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Content ArticleClive Flashman, Patient Safety Learning's Chief Digital Officer, shares his presentation slides from the Health Plus Care 2022 conference. The presentation slides include basic principles, how to involve the patient and public in design, key issues and Clive's ten top tips for digital health innovators.
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Community PostWe are looking into introducing a new device to deliver CPAP at ward level into our trust. Currently we use NIPPY machines which can deliver some PEEP when in a selected mode, however the downfall to this is, it can only produce an oxygen concentration of around 50%. Often, the patient groups that require this intervention are on high oxygen requirements and so particularly in the early stages would benefit from a device that could deliver both. I have previously worked with Pulmodyne 02-Max trio which allows up to 90% oxygen and PEEP up to 7.5cmH20. Majority of patients responded very well to this treatment. I wondered whether any other trusts/ team have any other experiences/ devices that they may use and recommend? @Danielle Haupt@Claire Cox@Emma Richardson@Mandy Odell@PatientSafetyLearning Team@Patient Safety Learning@Patient safety Hub@CCOT_Southend
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Content ArticleThis free eGuide will aid your strategic communications design, and show you how you can develop strategic communications that support and educate populations and patients to make better lifestyle decisions and live healthier lives. In the eGuide, you’ll discover: Why is behavioural change critical for prevention? What are the fundamental elements of strategic healthcare communications. How to develop your vision for patient activation communications to become a reality. The guide is free, but you will need to submit your details download the Apteco guide from their website.
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Content ArticleThis article forms a section of A guide to good governance in the NHS, published by NHS Providers. Mary Dixon-Woods and Graham Martin contrast problem-sensing with comfort-seeking, confront structural complacency and a lack of eagerness to use hard and soft intelligence, and discuss the crucial importance of openness.
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Content ArticleThis year marks the NHS's 75th anniversary, and is an important moment to look back at where the service has come from, consider where it stands today and to look forward to how it needs to change to meet future needs. This report from the NHS Assembly draws on the feedback of thousands of people who have contributed to a rapid process of engagement with patients, staff and partners. It aims to help the NHS, nationally and locally, plan how to respond to long term opportunities and challenges. It sets out what is most valuable about the NHS, what most needs to change, and what is needed for the NHS to continue fulfilling its fundamental mission in a new context.
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Content ArticleThis report assesses why NHS hospitals are failing to deliver higher activity despite higher spending on the service and higher levels of staffing over the last couple of years. It argues that politicians need to urgently focus on capital investment, staff retention and boosting management capacity, and sets out key questions for policy makers to address if they want to solve the NHS crisis. The NHS has been on a longer-term negative trajectory: most of the challenges identified in the report existed before the pandemic and have been exacerbated since.
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Content ArticleThis report summarises the key insights from the Birmingham ICS Delivery Forum event, held in Birmingham in April 2023. It places the discussions that took place into the broader context of health and care transformation, both at a local and national level, and uses wider sources and research to expand upon the key points.
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Content Article
Adverse incidents arising from suboptimal healthcare are a major cause of worldwide morbidity and mortality. Arriving at an understanding of the conditions under which adverse incidents occur has the potential to improve the safety of healthcare provision. Staff working in the NHS have been contributing their experiences via a narrative data capture platform – SenseMaker – to help gain contextual insights on a wide range of topics under exploration by the NHS Horizons team. This blog by Rosanna Hunt (Senior Associate, NHS Horizons) in collaboration with Lizzy MacNamara (Junior Research Consultant, The Cynefin Co.) and Taj Nathan (Consultant Forensic Psychiatrist, Cheshire & the Wirral Partnership Foundation Trust) describes how the SenseMaker® platform could be used to extract staff experiences on the topic of patient safety incidents both reported and unreported by staff, and the facilitated conversations that would be needed to transform the data into actionable insights and commitment to change. -
Content ArticleThe widespread adoption of effective hybrid closed loop systems would benefit people living with type 1 diabetes by improving the amount of time spent within target blood glucose range. Hybrid closed loop systems (also known as 'artificial pancreas' typically utilise simple control algorithms to select the best insulin dose for maintaining blood glucose levels within a healthy range. Online reinforcement learning has been utilised as a method for further enhancing glucose control in these devices. Previous approaches have been shown to reduce patient risk and improve time spent in the target range when compared to classical control algorithms, but are prone to instability in the learning process, often resulting in the selection of unsafe actions. This study in the Journal of Biomedical Informatics presents an evaluation of offline reinforcement learning for developing effective dosing policies without the need for potentially dangerous patient interaction during training.
