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News ArticleScotland's Health Secretary Humza Yousaf says the NHS is facing the "biggest crisis" of its existence. There's a shortage of beds, the demand for ambulances is soaring and waits in accident and emergency departments are getting longer. On top of that, COVID-19 admissions have been rising fast as the number of infections in Scotland spiralled at the end of the summer. BBC News share five charts illustrating the enormous pressures currently being felt by NHS Scotland. Read full story Source: BBC News, 23 September 2021
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News ArticleA retiring chief executive was “astonished” how many junior doctors had never met the senior directors of their hospitals — and stressed how being visible on the wards is “critical” to good leadership. Karen Partington, who has this month stepped down after 10 years leading Lancashire Teaching Hospitals Foundation Trust, said she had made it her mission to understand the feelings and motivations of frontline staff. In an interview with HSJ, she was asked if being visible and spending significant time talking to frontline staff is the most important bit of advice she would give a first-time chief executive. She said: “In my personal opinion, it’s critical. How can CEOs be compassionate leaders without understanding the daily pressures faced by the whole team?" “My executive team and I [would] meet regularly with our junior doctors and do a ‘you said, we did’ session, which really helped us to change their experiences for the better. But it was also an opportunity to ensure our frontline colleagues understood the environment they were working in as well. I have always found that when people understand ‘why’, [then] they will come up with the solutions." Read full story (paywalled) Source: HSJ, 14 September 2021
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News Article
Sharp rise in acute medical beds occupied by children with nowhere else to go
Patient Safety Learning posted a news article in News
A third of all children’s acute hospital beds in parts of England are being occupied by vulnerable children who do not need acute medical care but have nowhere else to go, safeguarding experts have warned. Doctors say they feel like very expensive “babysitters” for vulnerable children, many of whom are in care but whose placements have broken down because of their violent and self-harming behaviour. Others have severe neurodevelopmental or eating disorders and need specialist treatment not available on ordinary children’s wards, where they get “stuck”, sometimes for months at a time. Paediatricians told the Guardian they have had to deal with vulnerable children who were not physically ill but displayed such challenging behaviour that they could not be looked after in children’s homes. “It is estimated that roughly a third of acute hospital beds at the moment are full of these vulnerable young people, many who are subject to child protection plans, or they are already children in care, living in a residential placement that’s falling apart,” said Dr Emilia Wawrzkowicz, a paediatric consultant who is the assistant officer for child protection at the Royal College of Paediatrics and Child Health (RCPCH). Though many of these children are in extreme distress, they often have no diagnosable mental illness and do not qualify for a psychiatric “tier four” bed. “Some children have such extreme emotional and behavioural issues or are at risk of exploitation that they can’t get back to their residential placements or their foster parents. They can’t obviously go back to their homes, and we’ve got to keep them safe. So they sit in the hospital because there’s nowhere else to go. There are children sitting on our wards for months,” said Wawrzkowicz. Charlotte Ramsden, president of the Association of Director of Children’s Services, warned that a failure to increase the suitable provision for traumatised children would lead to more child suicides and more children ending up in custody after harming others. Read full story Source: The Guardian, 13 September 2021 -
News ArticleMore than one in five ‘covid deaths’ were both probably hospital-acquired, and caused at least in part by the virus, at several trusts, according to analysis released to HSJ. HSJ obtained figures from more than 30 trusts which have looked in detail at cases where patients died after definitely, or probably, catching covid in hospital. Thirty-two acute trusts provided HSJ with robust data, out of the total 120 in England. Across all 32, they had recorded 3,223 covid hospital deaths which were either “definitely” or ‘probably’ nosocomial — making up around 17% of their total reported 19,020 hospital deaths. The trusts said 2,776 of the 3,223 deaths also had covid listed on their death certificate, either as an “immediate cause” or as a contributory factor. That constitutes about 15% of all the hospitals’ covid deaths, and 86% of the nosocomial deaths. When approached by HSJ, these trusts said they followed robust infection control practices, and that high community covid prevalence, and covid admissions, were the main cause of hospital-acquired infection. Some trusts also cited their ageing infrastructure. Read full story (paywalled) Source: HSJ, 6 September 2021
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Content ArticleThis article, published in the BMJ, looks at the declining mental health of staff in ICU during the height of the Covid-19 pandemic, based on research by King's College London in 2020.
