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Found 107 results
  1. Content Article
    The safety huddle has become an important way for hospitals to surface safety concerns affecting patients and the workforce. The best huddles are multidisciplinary, highly structured, brief (15 minutes or less), take place early in the morning and focus on incidents from the day before and risks to safety in the day ahead. Is the safety huddle effective? Have organisations grown lax with the process over time? Some participants have observed that, over time, safety huddles tend to become "just another meeting" or "another box to check off." Dr. James Reinertsen, who has spent decades coaching clinical leaders and staff about safety, says too many huddles allow department leads to report "no safety issues today." That's impossible, says Reinertsen. Every department has safety risks; it's a matter of being proactive and looking for them. In this podcast, Ronette Wiley shares the story of the turnaround with the safety huddle and the tools they use at Bassett Medical Center in upstate New York, USA, and Dr Helen Mackie educates us about the safety huddle at Hairmyres Hospital in Scotland where issues are flagged daily in a rigorous process known as The Onion. 
  2. Content Article
    Improving patient safety culture (PSC) is a significant priority for OECD countries as they work to improve healthcare quality and safety—a goal that has increased in importance as countries have faced new safety concerns connected to the COVID-19 pandemic. Findings from this OECD benchmarking work in PSC show that there is significant room for improvement.
  3. Content Article
    This article, published in the Journal of Cognitive Engineering and Decision Making, discusses communication during end-of-shift handovers and how improved communication between staff may reduce errors and adverse outcomes for hospitalised patients.
  4. Content Article
    This article, published in The Joint Commission Journal on Quality and Patient Safety, explores the effectiveness of shift handoffs (handovers) by staff. It discusses how poor-quality handoffs have been associated with serious patient consequences, and that standardisation of handoff content and delivery improves both quality and safety.
  5. Content Article
    Spotting and acting on the signs of deterioration in a patient or care home resident is vital to ensuring patient safety. The objective of the national Managing Deterioration Safety Improvement Programme (known as ManDetSIP) is to create and embed the conditions for staff across the healthcare system to improve the safety and outcomes of patients by managing deterioration, and provide a high quality healthcare experience across England.
  6. Event
    This Hospital at Night Summit focuses on out of hours care in hospitals delivering high quality safe care at night, and supporting the wellbeing of those working at night. Through national updates, networking opportunities and case studies this conference provides a practical guide to delivering a high quality hospital at night and transforming out of hours services and roles to improve patient safety. The 2023 conference will focus on the developing an effective Hospital at Night service, and focus on the practicalities of supporting staff at night, improving wellbeing and fighting fatigue. Benefits of attending this conference will enable you to: Network with colleagues who are working to improve Hospital at Night Practice. Learn from recent developments. Improve your skills in the recognition management and escalation of deteriorating patients at night. Understand and evaluate different models for Hospital at Night. Examine the role of task management solutions for Hospital at Night, including handover and eObservations. Ensure effective and safe staffing at night. Improving and supporting the wellbeing of hospital at night staff. Examine Hospital at Night team roles, competence and improve team working. Improve safety through the reduction of falls at night. Supporting staff and reducing fatigue at night. Develop the role of Clinical Practitioner and Advanced Nursing Practice at night. Identify key strategies to change practice and ways of working in Hospital at Night. Understand how hospitals can improve conditions for night workers and support Junior Doctors. Self assess and reflect on your own practice. Supports CPD professional development and acts as revalidation evidence. This course provides 5 Hrs training for CPD subject to peer group approval for revalidation purposes. Register hub members receive a 20% discount. Email info@pslhub.org for discount code.
  7. 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.
