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Showing results for tags 'Emergency medicine'.
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News Article
Record 1 million 999 calls made to NHS in July
Patient-Safety-Learning posted a news article in News
Latest data has revealed more than one million 999 calls were placed in July, showing paramedics were sent out to 82,000 emergencies last month and 8,000 more than the record set in June. This comes after A&E departments became overwhelmed with an influx of new patients over the summer, with many hospitals having to cancel operations due to being dangerously understaffed. Dr Katherine Henderson, president of the Royal College of Emergency Medicine has said, "The NHS has been running hot for months now and these figures show we are nearly at boiling point. We are worried that the public think things are getting back to normal on the virtual eve of a further reduction in restrictions, and messages from the centre that say things are OK are disingenuous – the reality is that the health service is really struggling." Read full story. Source: The Independent, 12 August 2021 -
News Article
NHS’ promotion of 111 First ‘not strong enough’, watchdog warns
Patient-Safety-Learning posted a news article in News
Not enough people know about the NHS 111 First A&E booking service as the messaging hasn't been strong enough, says Healthwatch England. The service can be used for patient who need urgent care but are not in an emergency situation, and patients can call 111 to "book" into urgent care. However, not enough people know about it, or what it's used for. “There’s a real gap in high quality communication to the public,” she said. “They [the NHS leadership] expect the public just to catch up with the changes they have made. 111 First [or] online booking services come along and we’re all supposed just to know how to use it. That’s caused a lot of frustration for people. Our evidence shows that when people understand and use [111 First], they like it. But not enough people know about it and the comms have not been strong enough.” Says Imelda Redmond, the outgoing national director for Healthwatch England. Read full story (paywalled). Source: HSJ, 2 August 2021 -
News Article
Paramedics left in tears from ‘unsustainable demand’, warns union
Patient-Safety-Learning posted a news article in News
In a letter seen by The Independent to ambulance trust chief executives, union officials have warned the health of paramedics is being put at risk due to "unsustainable demand". Union bosses have also warned paramedics are being left in tears at the end of their 12 hour shifts and often working overtime in order to meet demand, warning this increased amount of pressure is taking its toll on the health of ambulance workers. “Ambulance workers have faced exceptional pressures over the past 17 months. It’s not surprising many have reached burnout. They cannot be left to just carry on doing excessive hours without proper breaks and rest between shifts. Employers must act swiftly by doing all they can to limit the unprecedented pressures on staff. Additional welfare support is needed, and the government should make this a top priority.” Says Deputy head of health Helga Pile. Read full story. Source: The Independent, 02 August 2021 -
News Article
Paramedics abused and assaulted while on duty, survey reveals
Patient-Safety-Learning posted a news article in News
New data has revealed hundreds of paramedics experience physical assault and verbal abuse whilst serving the public. According to NHS, there has been a 32 per cent rise in assault against paramedics over the past 5 years, with more than 1,600 saying they had been threatened while on duty or feared for their own lives. Now, ambulance trusts are aiming to fit paramedics with body cameras while the West Midlands have CCTV inside their ambulances. "After years of lobbying, the legislation is now in place to ensure that the worst offenders are severely and appropriately dealt with. The problem is that the law is not being used to full effect and sentences are still far too lenient. We are calling today on the courts to step up and impose the harshest penalties available to them." Said Tracy Nicholls, chief executive of the College of Paramedics. Read full story. Source: The Independent, 28 July 2021 -
News Article
Hospitals experiencing "perfect storm"
Patient-Safety-Learning posted a news article in News
NHS bosses have warned as Covid-19 infections rise, the demand for A&E ha surged, colliding with holiday season. According to reports, hospitals are being told to brace themselves as admissions to hospital for patients with Covid have risen by more than 30 per cent over the past week. Newcastle upon Tyne Hospitals, chief executive Dame Jackie Daniel has said, “We are going through the ‘perfect storm’ of high numbers of Covid patients in hospital, high Covid infections in the community, which is affecting staff and our families, unprecedented levels of urgent and emergency demand and peak holiday season, all of which comes after 18 months of exhausting work.” Read full story. Source: The Independent, 25 July 2021 -