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News Article
Huge gulf in hospitals' ability to contain Covid
Patient-Safety-Learning posted a news article in News
New analysis looking at the spread of Covid-19 in hospitals has revealed a massive gulf in ability to contain the virus during the first wave. According to the published data, overall only 1 in 10 people actually caught the virus whilst in the hospital, however 314 UK hospitals showed that ranged from just one in 100 cases caught in hospital, to more than 1 in 4, with an estimate of between 5,700 and 11,900 people who were infected in hospital. Professor Calum Semple, one of the researchers from the University of Liverpool has said, "There will be tragedy behind this story, people that came into hospital with one problem, caught Covid and sadly died." Read full story. Source: BBC News, 13 August 2021 -
Content ArticleThis resource, published by the AHA Physician Alliance and the American Hospital Association, is a guide for health system leaders developing well-being programmes, focusing on the challenges of burnout due to COVID-19. This resource is in two-parts: COVID-19-specific resources and a guide to walk you through well-being program development and execution. These resources will help leaders build on tools already in place and learn from others who are doing this work.
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Content Article
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At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That's why we created the hub; providing a space for people to come together and share their experiences, resources and good practice examples. This month, our Content and Engagement Manager, Steph, has hand-picked seven resources, particularly relevant for patient safety managers working in hospital settings. Shared with us by hub members and patient safety advocates, they are jam-packed with practical tools and rich insights. -
Content Article
Staff safety and wellbeing
Becky T posted an article in Staff safety
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An original article that explores the significance of both staff physical safety in the workplace as well as their psychological safety and wellbeing. In particular, I highlight the impact the COVID-19 pandemic has had on both these areas, and discuss the importance of ensuring all aspects of staff safety. -
EventThis 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. For more information visit: https://www.healthcareconferencesuk.co.uk/virtual-online-courses/hospital-at-night-summit or email nicki@hc-uk.org.uk hub members receive a 20% discount. Please email info@pslhub.org for discount code Follow on Twitter @HCUK_Clare #hospitalatnight
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Content Article
Approximately 1,000[1] UK health and care workers have died from Covid-19. Many were working with Covid-positive patients and with substandard Personal Protective Equipment (PPE). It is estimated that a further 122,000 health service workers who contracted Covid-19 are struggling with prolonged symptoms, often referred to as Long Covid. It has also become clear that a significant number of inpatients who had Covid-19, acquired the virus whilst in hospital.[2][3] In this opinion piece, Dr David Tomlinson argues that current PPE guidance still fails to adequately protect staff and patients against the airborne nature of the Covid-19 virus. David highlights the attempts made by many to raise their related safety concerns; arguing that the response to date has been inadequate, unsafe and unlawful. -
Content ArticleThis guide provides guidance for hospital clinical staff and managers in the secondary care of COVID-19 patients, based on the experience of hospital trusts that performed well during the early phase of the pandemic. It summarises the challenges faced by, and responses of, several high performing trusts visited as part of the GIRFT cross-specialty COVID-19 deep dives, as well as identifying successful innovations they implemented.
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Content Article
Parkinson's Disease awareness video
PatientSafetyLearning Team posted an article in Neurological conditions
In this film the team at Leeds Teaching Hospitals NHS Trust provide an overview of Parkinson's and why it is important that medication is administered properly and on time. They also talk about improvements they have made in their own practice, and offer tips around medication management for Parkinson's.- Posted
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Content Article
Dr Gordon Caldwell believes that patient safety should be an active process of checking for avoidable errors. In this blog for the hub, he describes how he developed a checklist for his ward rounds and how this became incorporated into the daily clinical review notes to ensure that all the important aspects of care on a team’s routine ward rounds are actively addressed. -
Content ArticleIt is important that people with Parkinson's get their medication on time. Planning for a hospital stay when you have Parkinson’s will help you manage your condition and make sure you can leave hospital as quickly as possible and recover well. Parkinson's UK have developed this resource to help people with Parkinson's have a safe stay while they are in hospital.