  8. Community Post
    Morning all, As a Critical Care Outreach nurse of many years, one of my greatest bugbears is SBAR handover, or there lack of! Within my trust, there is an SBAR proforma attached to the NEWS2 chart, which appears to be fit for purpose currently. (We are still on paper obs charts, moving to e-obs by the end of the year) SBAR is taught and embedding in all our teaching and training, the candidates at the time of the courses are all able to giver perfect SBAR handovers in simulation but as soon as they walk out the door all of that seems to disappear. It is all too often we receive poor handovers for referrals, the lack of information and clarity means that we cannot prioritise patients effectively. I am currently looking at the nuts and bolts of why this is and what we need to do to address the issues. I have started by sending a survey out to all registered nursing staff so that we can get feedback from those who should be using it. Hopefully, from the responses this may mean we can formulate a plan to improve this. Does anyone else have the same issues/ concerns in you line of work? Has anyone got anything that they do in their trust that works?
  9. Content Article
    A casually centred proposal identifying how Fire and Rescue Services can improve pre-hospital care and quality of life outcomes for burn survivors.  David Wales and Kristina Stiles have released this report looking at the burn survivor experience in the pre-hospital environment. The work makes ten operational recommendations and also two 'lessons learned' recommendations exploring strategic partnership working and the resulting fragmented services.
  10. Content Article
    Hospitals can significantly elevate patient satisfaction and enhance the delivery of healthcare services by incorporating best practices from adjacent and non-adjacent sectors. Chetan Trivedi explores several solutions, from multiple sectors, that can serve as a blueprint for hospitals across every key step of the patient journey, spanning from admission to discharge.
  11. Content Article
    This white paper from CEMBooks aims to unpick some of the deeper issues surrounding bed block and emergency department crowding from the perspective of a frontline medic with two decades of emergency and flow management experience. It aims to provide a greater understanding of the factors influencing the current situation and the measures used to define it followed by some practical implementable solutions.
  12. News Article
    Ambulance handover delays could harm 160,000 patients a year, 12,000 of them severely, according to a structured clinical review of cases by service bosses earlier this year. The Association of Ambulance Chief Executives examined a sample of 470 cases where handover to A&E was delayed for an hour or more on 4 January this year. The review, whose findings were shared with HSJ, involved every mainland ambulance service in England. It found that 85% of those who waited more than an hour suffered potential harm, with nine per cent potentially severely harmed. Extrapolated across an entire year, using levels of delays up to September 2021, this suggests 160,000 patients are potentially harmed annually. Patients who waited the longest for handover were at greatest risk of some level of harm, and the risk of severe harm more than tripled for those waiting more than four hours compared with those waiting for 60 to 90 minutes. Read full story Source: HSJ, 14 November 2021
  13. News Article
    Patients are being put at "catastrophic risk" of harm due to ambulance handover delays, health bosses say. West Midlands Ambulance Service (WMAS) has raised its risk rating for such delays to its highest level for the first time in its history. The risk rating shows the trust believes patient harm is "almost certain" due to the handover hold-ups. Mark Docherty, director of nursing and clinical commissioning, said it was a "completely unacceptable situation". It comes as a patient died after waiting more than five hours in the back of an ambulance in Worcestershire. At a meeting on Wednesday, the ambulance service's board of directors heard the amount of time being lost to delays had reached previously unseen levels, the Local Democracy Reporting Service said. Mr Docherty warned the situation was set to get worse over the coming months as a result of winter pressures. "Despite everything we are doing by way of mitigation, we know that patients are coming to harm as a result of delays," he said. "We know that there are patients that are having significant harm and indeed, through our review of learning from deaths, we know that sadly some patients are dying before we get to them." Read full story Source: BBC News, 28 October 2021
  14. News Article