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Content ArticleThis is the recording of a roundtable hosted by the Institute of Health & Social Care Management (IHSCM) about virtual wards. Roy Lilley, IHSCM Chair and health policy analyst, discusses reducing waiting times, being innovative and sustainable and improving patient outcomes and patient journeys with a panel of speakers. The panel includes: Kris Glover, MD & Founder of Neon Health Solutions Paul Rylance, CTO, JKMCare Dr Folarin Majekodunmi, Director at Peopletoo
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Content ArticleThe Royal United Hospital Bath NHS Trust project tested different ways to communicate with staff about patient safety, to encourage the reporting of incidents and to promote a learning culture.
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Content ArticleThis is the recording of a webinar hosted by The Patients' Association, looking at how virtual wards work and patients' experiences of virtual wards. A panel answered questions about who was suitable for care on a virtual ward, how they are staffed and what happens if you're not tech-savvy. The panel was: Jono Broad, a patient leader in the southwest of England. He is a Senior Manager for Personalised Care, NHS England South West, works on patient experience, safety and quality. Emma Matthews, Regional Community Development Lead NHS England South West, Consultant Practitioner Older People and Frailty. Dr Shelagh O’Riordan, Consultant Community Geriatrician at Kent Community Health NHS Foundation Trust and Professional Adviser to the virtual ward team at NHS England. She is also Clinical Director for Frailty in East Kent and runs a large frailty virtual ward. Dr Crystal Oldman CBE, Chief Executive, The Queen's Nursing Institute. Crystal qualified as a nurse at University College Hospital, London. In 2017, Crystal was awarded a CBE in the Queen’s Birthday Honours List for services to community nursing and her leadership of the QNI. Crystal is an Honorary Professor at London South Bank University. Patients Association member, Alan Bellinger, who represents patients on the Hospital at Home programme in Hertfordshire, and is a patient representative on the Eastern Academic Health Science Network Review of Remote Monitoring.
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Content Article
D1abasics campaign resources (UHS, May 2023)
Patient-Safety-Learning posted an article in Diabetes
People with diabetes account for one in three hospital inpatients, and this is projected to increase to one in five in the next few years. Often, people are in hospital for reasons other than their diabetes, so it is important that staff across all specialties understand the basics of diabetes care in order to ensure patient safety. D1abasics is an innovative project that aims to equip all healthcare professionals to support the basic diabetes healthcare needs of their patients. Developed by the diabetes team at University Hospital Southampton with funding and support from the charity Diabetes UK, the campaign includes resources such as posters, lanyards and prompt cards. The diabetes team is supporting learning across the hospital by making visits to all wards and specialties to promote D1abasics. You can download the D1abasics poster below. -
Content Article
The Community Health and Wellbeing Worker (CHWW) model was devised in Brazil in the 1990s, where it is called the Family Health Strategy. There are over 250,000 CHWWs in Brazil, described as ‘the ears and eyes of the GP in the community’. They are full time members of the local primary care team and focus on a defined location, usually 200 households, keeping in regular contact with the residents. By visiting households at least once a month, the delivery of primary care becomes truly local and embedded into everyday life. This article describes a pilot of a CHWW model by the NIHR Applied Research Collaboration Northwest London. It discusses how the project was established and includes case studies from the pilot. -
Content ArticleThis case study published by The Beryl Institute looks at an initiative to collect real-time feedback on patient experiences at the Stanford Health Care emergency department in California. Previously, the department had sent a survey to patients well after their visit, but the team realised that capturing this information sooner was critical. Matthew Lim, Patient Experience Manager at Stanford Health Care describes the practical and replicable steps the organisation took in implementing a QR code-based feedback system. He describes the results, lessons learned and potential future developments.
