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Content ArticleAs part of Patient Safety Awareness Week 2020, the Royal College of Pathologists have released three videos. In these videos, trainees discuss error scenarios and how we can foster a positive culture of learning from those mistakes. Speakers include Dr Mathew Clark, Miss Laura Whitehouse and Dr Hamed Sharaf.
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Content ArticleJames Munro, Chief Executive of Care Opinion, argues that there is extraordinary, yet untapped value in patient feedback which is not being recognised in current policy and practice. His blog follows the launch of the National Institute of Healthcare Research's (NIHR) themed review on using patient feedback to improve care. Gathering feedback from people who use health services sounds like a simple and straightforward matter. Doesn’t everyone love feedback? The NIHR themed review Improving Care by Using Patient Feedback highlights that this is a topic beset by complexity, uncertainty and disagreement. It’s also an area which can provoke strong emotions both from those offering feedback, such as: “why isn’t anyone listening?” and those receiving it: “why am I being attacked when I work so hard?”.
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News ArticleJust 1 in 4 UK GPs are satisfied with time they are able to spend with patients – appointment times are among the shortest of 11 countries surveyed. A report published today by the Health Foundation paints a picture of high stress and low satisfaction with workload among UK GPs. The report is an analysis of an international survey of GPs from 11 high-income countries, including 1,001 UK GPs, undertaken by the Commonwealth Fund in 2019. Among 11 high-income countries included in the study, only France has lower levels of overall satisfaction with practising medicine, and only Sweden reported higher levels of stress. Over half of UK GPs (60%) say they find their job 'extremely' or 'very' stressful, and almost half (49%) plan to reduce their weekly hours in the next three years. UK GPs also reported significantly shorter appointment lengths than their international colleagues. The average length of a GP appointment in the UK is 11 minutes, compared with a 19 minute average appointment for GP and primary care physicians in the other countries surveyed. Dr Rebecca Fisher, one of the Health Foundation report's authors and a practising GP, says: "These findings illustrate the pressures faced by general practice, and the strain that GPs are under. Right now the health system is in unprecedented territory and mobilising to meet the challenge of Covid-19. This survey shows that over the long term we need concerted action to stabilise general practice. Despite performing strongly in some aspects of care, many GPs consider that appointments are simply too short to fully meet the needs of patients. Too many GPs are highly stressed and overburdened – to the point of wanting to leave the profession altogether." Read full story Source: The Health Foundation, 5 March 2020
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News Article
‘Shameful’ data reveals NHS treatment of minority ethnic staff
Patient Safety Learning posted a news article in News
Five years after launching a plan to improve treatment of black and minority ethnic staff, NHS England data shows their experiences have got worse. Almost a third of black and minority ethnic staff in the health service have been bullied, harassed or abused by their own colleagues in the past year, according to “shameful” new data. Minority ethnic staff in the NHS have reported a worsening experience as employees across four key areas, in a blow to bosses at NHS England, five years after they launched a drive to improve race equality. Critics warned the experiences reported by BME staff raised questions over whether the health service was “institutionally racist” as experts criticised the NHS “tick box” approach and “showy but pointless interventions”. Read full story Source: The Independent, 18 February 2020 -
News Article
NHS Staff Survey 2019
Patient Safety Learning posted a news article in News
Today the results of the National NHS Staff Survey 2019 are out. This is of the largest workforce surveys in the world with 300 NHS organisations taking part, including 229 trusts. It asks NHS staff in England about their experiences of working for their respective NHS organisations. The results found that 59.7% of staff think their organisation treats staff who are involved in an error, near miss or incident fairly. While an improvement on recent years (52.2% in 2015) work is needed to move from a blame culture to one that encourages and supports incident reporting. It also found that 73.8% of staff think their organisation acts on concerns raised by patients/service users. It is vital that patients are engaged for patient safety during their care and there is clear research evidence that active patient engagement helps to reduce unsafe care. Patient Safety Learning has recently launched a new blog series on the hub to develop our understanding of the needs of patients, families and staff when things go wrong and looking at how these needs may be best met. -
Content Article
National NHS staff survey 2019 results
Patient Safety Learning posted an article in Culture
The NHS Staff Survey is one of the largest workforce surveys in the world and has been conducted every year since 2003. It asks NHS staff in England about their experiences of working for their respective NHS organisations. The survey provides essential information to employers and national stakeholders about staff experience across the NHS in England. Participation is mandatory for trusts and voluntary for non-trust organisations (CCGs, CSUs, social enterprises). The survey does not cover primary care staff. The report below provides a concise summary of key national results. Detailed local (organisation-level) results are also available here.- Posted
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Content Article
This is how to not fail at failing – blog by Roi Ben-Yehuda
Patient Safety Learning posted an article in Culture
In this blog, Roi Ben-Yehuda, a trainer at LifeLabs Learning, discusses why learning from failure is so rare and difficult and gives his top tips on what we need to do to stop failing at failing. -
Content ArticleHow people are treated following their involvement in a workplace accident can have far reaching implications for both the individual and the organisation. This paper, published by Science Direct, examines the impact the use of retributive justice mechanisms within the accident analysis process have on both the individual and the organisation. It analyses the perceptions of those involved in five accidents where retributive justice mechanisms were used. The study of these cases shows retributive justice mechanisms used as part of the accident analysis process negatively impacts three key areas; (1) the mental health of the individual; (2) organisational learning and; (3) organisational performance. The study also illustrates that the language used as part of the accident analysis has a significant impact upon the perception of the process and the willingness to participate.