News Article
Patients waiting 10 minutes for 999 calls to be answered
Patient-Safety-Learning posted a news article in News
Some people calling 999 are having to wait up to 10 minutes before their call is answered. Staff have warned patients may be coming to harm, and may be even dying as a result of the delays and with paramedics also reporting it's taking as long as 24 hours for some ambulances to reach patients. One paramedic has told The Independent, “We are stacking over 500 jobs, with patients waiting hours for an ambulance response. That includes elderly vulnerable people who have fallen but only merit a category three, so their calls are routinely pushed further and further down the queue. In the last few days, I've been to patients waiting 11 or 13 hours. And just to be clear: this is not the hospitals’ fault. The system is profoundly broken.” Read full story. Source: The Independent, 22 July 2021 -
News Article
London Ambulance Service declares incident as 999 calls surge
Patient-Safety-Learning posted a news article in News
The London Ambulance service declared a 'business continuity incident' on Monday after a surge in 999 calls. Paramedics were told the ambulance service was under extreme demand after the calls threatened to overwhelm the service. The announcement was made after more than 400 calls were made in a single hour during Monday afternoon. “Yesterday we saw high levels of demand for our services and used tested processes to care for our patients – this allowed some people with the least urgent care needs to be treated through alternative routes" said a London Ambulance Service spokesperson. Read full story. Source: The Independent, 20 July 2021 -
News Article
Greater Manchester hospitals ‘forced to provide extra critical care beds’
Patient-Safety-Learning posted a news article in News
Hospital waiting lists across the country could hit 13 million in the months to come. Reports have found Manchester Hospitals are having to provide extra beds for critical care patients as the number of people coming in has surged. Hospitals are struggling to cope due to increase in patients attending hospitals in the city a reports the Manchester Evening News. The “number of people attending emergency departments across Greater Manchester has seen a significant increase in recent weeks” and that assistance from hospitals in other parts of the country was “part of our usual processes”, a spokesperson for the Greater Manchester Health and Social Care Partnership has said. Read full story. Source: The Independent, 15 July 2021 -
News Article
'We feel bullied' say emergency department staff
Patient-Safety-Learning posted a news article in News
In November last year, Unison and RCN raised concerns with NHS Forth Valley chief executive Cathie Cowan amid bullying claims made by emergency department staff at Forth Valley Royal Hospital. In light of the reports of bullying, a review was commissioned and leaked details revealed junior doctors were left unsupervised on shifts, nurses and doctors had said they are 'battle-weary', and many senior staff members have resigned their posts. Karren Morrison, Unison Forth Valley health branch secretary has said: ‘Last year, concerns were being raised by our members who worked in, or who had previously worked in the ED. Staff talked to us about feeling bullied and intimidated, being frightened to speak up, concerns about the delivery of safe patient care, high staff turnover and other issues.’ Read full story (paywalled). Source: Nursing Standard, 12 July 2021 -
EventuntilThis study day from the Royal College of Emergency Medicine will give you the unique opportunity to hear from top national and local public health experts. We will consider how to identify and address inequalities in an emergency department. Gain basic skills in public health advocacy and prepare for your role as agents of change by tackling the major causes of premature death and issues driving the demand across the healthcare system. Learning Objectives Gain a better understanding of the prevention and public health priorities in the context of unplanned emergency care. Develop ideas and showcase projects for local public health activities that align with these priorities. Identify some of the tools to implement public health interventions including through partnership working with other agencies. This event is open to all employment grades, as well as other public health practitioners and specialists. More information and booking
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EventuntilThis face-to-face event by The Royal College of Emergency Medicine will look at research around burnout and other psychological impacts of working in the emergency department. It will feature talks from clinicians promoting staff wellbeing and explore opportunities to work with the Sustainable Working Practice Committee. View the event programme Book this event. Reduced fees are available for RCEM members and student members LMIC clinicians and students.