    Eleven patients have suffered harm after being kept waiting in ambulances outside accident and emergency departments, a review has found. South East Coast Ambulance (SECamb) Service Foundation Trust launched the review after a specific incident at Medway Foundation Trust on Monday 16 November. Although details of the incident have not been released, HSJ has been told one patient waited for nine hours before being seen in the trust’s A&E department that day. The review covered all long waits across SECAmb’s area over the last few weeks. Out of 120 cases examined, 11 patients were found to have suffered some degree of harm, SECAmb’s executive director of nursing and quality Bethan Eaton-Haskins told Kent’s health overview and scrutiny committee last week. However, the trust has not revealed which hospitals were involved. Ms Eaton-Haskins said the ambulance trust was “struggling significantly” with handovers and expecting the recent pressure experienced at Medway FT to affect the county’s other hospitals soon. However, she indicated some other trusts in Surrey and Sussex had also had long delays. Ambulance services have been concerned for some time that handover delays could pose significant problems this winter. They are thought to have contributed to the North West Ambulance Service Trust declaring a major incident earlier this month. HSJ has also been told of waits of several hours in other ambulance trusts. Read full story (paywalled) Source: HSJ, 1 December 2020
  15. News Article
    Between April 2020 and March 2021 there were approximately 185,000 ambulance handovers to emergency departments throughout Wales. However, less than half of them (79,500) occurred within the target time of 15 minutes. During that period there were also 32,699 incidents recorded where handover delays were in excess of 60 minutes, with almost half (16,405) involving patients over the age of 65 who are more likely to be vulnerable and at risk of unnecessary harm. Data published by the Welsh Government highlighted that in December 2020 alone, a total of 11,542 hours were lost by the ambulance service due to handover delays. This figure has been rising sharply and has now reached pre-pandemic levels once again. Inspectors said these delays have consistently led to multiple ambulances waiting outside A&E departments for excessive amounts of time, unable to respond to emergencies within their communities. "These delays have serious implications on the ability of the service to provide timely responses to patients requiring urgent and life-threatening care," the report stated. Read full story Source: Wales Online, 7 October 2021
  16. News Article
    A new snapshot survey by the Royal College of Emergency Medicine has found that in August 2021 half of respondents stated that their Emergency Department had been forced to hold patients outside in ambulances every day, compared to just over a quarter in October 2020 and less than one-fifth in March 2020. The survey, sent out to Emergency Department Clinical Leads across the UK, also found that half of respondents described how their Emergency Department had been forced to provide care for patients in corridors every day, while nearly three-quarters said their department was unable to maintain social distancing every day. One-third said that the longest patient stay they had had in their Emergency Department was between 24 and 48 hours, with 7% reporting the longest stay to be more than 48 hours. Dr Ian Higginson, Vice President of the Royal College of Emergency Medicine, said: “It is shocking to see the extent of the challenges faced by Emergency Departments across the UK. Holding ambulances, corridor care, long stays – these are all unconscionable practices that cause harm to patients. But the scale of the pressures right now leaves doctors and nurses no options. We are doing all we can to maintain flow, maximise infection prevention control measures, and maintain social distancing. Our priority is to keep patients safe, and ensure we deliver effective care quickly and efficiently, but it is extremely difficult right now." Read full story Source: The Royal College of Emergency Medicine, 6 September 2021
  17. News Article
    An ambulance trust has highlighted the death of a woman which it says was due to “being delayed on the back of an ambulance”, just two days after it warned that lives were ‘at risk’ from long handovers. West Midlands Ambulance Service University Foundation Trust’s board papers this month reveal the woman in her 90s — who has not been named — was taken to hospital because a severe nose bleed would not stop. Its clinical quality board paper says the “patient story” showed ”how a patient being delayed on the back of an ambulance resulted in significant deterioration and ultimately the death of a patient”. Read full story (paywalled) Source: HSJ, 28 May 2021
  18. Event
    Unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in health care systems across the world. WHO Patient Safety Flagship has initiated a series of monthly webinars on the topic of “WHO Global Patient Safety Challenge: Medication Without Harm”,. The main objective of the webinar series is support implementation of this WHO Global Patient Safety Challenge: Medication Without Harm at the country level. Considering the huge burden of medication-related harm, Medication Safety has also been selected as the theme for World Patient Safety Day 2022. With each transition of care (as patients move between health providers and settings), patients are vulnerable to changes, including changes in their healthcare team, health status, and medications. Discrepancies and miscommunication are common and lead to serious medication errors, especially during hospital admission and discharge. Countries and organizations need to optimise patient safety as patients navigate the healthcare system by setting long-term leadership commitment, defining goals to improve medication safety at transition points of care, developing a strategic plan with short- and long-term objectives, and establishing structures to ensure goals are achieved. At this webinar, you will be introduced to the WHO technical report on “Medication Safety in Transitions of Care,” including the key strategies for improving medication safety during transitions of care. Register
