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Content ArticleThere is a prevailing popular belief that expenditure on management by healthcare providers is wasteful, diverts resources from patient care, and distracts medical and nursing staff from getting on with their jobs. There is little existing evidence to support either this narrative or counter-claims. Asaria et al. explore the relationship between management and public sector hospital performance. They found no evidence of association either between quantity of management and management quality or directly between quantity of management and any of the measures of hospital performance. However, there is some evidence that higher-quality management is associated with better performance. NHS managers have limited discretion in performing their managerial functions, being tightly circumscribed by official guidance, targets, and other factors outside their control.
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Content ArticleThe CQC inspection framework now includes multidisciplinary teams (MDTs) for end of life care, tumours and weekly MDTs for people with complex needs. However lack of time and staff availability for this is a real problem. MDTs are under increasing pressure and are already seeing an erosion of their power to assure safe and appropriate care. Anecdotally, non-attendance by key MDT members is a significant quality issue for many hospitals. This is not a problem of engagement — all MDT members and are willing to provide input — but staffing pressures and the complexity of rostering makes holding these MDT meetings near-impossible. So how do we stop this degradation? How can hospitals better manage the burgeoning requirement for MDTs? One possible answer is to change the emphasis from a single meeting to a managed series of recorded opinions and decisions. If properly supported by the right workflow technology, we can move away from the ‘single-point’ MDT meeting (MDTM) to a ‘multi-point’ MDT process (MDTP) which could allow better and more auditable decisions to be made. Where significant differences of opinion exist, then a meeting can be called – but the MDT members could act independently and in parallel using a suitable recording and monitoring system. In this article, Dr D J Hamblin-Brown explains how this might work.
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Content ArticleSurgical morbidity and mortality (M&M) meetings have a central function in supporting services to achieve and maintain high standards of care. Throughout the UK, practices provides advice on the following topics: around the structure and content of M&M meetings vary widely and so does their quality. According to Good Surgical Practice, all surgeons should regularly attend morbidity and mortality meetings as a key activity for reviewing the performance of the surgical team and ensuring quality.
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Content ArticleIn July 2017, the Royal College of Surgeons of Edinburgh published a number of critical recommendations to government to greatly improve safety in the delivery of surgical treatment and patient care, with seven recommendations for best practice. The RCSEd surveyed opinions from a cross-section of the UK surgical workforce - from trainees to consultants - which highlighted broad inefficiencies on the frontline which impact the working environment and the delivery of a safe service. The report notes factors adversely affecting morale, including a lack of team structure, poor communication, high stress levels, and limited training opportunities. The report also records how staff, at times, feel diverted away from the patient-centred care they strive to deliver because of administrative and IT issues, and believe that being more innovative and efficient with existing resources could make a positive difference.
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Content ArticleThe wellbeing of NHS staff is now recognised as a priority, as evidenced by the introduction of Wellbeing Guardians into the NHS. The NHS needs to appoint a National Wellbeing Guardian to provide a leadership role for the work of these guardians, and more generally to actively promote wellbeing in NHS staff, write Narinder Kapur, Christian Harkensee and Terry Skitmore in HSJ.
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Content ArticleWith a global nursing workforce shortage upon us, governments and health system decision makers are becoming alarmed at the potential risk to service delivery if solutions are not found. However, nurses know that what constitutes the fundamental threat to a healthy healthcare system is not the hard work of nursing, but rather the demoralizing conditions under which many nurses strive to practise their profession. This commentary examines the context for some of those conditions and encourages a collective commitment to articulating our vision for the profession in a manner that is sufficiently forceful to be effective.
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Content ArticleThe UK Government committed to establishing a Patient Safety Commissioner for England in the Medicines and Medical Devices Act 2021. The decision to create this role came about as a result of a specific recommendation in First Do No Harm: The Report of the Independent Medicines and Medical Devices Safety Review (also known as the Cumberlege Review), published in July 2020. The Department of Health and Social Care held a consultation asking for comments on the proposed arrangements for the appointment and operation of the new Patient Safety Commissioner between 10 June and 5 August 2021. This report analyses responses from the public and other interested parties.
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Content ArticleIn this 'letter', Dr Soojin Jun, as a healthcare professional and a patient advocate, gives her three recommendations to guard "patient safety" in the digital health era. Your end-users are ultimately patients, no matter who uses your product. Healthcare is not binary, and your digital solutions shouldn’t be either. Please look ahead and consider empathy for “patients” and provide solid feedback loops for the “users.”
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Content ArticleDoctors and other healthcare professionals are often trained to mask their emotions. The argument is that patients trust them when they “act professional.” But that model of health care leadership is changing, write Roel van der Heijde and Dirk Deichmann in this opinion piece. Roel van der Heijde is a trainer in fear reduction and vulnerable leadership for several hospitals and nursing homes in The Netherlands and a partner at Patient-Centered Care Association in The Netherlands. Dirk Deichmann is an associate professor at Erasmus University’s Rotterdam School of Management.
