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Showing results for tags 'Organisational Performance'.
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Content Article
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News Article
CQC taking ‘enforcement action’ against every fourth service it inspects
Patient Safety Learning posted a news article in News
A quarter of services the Care Quality Commission has recently inspected required enforcement action from the regulator, its chief executive has revealed. Speaking at the launch of the regulator’s annual State of Care report, Ian Trenholm called for a “long-term, sustainable funding solution” from the government to aid a service that was ”genuinely struggling to cope”. Mr Trenholm said “about a quarter of the services” the CQC has inspected in 2022 had resulted in it having to take “enforcement action”. Examples of action taken against NHS trusts in the last year included enforcement measures placed on Nottingham University Hospitals, University Hospitals Sussex, and Princess Alexandra Hospital. In response to a question from HSJ about the robustness of the CQC’s inspection regime following further care quality and safety scandals, Mr Trenholm said observers should not focus solely on the ratings given to trusts by the CQC as there was a lot ”work going on in the background, whether that’s enforcement or otherwise”. He added the CQC had significantly increased the amount of information it was gathering in relation to concerns about services. Read full story Source: HSJ, 21 October 2022- Posted
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- Organisational Performance
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Event
The NHS Patient Safety Conference
Patient Safety Learning posted an event in Community Calendar
The NHS Patient Safety Conference, in partnership with Patient Safety Learning, is a long-standing virtual and in-person event series that has welcomed over 1500 NHS professionals through its doors. In February 2021, further updates and changes were made to the NHS Patient Safety Strategy. The most significant strategy update is the new commitment to address patient safety inequalities, with a new objective added to the safety system strand of the strategy. This event series provides a timely platform to discuss these changes. Key event topics are run across 3 key pillars: Insight Adopt and promote fundamental safety measurement principles and use culture metrics to better understand how safe care is. Use new digital technologies to support learning from what does and does not go well, by replacing the National Reporting and Learning System with a new safety learning system. Introduce the Patient Safety Incident Response Framework to improve the response to an investigation of incidents and implement a new medical examiner system to scrutinise deaths. Improve the response to new and emerging risks, supported by the new National Patient Safety Alerts Committee Share an insight from litigation to prevent harm. Involvement Establish principles and expectations for the involvement of patients, families, carers, and other lay people in providing safer care. Create the first system-wide and consistent patient safety syllabus, training, and education framework for the NHS. Establish patient safety specialists to lead safety improvement across the system. Ensure people are equipped to learn from what goes well as well as to respond appropriately to things going wrong. Ensure the whole healthcare system is involved in the safety agenda. Improvement Deliver the National Patient Safety Improvement Programme, building on the existing focus on preventing avoidable deterioration and adopting and spreading safety interventions. Deliver the Maternity and Neonatal Safety Improvement Programme to support a reduction in stillbirth, neonatal and maternal death, and neonatal asphyxia brain injury by 50% by 2025. Develop the Medicines Safety Improvement Programme to increase the safety of those areas of medication use currently considered the highest risk. Deliver a Mental Health Safety Improvement Programme to tackle priority areas, including restrictive practice and sexual safety. Work with partners across the NHS to support safety improvement in priority areas such as the safety of older people, the safety of those with learning disabilities and the continuing threat of antimicrobial resistance. Work to ensure research and innovation support safety improvement. All organisations are committed to patient safety, but how do leaders ensure that they’re doing all they can to deliver safe and effective care? Join Dr Sanjiv Sharma, Executive Medical Director at Great Ormand Street Hospital for Children, and Helen Hughes, Chief Executive of Patient Safety Learning for a presentation at 9.05am. Dr Sharma will outline their ambitious patient safety transformation journey, how they are designing and delivering an innovative safety systems approach. Embedding Patient Safety Learning’s new standards for patient safety, hear how GOSH’s self assessment has informed the development of prioritised action plans, strengthened governance and leadership engagement and cross organisation collaboration. Helen Hughes, Chief Executive of Patient Safety Learning, will outline why a standards based approach to patient safety is needed and the benefits it can bring. Register- Posted
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- Medication
- Maternity
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News Article
Outstanding air ambulance team 'go the extra mile'
Patient Safety Learning posted a news article in News