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News Article
Patients at risk’ from ‘hastily rolled out virtual wards’
Patient Safety Learning posted a news article in News
NHS England’s plans to rapidly expand virtual wards are being ‘hastily rolled out’ and could put patients at risk while taking up significant staffing capacity, leading clinicians have warned. The Society for Acute Medicine and the Royal College of Physicians are among those who have raised concerns to HSJ about the huge increase in the use of the virtual wards model, under which patients are discharged home and given oximeters that fit on their finger so they can be remotely monitored by clinical staff. The concerns follow NHSE ordering trusts to ensure a minimum of 15% of hospital covid patients were being treated in virtual wards, in plans to help ease pressures on hospital wards announced just before Christmas. At the time NHSE announced the plans there were around 7,000 covid inpatients in English NHS hospitals, meaning around 1,000 patients should be in virtual wards. But the covid inpatient figure had more than doubled to nearly 16,000 by 5 January. The project is hugely significant because NHSE and trust chiefs want to use virtual wards much more widely – including for non-covid patients – and believe they represent a potentially game-changing option when it comes to alleviating pressure on hospitals and speeding up discharges. Many of the clinicians who spoke to HSJ were supportive of the principle of virtual wards but had serious concerns about the speed and timing of the rollout. They said there was a lack of evidence the approach was safe. Society for Acute Medicine president Tim Cooksley said virtual wards had potential for the future but that they “simply cannot be seen as a short-term mitigation measure which can be hastily rolled out mid-pandemic”. Read full story (paywalled) Source: HSJ, 7 January 2022 -
News ArticleThe year 2020 has been extraordinary. It would have been inconceivable 12 months ago that the process of developing and testing medicines would be a topic of intense political and public interest. The UK pharmaceutical sector has taken centre stage, with more support than ever before for Britain’s gold-standard regulatory framework. After a difficult year, this winter has seen a steady drumbeat of positive news about COVID-19 vaccines, demonstrating that the pharmaceutical industry can deliver world-leading clinical research at pace and at scale within the UK’s regulatory system. As the crisis of the COVID-19 pandemic hopefully eases over the coming months and the transition period for Britain’s exit of the EU comes to an end, we must seize the opportunity to strengthen this framework. Read full story Source: New Statesmen, 14 December 2020
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News ArticleNiamh McKenna, Chief Information Officer at NHS Resolution, hosted the recent digital focussed event, ‘2020: A Catalyst for Rapid NHS Digital Transformation’. Panellists from NHS England & Improvement, Health Education England, and Microsoft, looked to dissect the rapid acceleration of digitalisation in our NHS over the last twelve months, and what this means for our sector and our workforce. The two hour event hosted over 100 attendees and live-streamed on YouTube, allowing delegates to hear about the key considerations for the impact of a new digital-first way of working. Looking at the good and the bad from the last twelve months, the panellists shared insight into digital-first training, technology fatigue on the workforce, revolutionary digital approaches from case studies on COVID-19 wards, and much more. One important topic associated with digital is the role of learning for our NHS workforce, and Henrietta Mbeah-Bankas, Head of Blended Learning and Digital Literacy at Health Education England, raised some interesting opportunities, challenges, and considerations around digital learning for the workforce: “Properly defining digital literacy is one of the first vital steps for a digital transformation strategy to succeed, we can’t continue to make assumptions like ‘Millennials are digital-natives’." “There are three groups we need to consider to properly develop an inclusive digital transformation strategy that will be effective – the digitally engaged, digitally ambivalent, and those that say, ‘I don’t do tech’. For me there’s also a fourth group, those who are actually digitally excluded. Until you understand the barriers these people have and consider how they’ll approach digital solutions, you can’t begin to create an inclusive digital strategy that will ensure everyone comes on the journey with you." Niamh's key take-away from the event was that we need to make sure we continue to embrace rapid digital transformation, use it as a catalyst to get stuff done, improve work, improve lives, and improve patient care. We must use all this data available to us to understand the good and the not so good outcomes from the pandemic to shape initiatives for our new future. A recording of this event is now available to watch on demand here, along with downloadable supportive resources shared by the panellists. Read full story Source: Health Tech Newspaper, 30 November 2020
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News ArticleWearable devices will monitor the mood of all 70 staff at a large GP practice, in a trial aimed at improving employee health and wellbeing. Staff at Amicus Health, a GP practice in Devon, will be provided with a wearable device which allows the user to log how their day is going by pressing one of two buttons. The information gathered can be viewed by employers on a dashboard, identifying whether there are particular times in the day when moods drop. Users will also be able to see their data on a personal app, allowing them to track mood triggers and patterns. On the dashboard, employees’ data is divided into teams and is not anonymised, so employers can track the mood of individuals. Asked by HSJ whether this could deter some from using it, company co-founder Jonathan Elvidge said previous trials suggested it does not. He told HSJ that during trials on construction sites, employers found it easier to take action if they were able to identify workers who were regularly reporting that they were feeling low. He said employees preferred being identified as it gave them a voice and made it easier to express how they were feeling. The device — called a Moodbeam One — will be trialled on all 70 clinical and non-clinical staff members at the practice, including 25 GPs. It will largely be down to the practice to decide how the data is used, according to Mr Elvidge. Read full story (paywalled) Source: HSJ, 5 November 2020
