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Found 275 results
  1. News Article
    U.S. News has just released its list of the best hospitals with associated rankings and ratings. Scores are based on several factors, including survival, patient safety, nurse staffing and more. U.S. News reviews hospitals performance in 15 adult specialties, 10 pediatric specialties and 17 surgical procedures and medical conditions affecting millions of people across the country. Find all of the rankings and ratings here
  2. Content Article
    This maturity matrix from the Good Governance Institute is a resource designed to support organisations to self-assess whether they are appropriately applying the key principles of good governance practice in relation to quality assurance.
  3. Content Article
    No two countries are alike when it comes to organising and delivering healthcare for their people, creating an opportunity to learn about alternative approaches. Schneider et al. compared the performance of 11 high-income countries healthcare systems.
  4. News Article
    A trust which was heavily criticised for poor infection prevention and control last summer has been praised for making improvements. East Kent Hospitals University Foundation Trust was served with an enforcement notice by the Care Quality Commission in August last year, citing “serious concerns” about patient safety. The trust had twice the national rate of patients infected with COVID-19 after admission to hospital. But a new report, issued today, found significant improvements, with several areas of outstanding practice. The conditions imposed on the trust after last year’s inspection of the William Harvey Hospital in Ashford were also lifted, following the visit by the CQC in early March. Cath Campbell, CQC’s head of hospital inspections in the South East, said the improvements were particularly commendable as the trust had been under extreme pressure as a result of the pandemic. She said: “Leaders adopted learnings from other trusts, and from NHS Improvement which led to the development of a detailed infection prevention and control improvement plan. The trust then set up an improvement group to focus on implementing the actions in the plan and put a committee in place to review internal audit data and led improvements based on this information. “Although there were still one or two areas for improvement which we have advised the trust to look at now, overall this is a very positive report.” Read full story (paywalled) Source: HSJ, 23 April 2021
  5. News Article
    Regulators have sent an improvement director into a North West acute trust amid multiple allegations of poor care and ‘cover up’ across different specialties. University Hospitals of Morecambe Bay Foundation Trust, which spent 18 months in special measures midway through the last decade, is again now the subject of significant regulatory intervention from NHS England. The regulator has appointed Simon Bennett as a board-level improvement director, which comes after he undertook a similar assignment at the struggling Stockport FT. It comes amid ongoing external investigations into the trust’s urology and trauma and orthopaedics specialties, where serious allegations have been made about attempts to cover up poor care. The trust has a troubled history of care failings and regulatory intervention, including a major maternity scandal which culminated in the Kirkup Inquiry in the first half of the 2010s, and being placed in special measures in 2014. It was widely recognised that positive progress was subsequently made to implement the inquiry recommendations and improve services, which culminated in the trust exiting special measures in late 2015, and being rated “good” by the CQC in early 2017. However, the recent allegations and investigations have again brought regulatory intervention. Read full story (paywalled) Source: HSJ, 20 April 2021
  6. Content Article
    The 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.
  7. Content Article
    The focus on error detection and its management has not produced the expected gains in patient safety, primarily because these methods are not well suited to a complex adaptive system such as healthcare. Behaviours that produce errors are variations on the same processes that produce success, so focusing on successful practices may be a more effective tactic. One approach to focusing on success is positive deviance. While positive deviance can be used to describe the behaviour of an exemplary individual, the term can also be extended to describe the behaviours of successful teams and organisations.  Originating in international public health projects, positive deviance has recently been embraced to improve quality and safety of healthcare delivered in organisations. The premise is that solutions to common problems mostly exist within clinical communities rather than externally with policy makers or managers, and that identifiable members of a community have tacit knowledge and wisdom that can be generalised. Lawton et al. explain more in this BMJ article.
  8. Content Article
    Safety culture has been shown to be a key predictor of safety performance in several industries. It is the difference between a safe organisation and an accident waiting to happen. Thinking and talking about our safety culture is essential for us to understand what we do well, and where we need to improve. These cards from Eurocontrol are designed to help us to do this.
  9. News Article
    With the annual NHS Staff Survey recently published, expectation was that this year might look a little different, all things considered. For the mental health sector, the dial didn’t move massively on key questions. The sector still came out bottom for staff who agreed they’d be happy with the standard of care if a friend or family member needed it - otherwise called the “family and friends test”. Although the survey was not that revelatory this year, it is still a helpful barometer for trusts’ safety and quality culture. Sheffield Health and Social Care Foundation Trust comes out lowest on all of the main quality and safety-related questions. On the crucial family and friends question, just 47% of the trust’s staff agreed that would be happy with the standard of care. The trust has been one of the worst performers on the survey for a number of years but appears to have deteriorated further. Sheffield Health and Social Care FT also came out worst on the following key safety culture related questions: When errors, near misses or incidents are reported, my organisation takes action to ensure that they do not happen again I would feel secure raising concerns about unsafe clinical practice My organisation acts on concerns raised by patients/service users. The last two questions are a vital indicator of a trust’s approach to safety and quality. If staff do not feel secure to raise concerns, or if a trust does not act on patient concerns can it really address problems before they escalate? Read full story (paywalled) Source: HSJ, 12 March 2021
  10. Content Article
    In this blog, Patient Safety Learning outlines the key points included in its response to the Care Quality Commission’s (CQC) consultation on their new strategy from 2021, identifying the opportunities this presents for the health and social care regulator to help improve patient safety.