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Content ArticleWorld Cancer Day every 4 February is the global uniting initiative led by the Union for International Cancer Control (UICC). By raising worldwide awareness, improving education and catalysing personal, collective and government action, people are working together to reimagine a world where millions of preventable cancer deaths are saved and access to life-saving cancer treatment and care is equal for all – no matter who you are or where you live. Created in 2000, World Cancer Day has grown into a positive movement for everyone, everywhere to unite under one voice to face one of our greatest challenges in history. Each year, hundreds of activities and events take place around the world, gathering communities, organisations and individuals in schools, businesses, hospitals, marketplaces, parks, community halls, places of worship – in the streets and online – acting as a powerful reminder that we all have a role to play in reducing the global impact of cancer. This year's World Cancer Day's theme, 'I Am and I Will', is all about you and your commitment to act. Through positive actions, together we can reach the target of reducing the number of premature deaths from cancer and noncommunicable diseases by one third by 2030.
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Content ArticleJones et al. hypothesised that antimicrobial stewardship (AMS) could be enhanced through positive feedback for the behaviors of healthcare professionals. This project aimed to reduce antimicrobial consumption in a Pediatric Intensive Care Unit (PICU) by >5%, with secondary aims to reduce broad-spectrum antimicrobial consumption, and processes related to AMS.
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Content Article
What is clinical audit? (2009)
Patient-Safety-Learning posted an article in Clinical governance and audits
This guide by the University Hospitals Bristol clinical audit team provides a brief summary of what clinical audit is, and what it isn't. It outlines the main stages of clinical audit and describes how it can be used, how to engage patients in the process and which staff members should be involved. -
Content ArticleProfessor Anne-Sophie Darlington speaks to ecancer at the 2019 EORTC Groups Annual Meeting (EGAM) about the importance of including the patient's experiences and voice during clinical trial assessments. Professor Darlington details the use of questionnaires to measure these patient parameters and how these must be carefully developed to allow flexibility to withstand the evolving environment of clinical trial research.
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Content Article
Resources for setting up learning from excellence reporting
Claire Cox posted an article in Motivating staff
Safety in healthcare has traditionally focused on avoiding harm by learning from error. This approach may miss opportunities to learn from excellent practice. Excellence in healthcare is highly prevalent, but there is no formal system to capture it. We tend to regard excellence as something to gratefully accept, rather than something to study and understand. The preoccupation with avoiding error and harm in healthcare has resulted in the rise of rules and rigidity, which in turn has cultivated a culture of fear and stifled innovation. It is time to redress the balance. It is believed that studying excellence in healthcare can create new opportunities for learning and improving resilience and staff morale. This page is for useful resources for setting up and maintaining an excellence reporting programme: -
Content Article
Learning from excellence: Entrance interview questionnaire
Claire Cox posted an article in Motivating staff
Here is a template for an entrance interview, produced by Learning from excellence. It has been designed using Appreciative Inquiry (AI) principles. It is envisaged to be used at the start of a new job or rotational placement to guide formation of personal development plans. However it could be adapted for permanent staff at times of appraisal. -
Content Article
Ten Thousand Feet: workshops and consultancy
Claire Cox posted an article in Suggest a useful website
Ten Thousand Feet UK is a Consultancy led by Rob Tomlinson in collaboration with the Association for Perioperative Practice. Rob is a clinical nurse in the NHS and is leading the way to improving patient safety through clinician-led culture change in the UK. Rob has already delivered workshops on a national scale with success for teams who have embraced the new procedure. 'Never Events' within the NHS are still on the rise with distraction and a loss of situational awareness still being cited as one of the main causes. Ten Thousand Feet aim to embed new patient safety culture into operating theatre teams nationwide, so at any time, anyone working in the theatre who needs to focus their attention at the task in hand can can use the language tool “Ten Thousand Feet” to improve team efficiency and most importantly patient safety. At the end of the workshop theatre staff will be educated and empowered to use this concept in a safe and effective manner. -
Content ArticleFor 25 years, the Agency for Healthcare Research and Quality (AHRQ) has developed evidence-based surveys to support healthcare professionals in assessing and improving patients’ experiences with the healthcare system. The range of Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys means that patients can measure their experiences with: Providers, such as medical groups, practice sites, and individual clinicians. Care delivered in different settings, including hospitals, dialysis centers, and nursing homes. Care for specific health conditions. Health plans and related programmes. The purpose of the CAHPS programme is to advance our scientific understanding of patient experience with healthcare.