An air ambulance service has been praised by inspectors for providing an "outstanding level of care". The Care Quality Commission (CQC) carried out checks on the Essex & Herts Air Ambulance Trust (EHAAT) in August and September. The report said patients felt "truly respected and valued as individuals" and described teamwork as "exemplary". Ben Myer, EHAAT head of clinical delivery, said "everyone worked so hard to make the desired result a reality". The service provides emergency care and transport in Essex and Hertfordshire, and surrounding areas when needed. As well as being rated outstanding overall, the charity was also rated outstanding for being safe, effective, caring, responsive to people's needs - and being well-led. Jane Gurney, EHAAT chief executive, thanked the local community for supporting the service, and issued a personal thank you to "each team member across the charity, whatever their role, all of whom work so hard every day to uphold these high standards". Read full story Source: BBC News, 12 October 2022- Posted
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- Ambulance
- Organisational culture
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Event
This one day masterclass is part of a series of masterclasses focusing on how to use Human Factors in your workplace. Leadership in the NHS is the responsibility of all staff. Understanding human factors will allow healthcare to enhance performance, culture and organisation. These masterclasses have been re-designed in line with the new Patient Safety Syllabus. It will look at why things go wrong and how to implement change to prevent it from happening again or mitigate the risks. This masterclass will focus on non-technical skills to improve patient safety. Key learning objectives: Task analysis Cognitive overload Reliability Non-technical skills Examples Register- Posted
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- Human factors
- Organisational culture
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Event
Creating safe systems
Patient Safety Learning posted an event in Community Calendar
This one day masterclass is part of a series of masterclasses focusing on how to use Human Factors in your workplace. Leadership in the NHS is the responsibility of all staff. Understanding human factors will allow healthcare to enhance performance, culture and organisation. These masterclasses have been re-designed in line with the new Patient Safety Syllabus. We will look at why things go wrong and how to implement change to prevent it from happening again or mitigate the risks. This masterclass will focus on risk and behaviour to improve patient safety. Key learning objectives: evaluating risk using mapping techniques safety interventions behaviour assessing safety culture The course is facilitated by Perbinder Grewal, a General & Vascular Surgeon, Human Factors & Patient Safety Trainer, and Emotional Intelligence Practitioner; leads on medical education both locally and nationally; Member of the Faculty of Surgical Trainers at the Royal College of Surgeons of Edinburgh; formerly lead for e-learning for healthcare for the Royal College of Surgeons of England; experienced trainer and coach who uses new insights to develop patient safety, staff engagement and psychological safety; has Postgraduate Certificates in Leadership and Coaching. Register- Posted
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- System safety
- Behaviour
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Event
Patient safety management
Patient Safety Learning posted an event in Community Calendar
This one day masterclass is part of a series of masterclasses focusing on how to use Human Factors in your workplace. Leadership in the NHS is the responsibility of all staff. Understanding human factors will allow healthcare to enhance performance, culture and organisation. These masterclasses have been re-designed in line with the new Patient Safety Syllabus. We will look at why things go wrong and how to implement change to prevent it from happening again or mitigate the risks. This masterclass will focus on non-technical skills to improve patient safety. Key learning objectives: task analysis cognitive overload reliability non-technical skills examples The course is facilitated by Perbinder Grewal, a General & Vascular Surgeon, Human Factors & Patient Safety Trainer, and Emotional Intelligence Practitioner; leads on medical education both locally and nationally; Member of the Faculty of Surgical Trainers at the Royal College of Surgeons of Edinburgh; formerly lead for e-learning for healthcare for the Royal College of Surgeons of England; experienced trainer and coach who uses new insights to develop patient safety, staff engagement and psychological safety; has Postgraduate Certificates in Leadership and Coaching. Register- Posted
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- Human factors
- Training
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Event
Systems approach to patient safety
Patient Safety Learning posted an event in Community Calendar
This one day masterclass is part of a series of masterclasses focusing on how to use Human Factors in your workplace. Leadership in the NHS is the responsibility of all staff. Understanding human factors will allow healthcare to enhance performance, culture and organisation. These masterclasses have been re-designed in line with the new Patient Safety Syllabus. It will look at why things go wrong and how to implement change to prevent it from happening again or mitigate the risks. This masterclass will focus on systems to improve patient safety. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/systems-approach-patient-safety-masterclass or click on the title above or email kate@hc-uk.org.uk hub members can receive a 20% discount. Email info@pslhub.org for discount code.- Posted
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- Human factors
- Organisational culture
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Community Post
Should patients be actively involved in following up their referrals?
