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Content ArticlePeople affected by health conditions bring insights and wisdom to transform healthcare – ‘jewels from the caves of suffering'. Yet traditional patient and public engagement relies on (child–parent) feedback or (adolescent–parent) ‘representative' approaches that fail to value this expertise and buffers patients' influence. This editorial from David Gilbert outlines the emergence of ‘patient leadership' and work in the Sussex Musculoskeletal Partnership, its patient director (the first such role in the National Health Service) and a group of patient/carer partners, who are becoming equal partners in decision-making helping to reframe problems, generate insight, shift dynamics and change practice within improvement and governance work.
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Content ArticleRaising a concern is not always easy, but it is the right thing to do. It is about safeguarding and protecting, as well as learning from a situation and making improvements. This guide by the Royal College of Nursing is to help nurses, nursing associates, students and healthcare support workers based in the NHS and independent sector.
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Content ArticleOnline patient feedback is becoming increasingly prevalent on an international scale. However, limited research has explored how healthcare organisations implement such feedback. This research from Baines et al. sought to explore how an acute hospital, recently placed into ‘special measures’ by a regulatory body implemented online feedback to support its improvement journey.
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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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EventThis conference will focus on measuring, understanding and acting on patient experience insight, and demonstrating responsiveness to that insight to ensure Patient Feedback is translated into quality improvement and assurance. This is particularly important during COVID-19 where feedback and engagement is key in identifying opportunities to create the best possible experiences for patients and carers, who are often accessing services during difficult times for themselves and their families. Through national updates and case study presentations the conference will support you to measure, monitor and improve patient experience in your service, and ensure that insight leads to quality improvement. Sessions will include learning from patients, improving patient experience during and beyond COVIDd-19, a national update, practical sessions focusing on delivering a patient experience based culture, measuring patient experience, using the NHS Improvement National Patient Experience Improvement Framework, demonstrating insight and responsiveness in real time, monitoring and improving staff experience, the role of human factors in improving quality, using patient experience to drive improvement, changing the way we think about patient experience, and learning from excellence in patient experience practice. This conference will enable you to: Network with colleagues who are working to monitor and improve patient experience Learn from outstanding practice in developing systems to improve patient experience insight Reflect on a patient perspective Understand how to effectively integrate patient experience insight with complaints – and learn from a new NHS Complaints Framework pilot site Understand how patient experience measurement needs to adapt during and beyond the pandemic Ensuring patient experience feedback leads to changes in practice Learn how to use the National Patient Experience Improvement Framework in practice Understand the national context for patient experience Develop strategies for measuring and improving staff experience Understand how to work with staff to act on patient experience feedback in real time Reflect on how to improve patient experience feedback from diverse communities Use a Human Factors approach to deliver change and improvement based on patient experience insight Identify key strategies for developing a patient experience cultur Develop your role demonstrating insight and responsiveness Self assess and expand your skills in analysing patients experience data Register
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Content ArticleIn this blog, Patient Safety Learning’s hub Editor, Samantha Warne, summarises a recent Patient Safety Management Network (PSMN) session she joined to hear from James Munro, Chief Executive of Care Opinion, about how patients are using Care Opinion to share their experiences and how Trusts are using the feedback.
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Content ArticleIn this opinion piece for the BMJ, David Oliver, a consultant in geriatrics and acute general medicine, draws lessons from the Grenfell Tower disaster and subsequent public inquiry. 72 people lost their lives in the fire that destroyed Grenfell Tower in 2017. Evidence to the public inquiry has shown that several residents had raised concerns about the building's safety over many years, and that architects, building contractors, and providers and fitters of cladding material had also expressed concerns about the safety of the exterior cladding used on Grenfell Tower. David Oliver highlights that had these concerns been listened to and acted on, the disaster could have been avoided and many lives saved. He draws parallels with concerns being raised by patients about the safety of the healthcare system and highlights the role of staff in repeatedly raising and keeping a record of concerns. He states that NHS leaders must create a culture where no one is afraid to speak out and act to mitigate safety issues. Leaders must expect to be held accountable for their response - or lack of response - to safety issues raised.
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Blog: At the edge of inside (24 June 2016)
Patient-Safety-Learning posted an article in Culture
In this opinion piece for The New York Times, David Brooks looks at the value of being 'at the edge of the inside'. He argues that being within an organisation, but not so close to the centre that you are subsumed by the 'group think', puts an individual in a good position to positively influence the organisation's culture and practice.- Posted
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Content ArticleThe Patient Experience Platform (PEP) is a listening tool which offers a new approach to collecting and analysing the views of patients on health services. The platform delivers comprehensive real-time reporting of what patients think about their care and provides actionable insights to inform operational decisions. This second annual report explains how PEP data is collected and analysed and explores some key findings on trends and variations in patient experiences across hospitals in England.
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Content ArticleThis qualitative study in Patient Education and Counseling collected narrative accounts from doctors, nurses and patients to determine whether their perspectives can add new content to quality of care frameworks. The three groups raised the following 'quality of care' aspects: Successful communication among staff, with patients and care companions Staff motivation Frequency of knowledge errors Prioritisation of patient-preferred outcomes Institutional emphasis on building “quality cultures” Organisational implementation of fluid system procedures The study found that respondents primarily referred to care processes, rather than structure or outcomes, in their descriptions of 'quality of care'. 'Hippocratic pride' (in response to care successes) and 'rapid reactivity' (in response to (near) failures) emerged as two new outcome indicators of high-quality care.
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Content ArticleThis is draft material and is not live guidance. It is shared for information and will be tested with organisations who have agreed to pilot the new Complaint Standards. The model complaint handling procedure describes how your organisation will meet the expectations of the NHS Complaint Standards in practice. Download a Word version of the model complaints handling procedure from the link below to test within your NHS organisation.