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EventuntilInfection is a leading cause of childhood deaths, but many of these deaths are avoidable with timely treatment. The national Before Arrival at Hospital Project (BeArH), funded by the National Institute for Health Research (NIHR), explored what happens to children under five years of age with serious infections before they are admitted to hospital. The aim of this research was to explore what helps children get help quickly and what might slow this process down, so that lessons could be learned for the care of this group of children in the future. This forum will be led by Professor Sarah Neill, Dr Damian Roland and Natasha Bayes. To join the research forum and hear the findings of this important research project from the study team, email lpt.research@nhs.net for the Microsoft Teams link.
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Event
ECIST Keynote Lecture Series
Patient Safety Learning posted an event in Community Calendar
untilJoin via MS Teams -
Content ArticleAfter 12 years of brutal service, Neil Barnard, an NHS emergency medicine consultant, is leaving his NHS post to work abroad. His decision to leave is driven by financial and personal reasons. More than anything, he says he's tired and has little more left to give to the NHS.
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Content Article
National ambulance data (to end May 2022)
Patient Safety Learning posted an article in Data and insight
Report from the Association of Ambulance Chief Executives on national ambulance data. -
Content ArticleOne of the reasons why patient safety may be put at risk during healthcare interventions is a lack of staff adherence to patient safety guidelines. There could be a relationship between staff’s adherence to patient safety guidelines and their perceived level of reward for their work and/or motivation. This study from Asmoro et al. examined the relationship between reward and adherence to patient safety guidelines, and between motivation and adherence to patient safety guidelines, among nurses working in emergency departments (EDs) in Indonesia. They found that ensuring ED nurses are motivated for their work by offering rewards – such as a decent salary, a supportive workplace environment and career progression opportunities – is important to enhance their adherence to patient safety guidelines.
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Content ArticleOver the past year, delays in transferring patients from an ambulance to a hospital have risen exponentially. In April 2022 there were over 41,000 delays of over 60 minutes, up over a staggering 450 per cent in 12 months. This equates to 71,000 hours lost, with a significant risk of harm to patients, even though the proportion being taken to hospital by ambulance has fallen thanks to successful initiatives such as “hear and treat” and “see and treat”. These delays mean that, too often, ambulance crews are not able to respond to 999 calls from critically ill patients. Instead they are being held in “stacks” of hundreds each day – as ambulance control room teams strive to prioritise overstretched resources. The current reality is that crews are often waiting with patients in hospital corridors or outside, hearing urgent calls to which they are unable to respond. In addition to the direct impact on patients, this is incredibly demoralising, even traumatising, for many staff involved. So why is this happening? In an article for the Independent, Daren Mochrie, chair of AACE – the Association of Ambulance Chief Executives, and Saffron Cordrey, interim chief executive at NHS Provider, discusses what is happening in the NHS.
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Content ArticleHuman error plays a vital role in diagnostic errors in the emergency department. A thorough analysis of these human errors, using information-rich reports of serious adverse events (SAEs), could help to better study and understand the causes of these errors and formulate more specific recommendations. Baartmans et al. studied 23 SAE reports of diagnostic events in emergency departments of Dutch general hospitals and identified human errors. They found that the combination of different instruments and information-rich SAE reports allowed for a deeper understanding of the mechanisms underlying diagnostic error. Results indicated that errors occurred most often during the assessment and the testing phase of the diagnostic process. Most often, the errors could be classified as mistakes and violations, both intended actions. These types of errors are in need of different recommendations for improvement, as mistakes are often knowledge based, whereas violations often happen because of work and time pressure. These analyses provided valuable insights for more overarching recommendations to improve diagnostic safety and would be recommended to use in future research and analysis of (serious) adverse events.
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Content ArticleEvery day we use tools and resources to manage our lives, both personally and professionally. As a healthcare professional, you are committed to providing safe quality healthcare to all individuals. The checklists in this book are designed to help you succeed in that effort. You may be a first-time reader who has not had the opportunity to put these tools to the test, or you could be a returning reader interested in what new checklists you can use. In either instance, if you’re reading this book, then you are searching for tools to help your healthcare organisation navigate the increasing complexities of providing quality health care and maintaining the physical environment where healthcare is delivered.
