to access care quickly and easily, highlighting significant implications for effectiveness, efficiency and equity.
  16. Content Article
    This study, published in JAMA Network Open, looks at whether publicly reported feedback was associated with hospital improvement in an evaluation of medication-related safety performance. The results indicate that publicly reported feedback was associated with quality improvement, and the authors suggest that targeted measurement and reporting of process quality may be effective in encouraging improvement in specific areas.
  17. Content Article
    Although most current medication error prevention systems are rule-based, these systems may result in alert fatigue because of poor accuracy. Previously, we had developed a machine learning (ML) model based on Taiwan’s local databases (TLD) to address this issue. However, the international transferability of this model is unclear. This study examines the international transferability of a machine learning model for detecting medication errors and whether the federated learning approach could further improve the accuracy of the model. It found that the ML model has good international transferability among US hospital data. Using the federated learning approach with local hospital data could further improve the accuracy of the model.
  18. Content Article
    In his newsletter today (The Top 10 Dangers of Digital Health), the medical futurist, Bertalan Meskó, raises some very topical questions about the dangers of digital health. As a huge advocate of the benefits of digital health, I am aware of most of these but tend to downplay the negative aspects as I generally believe that in this domain the good outweighs the bad. However, as I was reading his article, I realised that it was written very much from the perspective of a clinician and, to some extent, a healthcare organisation too. The patient perspective was included but not from a patient safety angle. Many of the issues that he raises do have significant patient safety issues associated with them which I’d like to share in this blog.
  19. Content Article
    The world has significantly changed in the past decade and the healthcare sector has changed with it. Many healthcare organisations are now digital and digital tools enable patient safety and care. Electronic health records (EHRs) have replaced paper records. Picture archiving and communication systems have replaced film and light boxes. Computer-implemented or enabled hardware and software have replaced the mechanical systems of yesterday. In some instances, virtual visits have replaced in-person visits. And patients can transmit information about their health status and condition in real time to their clinicians via various software applications and devices. As a result of our digital transformation, electronic data is the lifeblood of the healthcare organisation. Electronic data, in the healthcare context, must be kept confidential, integrity must be preserved, and it must be made available on demand wherever and whenever it is needed. But if electronic data is not appropriately protected, clinical care and the business of healthcare can grind to a halt. This is why ransomware has been a significant concern for many healthcare organisations, as Lee Kim, Director Privacy and Security, HIMSS, explains in this article.
  20. Content Article
    Every time you go to a health provider they enter data in your Electronic Health Record (EHR). This should mean that somewhere up in the cloud (on a server) all your health data is organised and ready for the next visit, no matter who you see, why you see them, or where in the world you are located at the time of the visit. That’s how other data systems work. So why are EHRs failing to work as intended?
  21. Community Post
    I am currently working to develop a new process for the investigation of incidents related to digital healthcare, something which clearly sits outside of the usual framework or process of investigating traditional patient safety incidents. I would be grateful for opportunities to discuss and share experiences and ideas with others. If you have already investigated these sort of incidents what sort of approach did you utilise and have you reviewed it post event in respect of effectiveness. @Keith Bates Clive has suggested it would be beneficial for us to discuss?
  22. Content Article
    Patient safety is vital to well-functioning health systems. A key component is safe prescribing, particularly in primary care where most medications are prescribed. Previous research has demonstrated that the number of patients exposed to potentially hazardous prescribing can be reduced by interrogating the electronic health record (EHR) database of general practices and providing feedback to general practitioners (GPs) in a pharmacist-led intervention. This study aimed to develop and roll out an online dashboard application that delivers this audit and feedback intervention in a continuous fashion.
  23. Content Article
    Obstetric quality of care measures have largely focused on severe maternal morbidity (SMM), with little consensus about measures of less severe but more prevalent delivery and neonatal complications. This study, published in The Joint Commission Journal of Quality and Safety, analyses risk-adjusted maternal and neonatal outcomes using both ICD-10 coding and electronic health record (EHR) data.
  24. Community Post
    I've been posting advice to patients advising them to personally follow up on referrals. Good advice I believe, which could save lives. I'm interested in people's views on this. This is the message I'm sharing: **Important message for patients relating to clinical referrals in England** We need a specific effort to ensure ALL referrals are followed up. Some are getting 'lost'. I urge all patients to check your referral has been received, ensure your GP and the clinical team you have been referred to have the referral. Make sure you have a copy yourself too. Things are difficult and we accept there are waits. Having information on the progress of your referral, and an assurance that is is being clinically prioritised is vital. If patients are fully informed and assured of the progress of their referrals in real-time it could save time and effort in fielding enquiries and prevent them going missing or 'falling into a black hole', which is a reality for some people. It would also prevent clinical priorities being missed. Maybe this is happening, and patients are being kept fully informed in real-time of the progress of their referrals. It would be good to hear examples of best practice.
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