  19. Event
    This Hospital at Night Summit focuses on out of hours care in hospitals delivering high quality safe care at night. Through national updates, networking opportunities and case studies this conference provides a practical guide to delivering a high quality hospital at night, and moving forward during and beyond the Covid-19 pandemic. The conference will also focus on improving staff well-being at night and reducing fatigue. Attending this conference will enable you to: Network with colleagues who are working to improve Hospital at Night Practice Learn from developments as a results of Covid-19 Improve your skills in the recognition management and escalation of deteriorating patients at night Understand and evaluate different models for Hospital at Night Examine the role of task management solutions for Hospital at Night, including handover and eObservations Ensuring effective and safe staffing at night, including adequate breaks Examine Hospital at Night team roles, competence and improve team working Improving safety through the reduction of falls at night Supporting staff and reducing fatigue at night Develop the role of Clinical Practitioner and Advanced Nursing Practice at night Identify key strategies to change practice and ways of working in Hospital at Night Understand how hospitals can improve conditions for night workers and support Junior Doctors Improve the management of pain at night Work across whole systems to improve support for patients out of hours Self assess and reflect on your own practice Gain CPD accreditation points contributing to professional development and revalidation Evidence Register There are a limited number of free places for hub members. Email: info@pslhuborg if interested. Follow on Twitter @HCUK_Clare #hospitalatnight
  20. Content Article
    Report from the Association of Ambulance Chief Executives on national ambulance data.
  21. Content Article
    Handover is a critical process for ensuring quality and safety in healthcare, and research suggests that poor handover results in significant morbidity, mortality, dissatisfaction and increased financial costs. However, the safety of handover has not received much research attention to date. This study aimed to measure the perceived risk, degree of patient harm and the systems used to support handover, and to understand how this varied by care setting, type of clinical practice, location and level of experience. The authors suggest that the results of the study indicate that action needs to be taken to improve communication and reduce risk during all types of handovers. Clinical leaders should find ways to train and support handover with effective systems, particularly focusing on training less experienced staff. More research is needed to demonstrate which interventions improve the safety of handover.
  22. Content Article
    Handover in healthcare settings can be a time when the risk of error and harm is increased. This blog summarises the results of global survey that asked the opinions of healthcare workers on the safety of handover. It highlights ten key points raised by the results: Handover causes frequent errors and patient safety incidents Handover errors can cause serious harm to patients Most people think they are better than average at handover The longer you’ve been around, the scarier handover appears  Different types of handovers have a similar safety profile The safety of handover is a problem all over the world  Most practitioners use manual or informal systems to support handover EPR systems are not up to the job of supporting handover Staff need more training, and we need more time Healthcare leaders want better electronic systems The results of the survey have been published in Preprints.
  23. Content Article
    In order to become competent clinicians, doctors need to appropriately calibrate their clinical reasoning, but lack of follow-up after transitions of care can present a barrier to this. This study in the Journal of Hospital Medicine aimed to implement structured feedback about clinical reasoning for residents performing overnight admissions, measure the frequency of diagnostic changes, and determine how feedback impacts learners' self-efficacy. The authors concluded that structured feedback for overnight admissions is a promising approach to improve residents' diagnostic calibration, particularly given how often diagnostic changes occur.
  24. Content Article
    Research undertaken by digital health platform, CAREFUL shows that handover in hospitals is the cause of frequent and severe harm to patients.
  25. Content Article
    In this chapter, from the book 'Resilient Health Care, Volume 2: The Resilience of Everyday Clinical Work', Sujan et al. explore tensions and dynamic trade-offs through an example from our research on the safety of handover across care boundaries in emergency care. The authors describe the case study and then discuss the key theoretical concepts and their relationship to Resilience Engineering. It concludes the chapter with implications for research and for practice.
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