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News ArticleThe first wave of COVID-19 may gave subsided in some areas of the United States, but in others it is growing and hospitals everywhere are continuing to face significant challenges. The American Hospital Association recently estimated that hospitals will incur at least $323.1 billion in losses through the end of this year due to COVID-19. Key contributors include postponed and cancelled elective procedures, lower patient volumes across all departments, and higher costs for supplies and devices. Other factors compound the financial challenges, including pressure for hospitals to implement new initiatives that foster a safer care environment for COVID-19 patients, non-COVID-19 patients, and healthcare providers. This pressure is mounting, as spikes in cases continue to appear in various regions, and as concerns grow about the flu season. The good news is that improving patient, staff, and visitor safety can actually help hospitals recover from the financial losses they are experiencing due to the pandemic. For example, enhanced patient safety leads to: Fewer costly events, such as hospital-acquired infections or conditions, acute kidney injuries, adverse drug events, readmissions, and return visits to the emergency department. Faster and more proactive identification of cost-saving opportunities, such as IV to PO conversions and more optimal management of high-cost drugs. Higher patient volumes due to a stronger quality and safety reputation. Hospitals face significant financial challenges, but they must also act quickly to ensure patient, staff, and visitor safety. Luckily, improving margins and enhancing patient safety don’t need to be competing priorities. When hospitals implement effective safety improvement approaches, margin improvements naturally follow. Read full story Source: MedCity News, 25 October 2020
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News ArticleLondon-based HealthUnlocked has been acquired by worldwide leader Corrona. HealthUnlocked is a social network of 1.3 million patients across hundreds of condition-specific communities. Moderated by over 500 patient advocacy groups, it captures insights to better understand what matters most to these patients. Corrona, based in Massachusetts, US, describes itself as a built-for-purpose source of gold-standard real-world evidence. “By combining with HealthUnlocked, we are expanding our broad set of capabilities–ranging from highly granular and longitudinal structured data across our eight registries, to broader patient insights from HealthUnlocked,” said Abbe Steel, Chief Patient Officer of Corrona. “The HealthUnlocked communities provide access to engaged patients across the globe, allowing us to better understand the patient experience and what matters most to patients." Read full story Source: Business Cloud, 22 October 2020
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News ArticleWith so many operations put on hold when the pandemic started in March, surgeon Douglas Hartley and a team of medical veterans got to work pioneering new types of protective equipment. When the coronavirus pandemic first hit the UK, thousands of surgical procedures were put on hold. For surgeons like Douglas, who performs operations on deaf children to restore their hearing, this created a significant moral dilemma – he wanted to get back into surgery to provide this vital care, but didn’t want to inadvertently catch or pass on COVID-19 in the process. Douglas regularly carries out cochlear implant surgery, a process in which a surgeon embeds an electronic device which stimulates the hearing nerve in the ear. The scientific evidence is clear that this surgery needs to be performed at the earliest opportunity so that these children can benefit from being able to hear at a vital stage in their development. But performing the surgery as normal would have put both children and surgical teams in danger. They needed to come up with another way of doing things. The team in Nottingham had to combine creativity and science to develop a novel and safe way to restart cochlear implant surgery in a matter of just a few weeks. The team used a systematic evidence-based approach to evaluate a variety of PPE for its usability and effectiveness. During simulated cochlear implant surgery, they evaluated each type of PPE across several parameters, including its effect on a surgeon’s ability to communicate, their field of vision, and their comfort. Many of the PPE options were found to substantially restrict the surgeon’s vision during operating. That rendered them unsafe for performing this sort of surgery. Instead, they found that the combination of “spoggles” and a half-face respirator mask had consistently superior performance across all aspects of clinical usability compared with all other options. During their studies, Douglas and his team also worked with a surgical product manufacturer to develop a novel drape, basically a tent, that was designed to be suspended from a microscope covering the patient’s head and torso to provide a physical barrier between the site of drilling and the rest of the team. They found that the operating tent significantly contained the droplets and prevented them from spreading around the theatre environment. They are the first – and are currently only – group in the world to develop an operating tent design that is marked for medical use. After completing our studies, we now had appropriate PPE and a protective operating tent to permit the safe restarting of cochlear implant surgery during the pandemic. These recommendations were rapidly disseminated internationally via webinars and journal publications and quickly adopted as standard patient care by Nottingham University NHS Foundation Trust and, subsequently, embraced in other departments in the UK and across the world. Read full story Source: The Independent, 22 October 2020