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News Article
Up to 8,700 patients died after catching Covid in English hospitals
Patient Safety Learning posted a news article in News
Up to 8,700 patients died after catching Covid-19 while in hospital being treated for another medical problem, according to official NHS data obtained by the Guardian. The figures, which were provided by the hospitals themselves, were described as “horrifying” by relatives of those who died. Jeremy Hunt, the former health secretary, said that hospital-acquired Covid “remains one of the silent scandals of this pandemic, causing many thousands of avoidable deaths”. NHS leaders and senior doctors have long claimed hospitals have struggled to stop Covid spreading because of shortages of single rooms, a lack of personal protective equipment and an inability to test staff and patients early in the pandemic. Now, official figures supplied by NHS trusts in England show that 32,307 people have probably or definitely contracted the disease while in hospital since March 2020 – and 8,747 of them died. That means that almost three in 10 (27.1%) of those infected that way lost their lives within 28 days. “The NHS has done us all proud over the past year, but these new figures are devastating and pose challenging questions on whether the right hospital infection controls were in place”, said Hunt, who chairs the Commons health and social care select committee. Read full story Source: The Guardian, 24 May 2021 -
Content ArticleThis booklet has been produced for hospital staff, by Parkinson's UK, for hospital staff. It tells you everything you need to know about Parkinson's, and how to provide the highest quality care for your patients.
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Content ArticleAuthors of this study, published in BMJ Open, conclude that people with learning disabilities appear to experience poorer patient safety outcomes in hospital. The involvement of family and carers, and understanding and effectively meeting the needs of people with learning disabilities may play a protective role. Promising interventions and examples of good practice exist, however many of these have not been implemented consistently and warrant further robust evaluation.
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News Article
Wards to get ‘star ratings’ under first new NHS cleaning rules for 14 years
Patient Safety Learning posted a news article in News
The first new hospital cleaning standards for 14 years have been outlined by regulators, including confirmation of new food hygiene-style star ratings. Wards and theatres will be given ratings from one to five stars – based on audits which score the cleanliness of areas against safe standards – and these ratings will be made visible to patients. The plans for the new star ratings, which are expected to be easier for patients to understand than the current cleanliness percentage scores, were first revealed by HSJ in 2019. The ratings are also designed to encourage a more collaborative approach, by reflecting the cleanliness score for whole areas, as opposed to the performance of individual parties responsible for cleaning certain elements. Areas rated one to three stars would require improvement plans and be automatically placed under review, with “immediate action” being required in one-star rated areas. Read full story (paywalled) Source: HSJ, 6 May 2021 -
News ArticleWards at a trust facing an inquiry over the deaths of vulnerable patients have been downgraded to ‘inadequate’ over fresh patient safety concerns. The Care Quality Commission said five adult and intensive wards across three hospitals run by Tees, Esk and Wear Valleys (TEWV) Foundation Trust “did not manage patient safety incidents well”. It also criticised the trust’s leaders for failing to make sure staff knew how to assess patient risk. The watchdog rated the trust’s acute wards for adults of working age and psychiatric intensive care units as “inadequate” overall as well as for safety and leadership. The trust was also served a warning notice threatening more enforcement action if the patient safety issues are not urgently addressed. At the previous inspection in March 2020, the service was rated “good”. TEWV said it has taken “immediate action” to address the issues, including a rapid improvement event for staff and daily safety briefings, and will also spend £3.6m to recruit 80 more staff. The trust’s overall rating of “requires improvement” remains unchanged after this inspection. Brian Cranna, CQC’s head of hospital inspection for the North (mental health and community health services), said: “We found these five wards were providing a service where risks were not assessed effectively or managed well enough to keep people safe from harm." “Staff did not fully understand the complex risk assessment process and what was expected of them. The lack of robust documentation put people at direct risk of harm, as staff did not have access to the information they needed to provide safe care." Read full story (paywall) Source: HSJ, 26 March 2021
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News Article
40,600 people likely caught Covid while hospital inpatients in England
Patient Safety Learning posted a news article in News