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Content ArticleAppreciative inquiry is a collaborative, strengths-based approach to change in organisations and other human systems. It identifies the positive strengths of an organisation or system and builds on these, rather than focusing on problems that need to be fixed. This article for PositivePsychology.com outlines the history, theory and framework of appreciative inquiry, as well as looking at real-life examples.
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EventuntilThis conference will focus on measuring, understanding and acting on patient experience insight, and demonstrating responsiveness to that insight to ensure Patient Feedback is translated into quality improvement and assurance. Through national updates and case study presentations, the conference will support you to measure, monitor and improve patient experience in your service, and ensure that insight leads to quality improvement. Sessions will include learning from patients, improving patient experience during and beyond Covid-19, a national update, practical sessions focusing on delivering a patient experience based culture, measuring patient experience, using the NHS Improvement National Patient Experience Improvement Framework, demonstrating insight and responsiveness in real time, monitoring and improving staff experience, the role of human factors in improving quality, using patient experience to drive improvement, changing the way we think about patient experience, and learning from excellence in patient experience practice. Chair and speakers include: Cristina Serrao, Lived Experience Ambassador NHS England and Improvement Clare Enston, Head of Insight & Feedback NHS England and Improvement David McNally, Head of Experience of Care NHS England and Improvement. Book a place Patient experience conference brochure 25 Nov 2021.pdf
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Content ArticleFraser Gilmore, Head of Scotland at Care Opinion, outlines the highlights of the 'Annual Review of Stories told on Care Opinion about NHS Boards in Scotland during 2020/21'. He describes an increase in patient feedback and highlights the success of Care Opinion Scotland's online events, including their first conference.
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Content ArticleThis Annual Review contains data and infographics about patient and staff engagement with Care Opinion at 17 NHS boards in Scotland between April 2020 and March 2021. The theme of the review is 'Communication, connectivity and relationships' and it notes that use of online communication has become more widespread as a result of the COVID-19 pandemic, a factor which has contributed to increases in online patient feedback.
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Content ArticleWard audit is a specific and common form of audit and feedback used in hospitals around the world. This study in BMC Health Services Research describes the content of ward audits and how they are carried out. The authors found that ward audits can have unintended and sometimes negative consequences, often caused by punitive feedback. They highlight the need to make feedback more constructive, for example, by including suggestions for improvement.
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Content ArticleMany diagnostic mistakes are caused by reasoning errors, but lack of feedback makes it difficult for healthcare providers to make improvements in this area. This paper, published in BMJ Quality & Safety, describes the reason for and process of developing 'The Diagnosis Learning Cycle', a new model for feedback and improvement in diagnosis. The model is based on theory and knowledge from both outside and within the field of healthcare. It proposes a standardised feedback mechanism that includes concrete measures of factors such as reasoning and confidence.
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Content ArticlePeople increasingly provide feedback about healthcare services online. These practices have been lauded for enhancing patient power, choice and control, encouraging greater transparency and accountability, and contributing to healthcare service improvement. Online feedback has also been critiqued for being unrepresentative, spreading inaccurate information, undermining care relations, and jeopardising professional autonomy. Through a thematic analysis of 37 qualitative interviews, this paper explores the relationship between online feedback and care improvement as articulated by healthcare service users (patients and family members) who provided feedback across different online platforms and social media in the UK.
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Content ArticleThis article by the Patient Safety Network provides an overview of the impact of diagnostic errors on patient safety. It gives examples of incorrect applications of heuristics and suggests ways to overcome cognitive bias in the diagnostic process.
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Content ArticleThis blog looks at how positive reporting of good practice and success can help support health systems and organisations in their journey to become highly reliable and improve patient safety. This is part of a joint series of blogs and video conversations exploring how we can improve patient safety through the application of principles of high reliability in healthcare, made collaboratively by Patient Safety Learning and RLDatix.
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Schwartz Rounds publications
Patient Safety Learning posted an article in Research papers
Attached is a list of research papers on Schwartz rounds that you might find useful.- Posted
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Content ArticleThe World Health Organization (WHO) has recently published, for consultation, the third draft of its Global Patient Safety Action Plan 2021-2030. In this blog, Patient Safety Learning reflects on areas where our initial feedback in September 2019 has been incorporated into the new draft and where we believe the Action Plan can be further strengthened
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Are agency healthcare practitioners adequately covered to work in private hospitals?
Anonymous posted an article in Occupational health and safety
I would like to share with you my experience of an injury I sustained when working as an agency nurse doing bank shifts in a private hospital and highlight to colleagues the importance of knowing your entitlements when working for an Agency. Please make sure you are adequately covered for injury. -
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Learning from excellence in healthcare
Patient Safety Learning posted an article in Implementation of improvements
Learning from everyday work means learning from all activities regardless of the outcome. But when things go well, this is typically just gratefully accepted, without further investigation. ‘Learning from Excellence’ is changing this, as Adrian Plunkett and Emma Plunkett describe in this article.- Posted
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Content ArticleThis study in BMJ Open considers how the usefulness of internal whistleblowing is affected by other institutional processes in healthcare organisations. The authors examine how the effectiveness of formal inquiries (in response to employees raising concerns) affects the utility of whistleblowing. The study used computer simulations to test the utility of several whistleblowing policies in a variety of organisational contexts. This study found that: organisational inefficiencies can have a negative impact on the benefits of speaking up about poor patient care where resources are limited and reviews less efficient, it can actually improve patient care if whistleblowing rates are limited including 'softer' mechanisms for reporting concerns (for example, peer to peer conversation) alongside whistleblowing policies, can overcome these organisational limitations.
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