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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.
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation explores issues around patient handover to emergency care. Patients who wait in ambulances at an emergency department are at potential risk of coming to harm due to deterioration or not being able to access timely and appropriate treatment. HSIB has published an interim report outlining early investigation findings, and recommends a national response to tackle this urgent issue. Findings so far emphasise that an effective response should consider the interactions of the whole system: an end-to-end approach that does not just focus on one area of healthcare and prioritises patient safety. For its reference case, the investigation looks at the case of a patient who was found unconscious at home and taken to hospital by ambulance. The patient was then held in the ambulance at the emergency department for 3 hours and 20 minutes, and during this wait their condition did not improve. They were taken directly to the intensive care unit where they remained for nine days before being transferred to a specialist centre for further treatment.
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Content ArticleEvery year, thousands of emergency department (ED) visits result in patients being discharged with oral antibiotic prescriptions. Published studies that assess the appropriateness of these antibiotic regimens are limited. The purpose of this study from Bauman et al. was to examine the appropriateness of antibiotic prescriptions written for patients discharged from a community hospital’s ED. A total of 76% of the prescribed antibiotics were appropriate, 16% were inappropriate, and the remaining 8% were not assessable. Duration was the most common reason for a regimen to not be optimal. The most frequently inappropriately prescribed antibiotics included cephalexin (but it is noted cephalexin was included in almost half of the antibiotic regimens in this study), clindamycin, and azithromycin. Infections that were most frequently treated inappropriately were skin and soft tissue infections, dental infections, and sinusitis.
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Content ArticleEmergency Department (ED) patient waiting times provide an important barometer for the wider pressures experienced in the NHS. There are currently alarming levels of crowding in our EDs, indicating that the health service is unable to meet the needs of patients with the current level of resource and capacity. In March 2022, for the first time in the history of the metric, the numbers of patients waiting 12-hours or more from decision to admit (DTA) exceeded 20,000. However the Royal College of Emergency Medicine (RCEM) argue that this number represents the tip of iceberg, as far greater numbers of patients experience extreme waits of 12 hours or more from their time of arrival. To investigate this issue further, RCEM carried out a Freedom of Information (FOI) request examining the extent of very long stays in EDs, with a particular focus on the numbers of patients waiting 12 hours or more from their time of arrival. They found that the current 12-hour data is a gross underrepresentation of the reality of patient waits, as it fails to capture the vast majority of patients who have no choice but to spend extended lengths of time in EDs. It additionally conceals the patients who are discharged home after very long stays.
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Content ArticleKrista Haugen is National Director of Patient Safety for US-based emergency and patient relocation services provider Global Medical Response. In this interview, she describes how her 25-year career as an emergency medicine nurse has influenced her approach to safety and patient care. She discusses her personal experience of being involved in an accident as an air-ambulance flight nurse, and how this caused her to look at safety and risk management from a systems perspective, focussing on building a just culture where safety is optimised through organisational reflection and learning.
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Content ArticleSince 2010/11, the NHS has lost almost 25,000 beds across the UK. The evolving nature of healthcare provision means that the role of hospital admission has changed, but hospital beds still represent an essential part of healthcare, and the number available to the NHS should be carefully considered. A broad consensus has developed in recent years that the reduction in beds has happened too quickly. The outcome is that the NHS is now under-bedded. This has important consequences; patients must now endure long waits to be admitted with emergency department staff providing care normally provided in wards even as they continue to care for new arrivals; ambulance handover delays increase and there are delays to calls for an ambulance; planned operations are cancelled. Reducing long stays in emergency departments requires adequate staffing, space, efficient processes, and sufficient inpatient bed capacity. This report from the Royal College of Emergency Medicine (RCEM) focuses on inpatient bed capacity. While the unit of measurement is a bed, it must be remembered that a bed requires medical, nursing and other staff to safely function.