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Content ArticleListen for weak signals to avert potential disasters, urges Columbia Business School professor, Rita Gunther McGrath. We’ve all heard the stories. The multi-patent-holding chemist at Kodak who warned of the digital revolution. The experienced research and development person at Nokia who pointed out that the bean counters had taken over and the company couldn’t get new products out the door anymore. The scary-smart top engineers at General Electric who urged the company to bet on renewable energy rather than tying its fortunes to fossil fuels. It’s nearly always the case that someone, somewhere, saw a significant inflection point coming and tried to warn the ‘powers that be’ – to little avail. Ignoring these warnings imperils everyone. And yet, it happens over and over again. Let’s explore why, and what you as a leader might do about it.
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Content ArticleThis report was submitted to the United States Congress by the Department of Health and Human Services, in consultation with the Agency for Healthcare Research and Quality (AHRQ). It sets out effective strategies to improve patient safety and reduce medical error.
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Content ArticleHealthcare leaders are bringing renewed attention to patient safety issues that have been overshadowed by another year of the COVID-19 pandemic. Becker's Hospital Review asked patient safety experts the following question: "If you could fix one patient safety issue overnight, what would it be and why?" Read the answers Cynthia Barnard, Vice President of Quality at Northwestern Memorial Healthcare (Chicago), Patricia McGaffigan, Vice President of Safety Programs at the Institute for Healthcare Improvement, Ana Pujols McKee Vice president and CMO and Chief Diversity, Equity and Inclusion Officer at The Joint Commission and Gary Stuck, CMO at Advocate Aurora Health gave.
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Content ArticleLeading for the delivery of integrated care is a new leadership course from the King's Fund and this is your chance to be part of the first cohort in January 2022. The programme has been designed for senior managers and clinicians responsible for delivering integrated patient-centred services. The content is relevant if you are responsible for integrated services either: within the boundaries of a single organisation, such as a hospital working in a partnership role with two or more organisations, or; a hybrid role that incorporates both single and partnership responsibilities. You might be employed by the local integrated care system or integrated care partnership or neighbourhood and might be leading teams and coaching others to work in new ways to achieve improved patient/carer outcomes.
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Content ArticleNorthumbria Healthcare NHS Foundation Trust were awarded the Freedom to Speak Up Organisation of the Year Award at the 2021 HSJ Awards with their demonstration of an integrated approach to speaking up. Kirsty Dickson was appointed as the first Freedom to Speak Up Guardian at Northumbria, following recommendations in the Francis Report. Since then, she has been working proactively to make sure that Freedom to Speak Up is woven into the fabric of the organisation.
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Content ArticleIn this opinion piece for the BMJ, the authors argue that shortcomings in protection from contracting Covid-19 at work arise from legislation being ignored. They argue that government departments, including the Department of Health and Social Care and the Department for Education, did not adequately emphasise the legal obligations of employers to protect their employees health during the pandemic. The article states that laws dating back to the 1974 Health and Safety at Work Act make it a legal requirement for employers to ensure the health of their employees and of patients, students, and site visitors.
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Content Article
4th Learning from Excellence Conference videos (8 October 2021)
Sam posted an article in Improving patient safety
The theme for the 4th Learning from Excellence Community Event was “Being better, together”, reflecting LfE's aspiration to grow as individuals, and as part of a community, through focussing on what works. For this event, LfE partnered with the Civility Saves Lives (CSL) team, who promote the importance of kindness and civility at work and seek to help us to address the times this is lacking in a thoughtful and compassionate way, through their Calling it out with Compassion programme. -
Content ArticleAimed at those who are responsible for the overall performance of organisations, divisions or departments in diverse industries such as healthcare, aviation, construction, oil and gas, nuclear, railways and defence, this book introduces a new safety paradigm in comprehensible and practical terms. It aims at improving safety and overall organisational performance through a doable, different and directed approach using multiple small steps. This book will help readers in understanding how to integrate the natural variability of human performance – and our ability to compensate for unpredictability elsewhere – into organisational systems, thereby ensuring successful outcomes. It covers important topics, including complexity, effective workplace innovations, micro-experiments, maintaining alignment between rules and reality, maximising learning and restoring relations. It includes practical examples and supporting material referenced in the expansive notes section. This book: Presents multiple small steps that collectively facilitate the improvement of safety. Discusses improving safety in routine work;, not triggered by accidents. Covers a chapter on what to do when things go wrong. Discusses these methods with the help of numerous vignettes. Has a separate section on each industry. Safety professionals, academicians, researchers and students (undergraduate and graduate) in health and safety, human factors, ergonomics, occupational health and safety will also appreciate the brevity and clarity of this work in conveying the latest scientific insights on safety.