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News ArticleA pharmacist-led, new digital intervention that improves patient safety when prescribing medication in general practice reduced rates of hazardous prescribing by more than 40%, 12 months after it had been introduced to 43 GP practices in Salford, finds a new study. Due to its success, plans are underway to roll it out across Greater Manchester. Prescribing and medication are one of the biggest causes of patient safety incidents and the third WHO Global Patient Safety Challenge is focussed on Medication without Harm. The SMASH intervention addresses this. It was developed by researchers at the National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre (NIHR GM PSTRC), which is a partnership between The University of Manchester and Salford Royal hospital in collaboration with The University of Nottingham. Pharmacists working in general practice use the SMASH dashboard to identify patients who are exposed to potentially hazardous prescribing. For example, patients with a history of internal bleeding may be prescribed medications such as aspirin which could increase the risk of further internal bleeds without prescribing other treatments to protect them. SMASH identifies this and warns healthcare professionals about it, who can then decide on a possible course of action. The intervention is unique due to its ability to provide near real time feedback to prescribers as it updates every evening. Professor Darren Ashcroft, Research Lead for the Medication Safety theme at the GM PSTRC, said: "We worked with the Safety Informatics theme at the GM PSTRC to develop then test SMASH. It is designed to improve patient safety in general practice by reducing potential problems made when prescribing medication and inadequate blood-test monitoring. It brings together people and data to reduce these common medication safety problems that all too often can cause serious harm." Read full story Source: EurekAlert, 14 October 2020
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News Article
Need for tech to reduce medication error and improve patient safety
Patient Safety Learning posted a news article in News
Omnicell UK & Ireland, a leading provider of automated healthcare and medication adherence solutions, hosted a health summit on the eve of World Patient Safety Day, to discuss the impact of medication errors on patients and the NHS. The session focussed on the role technology can play in preventing such issues. The summit, this year held via webinar, comes off the backdrop of the Department of Health and Social Care disclosing that in England 237 million mistakes occur every year at some point in the medication process. These errors cause serious issues for patient safety, but also place a significant cost burden on an already stretched NHS. The 2019 Patient Safety Strategy published by NHS England and NHS Improvement also found the NHS failed to save 11,000 lives a year due to safety concerns with the cost of extra treatment needed following incidents being over £1bn. A number of high-profile panel members answered a series of questions from the audience on solutions and best practice to improve patient safety with the aim of debating and sharing ideas on how to meet challenges and the impact of COVID-19. One of the panelists, Patient Safety Learning's Chief Digital Office Clive Flashman, agreed with the other panel members that the NHS had become more collaborative and familiar with technology since Covid: “We’ve seen a definite increase in telehealth and telemeds. Covid has forced cultural blockers that were there before to be removed out of necessity. There has been a growth in robotic pharmacy automation to free up staff time from high volume administration tasks to do more complex work that adds value for patients.” But with the second-wave of COVID-19 still a very real threat he advised: “We don’t want to wait until the next wave to learn a lesson – we need to learn lessons now. Quality Improvement Leads should be focussed on what went right and what went wrong over that period between March and May. They need to be looking at what we can learn from that now and what we can do differently next time. If we don’t do that, we won’t succeed in the second wave where we might fail.” Ed Platt, Automation Director, Omnicell UK & Ireland, added: “Challenges within the NHS throughout Covid has forced them to embrace technology and drive innovation." "It’s important that when things go back to normal, we don’t go back to the same status quo. We need to invest in the right infrastructure in hospitals so unnecessary demands and stress are not put on pharmacy, supply managers and nurses so they are free to focus on patient care not administration tasks." Read full story Source: NHE, 17 September 2020 You can watch the webinar on demand here -
News ArticleA protective device against coronavirus for at-risk doctors is to be provided free to the NHS. The SNAP device for ear, nose and throat surgeons was created after Burton-upon-Trent consultant Amged El-Hawrani died with COVID-19 in March. He was one of the UK's first senior medics to die with the virus, his death showing that they were at serious risk. The device clips over patients' masks to prevent the virus spreading through coughs and sneezes. It was developed by surgeons Ajith George and Chris Coulson, with the help of Aston University, who said nasendoscopy procedures - where a small flexible tube fitted with a camera is inserted into the nose - often made patients cough, splutter and sneeze. It works by clipping on to either side of a normal surgical face mask, creating a hole for an endoscope to be inserted while keeping the patient's nose and mouth completely covered. When it is removed, a one-way valve closes the hole so no virus can escape. "We were concerned about the safety of doctors but also about the risk of missed diagnoses and opportunities for treatment of patients," Mr Coulson, an ENT surgeon working at the Queen Elizabeth Hospital in Birmingham, said. "Our aim has been to produce an easy-to-use, cheap device that would allow clinicians to return to routine practice." Read full story Source: BBC News, 16 September 2020
