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Showing results for tags 'Just Culture'.
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Content ArticleAlberta Health Services (AHS) is Canada’s first and largest province-wide, fully-integrated health system, responsible for delivering health services to the more than 4.3 million people living in Alberta, as well as to some residents of Saskatchewan, B.C. and the Northwest Territories.
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Creating a safety culture
Claire Cox posted an article in Other countries and national agencies
A safety culture is built on trust. It empowers staff to report errors, near misses, and recognise unsafe behaviours and conditions that can put patients at risk, all of which drive improvement. This video by the Joint Commission Centre for Transforming Healthcare explains how they are engaging staff and the importance of speaking up. -
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A reflective account of the culture of fear
Anonymous posted an article in Bullying and fear
This is my story of how one bad experience can lead to another. We talk a lot about patients and their safety (quite rightly so) but very rarely do we hear about the healthcare professional who is going through turmoil and their mental health. This is my story. -
Content ArticleSteve Turner is a healthcare professional, a nurse prescriber with experience in senior management in both the NHS and private sectors. He works as a clinician with vulnerable adults on the margins of society. In this blog, published on Care Right Now, he reflects on the situation in England based on his experiences and those of the many people he has met as a result. All of whom experienced the backlash that can happen when organisational reputation trumps patient safety. One thing many of us have in common is that, put simply, we never intended to become known as ‘whistleblowers’ we were just trying to do our job to the best of our ability.
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Content ArticleIn our previous blog we shared some reflections about the recent case of Dr Gawa-Barba and the implications the case has for the promotion of a learning culture in healthcare. In light of the Gawa-Barba case, the Government set up a review to which we have submitted a paper.
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Reflecting on the Bawa-Garba case
PatientSafetyLearning Team posted an article in Legal matters
When an adverse event occurs in healthcare, the consequences can be catastrophic for patients and their families. In the aftermath of such events there are multiple needs, expectations and demands. This blog from our Patient Safety Learning website, looks at the case in which Dr Hadiza Doctor Bawa-Garba was convicted of manslaughter.- Posted
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Content ArticleFollowing the 'A New Strategy for Patient Safety - Insight, Involvement, Improvement' conference held in Manchester on the 16 October 2019, chaired by Helen Hughes of Patient Safety Learning, I am pleased to share the speaker presentations on the hub. A new London conference has been announced for 29 April 2020. Telephone: 0161 376 9007; Email: info@openforumevents.co.uk for further information.
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Content ArticlePresentation from Ben Tipney and Vikki Howarth at the 'A New Strategy for Patient Safety - Insight, Involvement, Improvement' conference held in Manchester on the 16 October 2019.
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Content ArticlePresentation from Dr Devina Halsall, NHS England & NHS Improvement Northwest Region, at the 'A New Strategy for Patient Safety - Insight, Involvement, Improvement' conference held in Manchester on the 16 October 2019.
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Content ArticlePresentation from Dr Cicely Cunningham from the Doctors' Association UK at the 'A New Strategy for Patient Safety - Insight, Involvement, Improvement' conference held in Manchester on the 16 October 2019.
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Content ArticleSpeaking up, raising concerns, whistleblowing. However you describe it, we know it can be daunting. Supporting 'National Speak Up Month' , the General Medical Council (GMC) has provided advice and tools to help you.
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NHS Resolution: Saying sorry leaflet (September 2018)
PatientSafetyLearning Team posted an article in Good practice
Saying sorry meaningfully when things go wrong is vital for everyone involved in an incident, including the patient, their family, carers and the staff that care for them. This leaflet is part of NHS Resolution's work on duty of candour.- Posted
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Content ArticleIn this blog post, Vince discusses the challenges registrants face when something goes wrong, and why employers and regulators should be doing more to reassure professionals that openness is best for everyone.