  11. News Article
    Clinicians within a major teaching hospital’s cancer services have raised multiple concerns over patient safety, which they believe have resulted from badly planned service changes in response to the covid crisis. HSJ has spoken to several staff members who have worked in the haematology speciality at University Hospitals Birmingham Foundation Trust since last June, when the services underwent significant changes to free up capacity for coronavirus patients. This involved most haematology services at Heartlands Hospital in east Birmingham moving to the trust’s main Queen Elizabeth Hospital site in Edgbaston. The staff, who all wished to remain anonymous, told HSJ the transfer happened at just one week’s notice and was poorly planned. Once implemented, they said QEH’s newly enlarged service suffered from extreme staffing shortages, leading to several “never events”, such as patients being given the wrong blood type. In one resignation letter, a nurse who had transferred to QEH told managers patients’ “basic care needs are not being met”. The nurse said most shifts were understaffed, with examples of three nurses looking after 30 patients and added in the resignation letter: “I am witnessing strong and knowledgeable colleagues breaking down on each shift. “Furthermore, never events are happening at an alarming rate, necessary resources are commonly unavailable and communication between all levels of seniority is poor…" Read full story (paywalled) Source: HSJ, 2 February 2021
  12. News Article
    Bosses at the controversial NHS gender-change clinic for children have been removed after regulators highlighted a string of failures. The management team of the Gender Identity Development Service (GIDS) in London has been 'disbanded', documents reveal. It comes weeks after the clinic, run by the Tavistock and Portman NHS Trust, was judged 'inadequate' by the Care Quality Commission. Watchdogs said staff were afraid to raise concerns about patient safety for fear of 'retribution' from bosses. A report said: 'Staff did not always manage risk well. Many of the young [patients] were vulnerable and at risk of self-harm." The management team of the Gender Identity Development Service (GIDS) in London has been 'disbanded', documents reveal. It comes weeks after the clinic, run by the Tavistock and Portman NHS Trust, was judged 'inadequate' by the Care Quality Commission. "The size of the waiting list meant staff were unable to proactively manage the risks to patients waiting for a first appointment." Read full story Source: MailOnline, 31 January 2021
  13. Content Article
    A conversation with John Wilkes (AstraZeneca), Clifford Berry (Takeda), Amy D. Wilson, Ph.D. (Biogen), and Jim Morris (NSF Health Sciences). This article is the first part of a two-part roundtable Q&A focused on human performance in pharmaceutical operations. Part 1 discusses key drivers for human performance improvement, compares lean manufacturing and human performance programmes, and provides perspectives on human performance in the context of the rapid scale-up and production of COVID-19 therapeutics and vaccines.  Part 2 reviews human performance in the context of company investigation and CAPA programmes.
  14. Content Article
    A conversation with John Wilkes (AstraZeneca), Clifford Berry (Takeda), Amy D. Wilson, Ph.D. (Biogen), and Jim Morris (NSF Health Sciences). This article is the second part of a two-part roundtable Q&A on the topic of human performance in pharmaceutical operations. Part 1 evaluated the underpinnings of human performance and provided advice to those individuals managing rapid production scale-up to support COVID-19 production demand. Here in Part 2, human performance in the context of investigation and CAPA programmes is considered.
  15. Content Article
    This guide from the World Health Organization (WHO) focuses on actions required at the national, district and facility levels to enhance quality of health services, providing guidance on implementing key activities at each of these three levels. It highlights the need for a health systems approach to enhance quality of care, with a common understanding on the activities needed by all stakeholders. The guide articulates the key actions required to improve the quality of health services for the entire population. It recognises that the path varies for each country, district and facility – stimulating the reader to consider multiple factors and entry points for action. This planning guide is for staff working at all levels of the health system (i.e. national, district and facility) who have a role in enhancing the quality of health services. It is also relevant to all stakeholders initiating and supporting action at facility, district and/or national levels both in the public and private sectors.
  16. Content Article
    Despite the application of a huge range of human factors (HF) principles in a growing range of care contexts, there is much more that could be done to realise this expertise for patient benefit, staff well-being and organisational performance. Healthcare has struggled to embrace system safety approaches, misapplied or misinterpreted others, and has stuck to a range of outdated and potentially counter-productive myths even has safety science has developed. One consequence of these persistent misunderstandings is that few opportunities exist in clinical settings for qualified HF professionals. Instead, HF has been applied by clinicians and others, to highly variable degrees—sometimes great success, but frequently in limited and sometimes counter-productive ways. Meanwhile, HF professionals have struggled to make a meaningful impact on frontline care and have had little career structure or support. However, in the last few years, embedded clinical HF practitioners have begun to have considerable success that are now being supported and amplified by professional networks. The recent COVID-19 experiences confirm this. Closer collaboration between healthcare and HF professionals will result in significant and ultimately beneficial changes to both professions and clinical care.