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Content Article
Recently an enduring discussion evolved on Twitter on why safety culture is important for patient safety. My reaction, of course, was: it isn’t. Let me explain why. I think it is possible to address safety without addressing safety culture. Or, rather, to focus on actions that will improve both safety performance and safety culture (as a by-product) at the same time. In this blog I propose some of these actions – showing how to create an understanding of how work is (actually) done (rather than what it says on paper), seeing what makes it difficult and identifying what resources are missing. If we address these challenges, then surely we will be able to improve safety and safety culture will follow naturally. -
Content Article
House of Lords debate – Patient Safety Commissioner (2 December 2021)
Mark Hughes posted an article in England
This is a debate from the House of Lords on 2 December 2021 about when the process to appoint a Patient Safety Commissioner for England will commence and when the Commissioner is expected to be in post. -
Content ArticleIn the Scottish Government’s Programme for Government 2020-21 it committed to establishing a Patient Safety Commissioner for Scotland. The decision to create this role came about as a result of a specific recommendation in the First Do No Harm: The Report of the Independent Medicines and Medical Devices Safety Review (also known as the Cumberlege Review), published in July 2020. The Scottish Government held a consultation process seeking views on a range of issues relating to the creation of a new Patient Safety Commissioner role between 5 March 2021 and 28 May 2021. This report analyses responses from the public and other interested parties.
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News Article
Chief Medical Officer to lead the fight against AMR
Patient Safety Learning posted a news article in News
Public Health Minister, Seema Kennedy, has confirmed that Professor Dame Sally Davies will take on the role of UK Special Envoy on antimicrobial resistance (AMR) later this year. Dame Sally will be working across all sectors to deliver a ‘One Health’ response to AMR, which includes health, agriculture and the environment. The appointment of Dame Sally follows the government’s 20-year vision and 5-year national action plan published earlier this year, setting out how the UK will contribute to containing and controlling AMR by 2040. Professor Dame Sally Davies said: “AMR is a complex challenge which needs local, national and global action. The UK should be proud of its world-leading work on AMR. We have made tangible progress but it is essential we maintain momentum. I am honoured to have been asked to continue this vital work on behalf of the UK government.” Last year the government committed £32 million funding to accelerate the UK’s work in the global fight against AMR. The awarded funding will support the development of a state-of-the-art, virtual ‘open access’ centre that will link health outcomes and prescribing data. This technology, led by Public Health England (PHE), will gather real-time patient data on resistant infections, helping clinicians to make more targeted choices about when to use antibiotics and cutting unnecessary prescriptions. PHE will use £5 million in funding to develop a fully functional model ward, the first of its kind in the UK, to better understand how hospital facilities can be designed to improve infection control and reduce the transmission of antibiotic-resistant infections. Other successful funds include £4.4 million to Manchester University to test ‘individualised’ approaches to antibiotic prescribing by bringing together patient care and clinical research, and £3.5 million to the University of Liverpool to apply innovative genome sequencing to enable more personalised antibiotic prescribing. Public Health Minister Seema Kennedy said: “Antibiotic resistance poses an enormous risk to our NHS – we are already seeing the harmful effect resistant bugs can have on patient safety in our hospitals. It is vital that we retain the irreplaceable expertise of Professor Dame Sally Davies – an international expert in AMR – and continue to invest in research.” -
Content ArticleLast November, the UK, under its G7 Presidency, convened an event on patient safety entitled Patient Safety: from Vision to Reality, co-sponsored with the World Health Organization (WHO). The event was designed to build upon recent prominent initiatives taken forward by the UK Government and partner Member States to demonstrate the importance of taking action and facilitating collaboration to advance patient safety as an urgent global priority. This includes: annual Global Ministerial Summits on Patient Safety (from 2016) a Resolution on Global Action on Patient Safety (adopted by the World Health Assembly in 2019); and, the Global Patient Safety Collaborative developed in 2018 by the UK Government in partnership with the WHO to support patient safety improvement in low- and middle-income countries. Coupled with WHO’s Global Patient Safety Action Plan 2021-2030 and an annual World Patient Safety Day on 17th September, such initiatives will ensure that momentum can be maintained in order to tackle the truly global issue of patient safety within the wider context of strengthening national health systems. The link below is a recording of the event.
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Content ArticleThis article in the Financial Times by Alicia Clegg discusses how cronyism corrodes workplace relationships and destroys trust. It shows that the issues are common to both public and private sectors and demonstrates the need to seek out and resolve root causes.
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Content ArticlePatient leaders have a valuable role to play in tackling the problems facing health and social care at a national and local level. Amidst the chaos of reform and unprecedented challenges to improving health, the biggest asset we have - people who live with health problems and use services - remains untapped. Instead, patients are a problem to be solved, not the solution. But we need to improve the development of and access to learning opportunities in order to grow this pool of talent properly, says David Gilbert.
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Content ArticleTrust is the basis for almost everything we do. It’s the foundation on which our laws and contracts are built. It’s the reason we’re willing to exchange our hard-earned paychecks for goods and services, to pledge our lives to another person in marriage, and to cast a ballot for someone who will represent our interests. It’s also the input that makes it possible for leaders to create the conditions for employees to fully realize their own capacity and power. So how do you build up stores of this essential leadership capital? By focusing, the authors of this article argue, on the three core drivers of trust: authenticity, logic, and empathy. People tend to trust you when they think they are interacting with the real you (authenticity), when they have faith in your judgment and competence (logic), and when they believe that you care about them (empathy). When trust is lost, it can almost always be traced back to a breakdown in one of these three drivers. This article by Frances X. Frei and Anne Morriss explains how leaders can identify their weaknesses and strengths on these three dimensions and offers advice on how all three can be developed in the service of a truly empowering leadership style.