More than 40,600 people have been likely infected with coronavirus while being treated in hospital in England for another reason, raising concerns about the NHS’s inability to protect them. In one in five hospitals at least a fifth of all patients found to have the virus caught it while an inpatient. North Devon district hospital in Barnstaple had the highest rate of such cases among acute trusts in England at 31%. NHS England figures also reveal stark regional differences in patients’ risk of catching the virus that causes COVID-19 during their stay. Just under a fifth (19%) of those in hospital in the north-west became infected while an inpatient, almost double the 11% rate in London hospitals. Hull University teaching hospitals trust and Lancashire teaching hospitals trust had the joint second highest rate of patients – 28% – who became infected while under their care. The former has had 626 such cases while the latter has had 486. However, the big differences in hospitals’ size and the number of patients they admit mean that the rate of hospital-acquired infection is a more accurate reflection of the success of their efforts to stop transmission of the potentially lethal virus. Doctors and hospitals claim that many of the infections were caused by the NHS’s lack of beds and limitations posed by some hospitals being old, cramped and poorly ventilated, as well as health service bosses’ decision that hospitals should keep providing normal care while the second wave of Covid was unfolding, despite the potential danger to those receiving non-Covid care. “These heartbreaking figures show how patients and NHS staff have been abysmally let down by the failure to suppress the virus ahead of and during the second wave,” said Layla Moran MP, the chair of the all-party parliamentary group on coronavirus. Read full story Source: The Guardian, 26 March 2021 -
Content ArticleThe positive deviance approach seeks to identify and learn from those who demonstrate exceptional performance. This study from Baxter et al. sought to explore how multidisciplinary teams deliver exceptionally safe care on medical wards for older people. Based on identifiable qualitative differences between the positively deviant and comparison wards, 14 characteristics were hypothesised to facilitate exceptionally safe care on medical wards for older people. This paper explores five positively deviant characteristics that healthcare professionals considered to be most salient. These included the relational aspects of teamworking, specifically regarding staff knowing one another and working together in truly integrated multidisciplinary teams. The cultural and social context of positively deviant wards was perceived to influence the way in which practical tools (eg, safety briefings and bedside boards) were implemented. This study exemplifies that there are no ‘silver bullets’ to achieving exceptionally safe patient care on medical wards for older people. Healthcare leaders should encourage truly integrated multidisciplinary ward teams where staff know each other well and work as a team. Focusing on these underpinning characteristics may facilitate exceptional performances across a broad range of safety outcomes.
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Content ArticleIn this personal blog, an NHS volunteer describes her experience of supporting a patient dying in hospital of Covid-19. She highlights the role that volunteers can play in giving compassion and comfort to patients in an overwhelmed health system. She also draws attention to the lack of training she had before taking on the role, and the mental and emotional toll of volunteering in such environments.
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Content ArticleNew research by the Health Foundation shows that the amount of hospital care received by those living in care homes in England rapidly declined in the first three months of the pandemic in 2020 and was substantially lower than in the same period in 2019. The research, which is due to be peer reviewed, provides the first comprehensive and national analysis of all hospital care provided to care home residents during the first wave of the pandemic. It appears to substantiate concerns that care home residents (including those in nursing homes and residential care) may have faced barriers to accessing hospital treatment as the NHS rapidly reorganised to free up hospital capacity to care for critically ill COVID-19 patients.
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Content ArticleRaymond Cipollini, a long-time employee (recently retired) of the maintenance department at Einstein Medical Center Montgomery in East Norriton, Pennsylvania, used to visit patients during his shifts. His fellow staff noted that he would respond to call lights, asking how he could help, with a cheerful demeanor. Raymond often intervened if a patient was restless and pulling at IV lines or needed nurse assistance to get out of bed—potentially preventing falls. The Patient Safety Authority (PSA) named him the winner of its 2017 I AM Patient Safety Award in the category Individual Impact; he was nominated by his colleagues, who had frequently noted lively conversations coming from patient rooms, where he bonded with his “friends” over sports or other shared interests. It is lonely sometimes in those rooms, especially for patients who do not have visitors. “When I stop in, I hope I take their mind off their troubles and make them smile,” he said. These connections attend to patient’s physical safety and emotional well-being. Raymond brought his own perspective to his job and felt empowered to act for the benefit of patients and strengthened the fabric of the organisational culture.
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