Steve Turner posted a topic in Improving patient safety
- Secondary impact
- Tests / investigations
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(and 17 more)
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- Secondary impact
- Tests / investigations
- Treatment
- Transfer of care
- Reports / results
- Consultation
- Handover
- Organisation / service factors
- Flawed processes
- Long waiting list
- Deterioration
- Electronic Health Record
- Database
- Transparency
- Leadership exemplars
- Organisational Performance
- Patient engagement
- Information sharing
- Policies / Protocols / Procedures
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.- Posted
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- Secondary impact
- Tests / investigations
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(and 17 more)
Tagged with:
- Secondary impact
- Tests / investigations
- Treatment
- Transfer of care
- Reports / results
- Consultation
- Handover
- Organisation / service factors
- Flawed processes
- Long waiting list
- Deterioration
- Electronic Health Record
- Database
- Transparency
- Leadership exemplars
- Organisational Performance
- Patient engagement
- Information sharing
- Policies / Protocols / Procedures
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Community Post
Safety ratings published: are they helpful or not?
lzipperer posted a topic in Other countries and national agencies
- Risk assessment
- Benchmarking
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The US-based Leapfrog Group is a nonprofit organisation that routinely gauges hospital performance to inform purchaser choices as they navigate the healthcare system. While there are discussions on the value of the ratings ... they still pack a punch for organizations who do or don't do well. The latest set of numbers are out: Megan Brooks. One Third of US Acute-Care Hospitals Get 'A' on Patient Safety: Survey - Medscape - Nov 07, 2019.- Posted
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- Risk assessment
- Benchmarking
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Content Article
At the start of last summer, Merope Mills' 13-year-old daughter Martha was busy with life. She’d meet her friends in the park, make silly videos on her phone and play “kiss, marry, kill”. Her days were filled with books and memorising song lyrics. She’d wonder aloud if she might become an author, an engineer or a film director. Her future was brimming with promise, crowded with plans. By the end of the summer she was dead, after shocking mistakes were made at one of the UK’s leading hospitals. "Her preventable death is an example of what a hospital official described to us, in a barbarous phrase, as a 'poor outcome'. I will spend decades asking: why was my child the one to suffer such an unlikely fate?", writes Merope. Further reading Prevention of Future Deaths Report: Martha Mills- Posted
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- Patient death
- Children and Young People
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Content Article
Key points Harm caused by health care affects every health system in the world; the NHS is no exception. Research from the UK suggests that around 8-12% of admissions to hospitals will involve an adverse event, resulting in harm to the patient. Between half and one third of these adverse events are thought to be preventable. Similar figures are reported in international studies. The NHS has made great progress in tackling some specific causes of harm in hospitals. The number of people developing infections such as MRSA as a result of their care has remained low during this parliament. The proportion of patients receiving care that is free of four common adverse events, including pressure ulcers, has increased from 91% in July 2012 to 94% in February 2015. Staff reporting of hospital safety incidents continues to improve. There has been a sustained increase in the reporting of incidents during this parliament, while the percentage of staff saying they have witnessed an incident has remained roughly the same. This suggests that the proportion of hospital incidents going unreported has declined. Some warning signs are emerging among the NHS workforce. During this parliament, the percentage of staff who say there is a blame culture in their organisation has risen, as has the percentage of staff who have reported feeling unwell because of work-related stress. Around 40% of patients feel there aren’t always enough nurses on duty to care for them. We don’t know how safe health care services are outside of hospital. There is little published evidence from which to draw conclusions about levels of harm in primary and community care. Less than 1% of all reported incidents are in primary care, despite 90% of all patient contact taking place there, suggesting significant underreporting of harm in this care setting.- Posted
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- Patient safety incident
- Patient harmed
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Content Article
The new framework aims to: make things simpler. better reflect how care is actually delivered by different types of service as well as across a local area. connect CQC registration activity to its assessments of quality. The CQC will continue to use its existing quality ratings and five key questions, but this framework replaces the existing key lines of enquiry (KLOEs) and prompts with new ‘quality statements’, also known as 'we statements'. For each quality statement, the CQC will state which evidence it will always need to collect and look at, which will vary depending on the type of service,- Posted
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- Assessment and Recommendation
- Feedback
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Content Article
Summary of recommendations The following recommendations are made to support the delivery of a new regional policy/procedure for reporting, investigating and learning from adverse events. The Department of Health should work collaboratively with patient and carer representatives, senior representatives of Trusts, the Strategic Performance and Planning Group, Public Health Agency and Regulation and Quality Improvement Authority to co-design a new regional procedure based on the concept of critical success factors. Central to this must be a focus on the involvement of patients and families in the review process. Health and Social Care organisations should be required to evidence they are achieving these critical success factors to the Department of Health. The Department of Health should implement an evidence-based approach for determining which adverse events require a structured, in-depth review. This should clearly outline that the level of SAI review is determined by significance of the incident and the level of potential deficit in care. The Department of Health should ensure the new Regional procedure and its system of implementation is underpinned by ‘just culture’ principles and a clear evidence-based framework that delivers measurable and sustainable improvements. The Department of Health should develop and implement a regional training curriculum and certification process for those participating in and leading SAI reviews.- Posted
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- Patient safety incident
- Investigation
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Content Article
Ministry of Justice Annual Report and Accounts 2020‑21
Patient Safety Learning posted an article in Legal matters
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- Legal issue
- Data
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