  17. Content Article
    This study in BMJ Open considers how the usefulness of internal whistleblowing is affected by other institutional processes in healthcare organisations. The authors examine how the effectiveness of formal inquiries (in response to employees raising concerns) affects the utility of whistleblowing. The study used computer simulations to test the utility of several whistleblowing policies in a variety of organisational contexts. This study found that: organisational inefficiencies can have a negative impact on the benefits of speaking up about poor patient care where resources are limited and reviews less efficient, it can actually improve patient care if whistleblowing rates are limited including 'softer' mechanisms for reporting concerns (for example, peer to peer conversation) alongside whistleblowing policies, can overcome these organisational limitations.
  18. Content Article
    The Care Quality Commission (CQC) has published the second report of Professor Glynis Murphy’s independent review of its regulation of Whorlton Hall between 2015 and 2019. CQC commissioned Professor Murphy to conduct an independent review to look at whether the abuse of patients at Whorlton Hall could have been recognised earlier by the regulatory process and to make recommendations for how CQC can improve its regulation of similar services in the future. In addition, CQC asked Professor Murphy to conduct a review of international research evidence to look at how abuse is detected within services for adults with a learning disability and autistic people and how such detection can be improved. The first report of Professor Murphy’s review made a number of recommendations for CQC to strengthen its inspection and regulatory approach for mental health, learning disability and/or autism services. This second report outlines the progress that CQC has made to implement the recommendations. This includes publication of the final report of its review of restraint, seclusion and segregation; work on closed cultures and the development of a tool for rating support plans.
  19. News Article
    An Essex maternity department has been served with further warnings by the Care Quality Commission (CQC) and again rated “inadequate”. Serious concerns were raised about the services at Basildon University Hospital in the summer, after several babies were found to have been starved of oxygen and put at risk of permanent brain damage. Despite the CQC issuing warning notices to Mid and South Essex Foundation Trust in June 2020, a subsequent visit on 18 September found multiple problems had persisted. The CQC’s findings at Basildon included: the service was short-staffed and concerns were not escalated appropriately multidisciplinary team working was “dysfunctional”, which sometimes led to safety incidents doctors, midwives and other professionals did not support each other to provide good care. Read full story (paywalled) Source: HSJ, 19 November 2020
  20. Content Article
    COVID-19 has disrupted many industries and reshaped the way most organisations operate. Healthcare organisations have been especially affected by the disruptive force of this global pandemic. Yet all hope is not lost. Gallup analytics discovered that business units experiencing disruption are at an increased advantage and more resilient than their peers when employee engagement is strong.
  21. Content Article
    Elderly people in care homes in Cornwall were abused and neglected while failings led to reports of concerns not being investigated, a new Safeguarding Adults Review has found. The Morleigh Group, which operated seven homes in Cornwall and has since shut down, was exposed in a BBC Panorama investigation in 2016. A new Safeguarding Adults Review which was commissioned as a result of the TV show has been published making a number of recommendations to all agencies which were involved in the case. The review was completed in April 2019 but has only just been made public - Rob Rotchell, Cornwall Council Cabinet member for adult social care said that this was due to the number of agencies being involved.
  22. Content Article
    The NHS Staff Survey is one of the largest workforce surveys in the world and has been conducted every year since 2003. It asks NHS staff in England about their experiences of working for their respective NHS organisations. Follow the link below for further information and to complete the survey.
  23. Community Post
    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.
  24. Content Article
    Journey behind the front lines of the coronavirus pandemic with Northwell Health, New York’s largest health system. What was it like at the epicenter, inside the health system that cared for more COVID-19 patients than any other in the United States? Leading through a pandemic: The inside story of lhumanity, innovation and lessons during the COVID-19 crisis takes readers inside Northwell Health, New York’s largest health system. From the C-suite to the front lines, the book reports on groundwork that positioned Northwell as uniquely prepared for the pandemic.
  25. News Article
    Yesterday marked the second World Patient Safety Day, and this year’s theme shined a light on health worker safety – those on the frontline of the pandemic have been selfless in their sacrifices to care for an ailing global population. What has become ever clearer is that a health system is nothing without those who work within it and that we must prioritise the safety and wellbeing of health workers, because without safe health workers we cannot have safe patients. Improving maternity safety has been a priority for some time – although rare, when things go wrong the consequences are unthinkable for families and the professionals caring for them. Maternity negligence makes up 50% of the total value of negligence claims across all NHS sectors, according to the latest NHS Resolution annual report and accounts. It states there were claims of around £2.4 billion in 2019/20, which is in the region of £6.5 million a day. This cost says nothing of the suffering families and professionals associated. However, without investing in the maternity frontline we cannot hope to make integral systemic changes to improve maternity safety and save mothers’ and babies’ lives, writes Sara Ledger, head of research and development at Baby Lifeline in the Independent. "We owe it to every mother and baby to rigorously and transparently scrutinise the safety of maternity services, which will be in no small way linked to the support staff receive." Read full story Source: The Independent, 17 September 2020
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