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Content ArticleIn the worst moment of your life, what would you need? In 2017, Jen Gilroy-Cheetham’s life changed forever. Just six months after having her second child, she was diagnosed with a rare neuroendocrine tumour and was advised that she would need to undergo open surgery to have half of her stomach removed. Complications led to one of the darkest and scariest times of Jen’s life, as she was put into a hospital ward feeling unwell, vulnerable and unsafe. Now recovered, Jen shares her experiences as a patient from a hospital bed - or audience member - watching all of the healthcare staff around her - actors on a stage - doing everything they could to make her feel safe. In reliving her journey to recovery, Jen highlights what’s needed within a healthcare setting to make patients feel safe. Jen feels that highlighting what’s worked well to help her to feel safe and what needs to change is valuable and may help others in the future.
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Content Article
Learning from excellence (2017)
Claire Cox posted an article in Organisational
Safety in healthcare has traditionally focused on avoiding harm by learning from error. This approach may miss opportunities to learn from excellent practice. Excellence in healthcare is highly prevalent, but there is no formal system to capture it. We tend to regard excellence as something to gratefully accept, rather than something to study and understand. Our preoccupation with avoiding error and harm in healthcare has resulted in the rise of rules and rigidity, which in turn has cultivated a culture of fear and stifled innovation. -
Content ArticleBoth staff and patients want feedback from patients about the care to be heard and acted upon and the NHS has clear policies to encourage this. However, doing this in practice is complex and challenging. This report from the National Institute for Health Research (NIHR) features nine new research studies about using patient experience data in the NHS. These show what organisations are doing now and what could be done better. Evidence ranges from hospital wards to general practice to mental health settings. The report found that although a lot of resource and energy goes into collecting feedback data, less goes into analysing it in ways that can lead to change or into sharing the feedback with staff who see patients on a day-to-day basis. Patients’ intentions in giving feedback are sometimes misunderstood. Many want to give praise and support staff and to have two-way conversations about care, but the focus of healthcare providers can be on complaints and concerns, meaning they unwittingly disregard useful feedback. The report provides insights into new ways of mining and analyzing big data, using online feedback and approaches to involving patients in making sense of feedback and driving improvements.
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Content ArticleHealthy eating and fitness mobile apps are designed to promote healthier living. However, for young people, body dissatisfaction is commonplace, and these types of apps can become a source of maladaptive eating and exercise behaviours. Furthermore, such apps are designed to promote continuous engagement, potentially fostering compulsive behaviours. This study, published by JMIR Publications, highlights the necessity for careful considerations around the design of apps that promote weight loss or body modification through fitness training, especially when they are used by young people who are vulnerable to the development of poor body image and maladaptive eating and exercise behaviours.
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Content Article
#NHSMeToo
Claire Cox posted an article in Motivating staff
The NHS is Britain’s greatest treasure. Yet it still harbours a culture of hierarchy where bullying, harassment and appalling training environments can go unchallenged. The Doctors Association UK (DAUK) believe that bullying, and discouraging victims from speaking up, goes hand in hand with a blame culture. Often doctors are shamed into silence, and don’t realise other doctors are struggling just as much as they are. Morale is at an all time low in the NHS, with rates of burnout and sadly, even physician suicide on the rise. DAUK are teaming up with the Royal Colleges as part of a wider NHS anti-bullying alliance and are encouraging doctors to speak about their experiences. -
Content ArticleThe report, Improving care by using patient feedback, published by the National Institute for Health Research, features nine new research studies about using patient experience data in the NHS. These show what organisations are doing now and what could be done better. Here, we highlight one of the examples from the report, showing some correspondence between a patient and a nursing team.
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Content ArticlePatients are increasingly being asked for feedback about their healthcare experiences. However, healthcare staff often find it difficult to act on this feedback in order to make improvements to services. This paper, published by Social Science & Medicine, draws upon notions of legitimacy and readiness to develop a conceptual framework (Patient Feedback Response Framework – PFRF) which outlines why staff may find it problematic to respond to patient feedback.
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Content ArticleThere is little research focusing on how bereaved families experience NHS inquiries and investigations. Despite this gap, there is a consistent assumption that these processes provide families with catharsis. Drawing on her personal experiences of NHS investigations over a five‐year period after the death of her son, Connor Sparrowhawk, the author suggests the assumption of catharsis is misplaced and works to erase the considerable emotional ‘accountability’ labour that families undertake during these processes. She further question whether inquiries or investigations are an effective way of holding stakeholders to account. She concludes with two points: first, qualitative research is needed to better understand bereaved family experiences of inquiries and investigations and second, the ‘lessons learned’ objective underpinning inquiries should be replaced with ‘leading to demonstrable change’, which is what families typically want.
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Content ArticleRecent years have seen increasing calls for more proactive use of patient complaints to develop effective system-wide changes, analogous to the intended functions of incident reporting and root cause analysis (RCA) to improve patient safety. Given recent questions regarding the impact of RCAs on patient safety, the authors sought to explore the degree to which current patient complaints processes generate solutions to recurring quality problems.