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Content ArticleThe All Party Parliamentary Group (APPG) for Whistleblowing was launched in July 2018 to look at the case for an Independent Office for the Whistleblower. The APPG have set an ambitious workplan aiming to take back the UK’s lead on this legislation, proposing to deliver world class, gold standard draft legislation – a global solution to a global problem. The objectives of the APPG for Whistleblowing are: Influencing policies and decisions that affect whistleblowers globally. Drafting legislation to ensure effective protection for whistleblowers. Commissioning and publishing research, based on our work with whistleblowers and relevant groups and stakeholders across all sectors. Engaging our supporters in campaigns to influence decisions affecting whistleblowers. Giving whistleblowers safe platforms to speak out on issues affecting them. Promoting positive social attitudes towards whistleblowing. Encouraging MPs to promote positive recognition for whistleblowers. Supporting and upskilling MPs and their staff to identify and manage constituent whistleblower cases.
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Content ArticlePatient safety is typically seen as a strategic priority. This sounds important, but it means that, in practice, health and social care decision-makers will weigh (and inevitably trade-off) the importance of patient safety against other priorities, like finances, resources or efficiency. We believe that patient safety is not just another priority: it is part of the purpose of health care. Patient safety should not be negotiable. Our report, A Blueprint for Action, sets out the action needed to progress towards the patient-safe future. Underpinned by systemic analysis and evidence, it proposes practical actions to address the six foundations of safer care for patients. These foundations are shared learning, leadership, professionalising patient safety, patient engagement, data and insight, and Just Culture.
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Content ArticleThis short video from the Derbyshire Community Health Services NHS Foundation describes the importance of speaking up, what the process is and how speaking up will improve patient safety.
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RCN: A guide to raising concerns
Claire Cox posted an article in Whistle blowing
This resource from the Royal College of Nursing, will support you to raise concerns wherever you work – in the NHS or independent sector – and whether you raise a concern as an individual or as part of a group.- Posted
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Content ArticleWhat links the Mercedes Formula One team with Google? What links Team Sky and the aviation industry? What connects James Dyson and David Beckham? According to this book, they are all Black Box Thinkers. Written by Matthew Syed, Black Box Thinking is a new approach to high performance, a means of finding an edge in a complex and fast-changing world.
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NHS Improvement: A Just Culture guide (updated 14 December 2018)
Claire Cox posted an article in Good practice
The fair treatment of staff supports a culture of fairness, openness and learning in the NHS by making staff feel confident to speak up when things go wrong, rather than fearing blame. Supporting staff to be open about mistakes allows valuable lessons to be learnt so the same errors can be prevented from being repeated. In any organisations or teams where a blame culture is still prevalent, this guide will be a powerful tool in promoting cultural change. -
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NHS Improvement: A Just Culture guide – animation (15 March 2018)
Claire Cox posted an article in Good practice
A Just Culture guide helps NHS managers ensure staff involved in a patient safety incident are treated fairly, and supports a culture of openness to maximise opportunities to learn from mistakes.- Posted
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Content ArticleTejal K. Gandhi, Institute for Healthcare Improvement's (IHI) Chief Clinical and Safety Officer, reflects on the World Health Organization (WHO) challenge to “Speak Up for Patient Safety” and how broadly it applies to improvement work.
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Whistleblowing disclosures joint report 2019
Patient Safety Learning posted an article in Whistle blowing
On April 1 2017, a new legal duty came into force which required all prescribed bodies to publish an annual report on the whistleblowing disclosures made to them by workers. The Nursing and Midwifery Council has published a a joint whistleblowing disclosures report with other healthcare regulators. The aim in this report is to be transparent about how we handle disclosures, highlight the action taken about these issues, and to improve collaboration across the health sector. As each regulator has different statutory responsibilities and operating models, a list of actions has been devised that can accurately describe the handling of disclosures in each organisation.- Posted
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What is the National Guardian Freedom to Speak Up?
Claire Cox posted an article in Speak Up Guardians
The National Guardian’s Office is an independent, non-statutory body with the remit to lead culture change in the NHS so that speaking up becomes business as usual. The office is not a regulator, but is sponsored by the CQC, NHS England and NHS Improvement.- Posted
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Content ArticleIn this article published in JAN Interactive, Catherine Best critiques the importance of understanding Human Factors in ensuring the delivery of safe and effective care.
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Content ArticleRichard Smith, former BMJ Editor and Chair of the Point of Care Foundation, finds out more about Schwartz rounds in this opinion article published in the BMJ.
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