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Showing results for tags 'Organisational culture'.
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Content ArticleIn a previous blog, 'What is a Whistleblower',[1] Hugh drew attention to negative perceptions of whistleblowers in the eyes of some people. A crossword and clues were published on the hub to emphasise how wrong such perceptions are and how damaging they can be, with serious patient safety implications.[2] This follow-up outlines the nature of the journey travelled by some NHS staff who have spoken up and the problems which still exist with NHS whistleblowing culture. It provides a link to an attached file which contains the answers to each clue. The attachment also shows the completed crossword in larger, easier-to-read, format than the small illustration in this blog. There is a further link to companion notes which expand on the answer to each clue. These notes contain more detail about the realities of speaking up. They reinforce the link between hostility towards those who speak up and an ongoing series of patient safety scandals.[7-21]
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Content ArticlePositive defensive medicine describes an approach to healthcare that involves excessive testing, over-diagnosing and overtreatment. Negative defensive medicine, on the contrary, describes an approach where doctors avoid, refer or transfer high risk patients. This article in Patient Safety in Surgery examines how both defensive medicine approaches can contribute to medical errors.
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- Organisational culture
- Safety culture
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Content ArticleDr Robert D. Glatter, medical advisor for Medscape Emergency Medicine, Dr Megan Ranney, professor of emergency medicine and the academic dean at Brown University School of Public Health and Dr Jane Barnsteiner, emeritus professor at the University of Pennsylvania School of Nursing, discuss the tragic case involving RaDonda Vaught, who was an ICU nurse who was recently convicted in Tennessee of criminally negligent homicide and gross neglect following a medical error due to administration of the wrong medication that led to a patient's death.
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- Human error
- Legal issue
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Content ArticleThis is part of our new series of Patient Safety Spotlight interviews, where we talk to people about their role and what motivates them to make health and social care safer. Ehi talks to us about how building a connection with patients makes their care safer, the safety issues caused by lack of regulation, accountability and transparency, and the moral responsibility each of us has to speak up when we spot safety risks or see a patient harmed.
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- Africa
- Transparency
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Content ArticleThe Ockenden review of maternity services at Shrewsbury and Telford NHS Trust uncovered the biggest maternity scandal in the NHS’s history. The report concludes that 201 babies and nine mothers might have survived if they had received better care and raises serious questions about how avoidable deaths and injury to so many mothers and babies could have happened Staffing pressures, training gaps, and overstretched rotas all contributed. But so did a failure to follow clinical guidelines or to investigate and learn from mistakes. Staff did not listen to patient experience, women were blamed or held responsible for poor outcomes—even their own deaths—and there was a lack of compassion in how patients were treated and responded to. Inadequate leadership and a bullying culture left staff feeling unable to raise concerns or escalate problems Is there a failure to listen to women across the NHS? Why are women’s voices ignored and their health concerns brushed aside?
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- Womens health
- Obstetrics and gynaecology/ Maternity
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Content ArticleFollowing the Shrewsbury maternity scandal where "at least 201 babies would have survived with better care", outgoing CQC chief inspector of hospitals Ted Baker said the NHS should listen to criticism to be able to change. Ted Baker said the NHS faced a resistance to being challenged and "for anyone to refuse to listen to criticisms of what the NHS does I think is a big mistake." Listen to Ted Baker's, CQC's outgoing chief inspector, full interview on Times Radio.
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- Organisational culture
- Organisation / service factors
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Content ArticleIn August 2021, University Hospitals North Midlands Trust (UHNM) commissioned brap and Roger Kline to conduct a review of bullying and harassing behaviours across the Trust. The purpose of the review was to understand: the nature of bullying/harassment within the Trust (what types of behaviour are staff being subject to?) the basis of bullying/harassment (is poor treatment linked to people’s protected characteristics or other aspects of identity (such as language spoken) the scope of bullying behaviour (how frequently are staff subject to bullying behaviours and are they concentrated in particular sites, job roles, or bands? Are staff subject to bullying from patients/visitors or primarily from colleagues?) the response to any unprofessional behaviours (do people feel confident reporting or challenging poor behaviour? If not, why?) the conditions that allow bullying behaviours to continue (what aspects of organisational culture may be contributing to the persistence of bullying? Are stress, workloads, or poor management practice roots causes?) The review was prompted by anecdotal claims of inappropriate behaviour within some parts of the Trust. (The Trust has a range of mechanisms to monitor levels of bullying and harassment, including national and local surveys, reports from the Freedom to Speak Up Guardians, Dignity at Work reports, and staff listening events.) In addition, a survey conducted by BAPIO/LNC raised concerns about the treatment of doctors and how this intersected with issues around race. As such, this review sought to explore whether the treatment of Black and minority ethnic (BME) people was different to that of White British staff.
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- Bullying
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Content ArticleThis analysis by Paul Gallagher, Health Correspondent at i News discusses the prevalence of maternity scandals in the NHS, in light of the publication of the Ockenden Review into failings in maternity services at Shrewsbury and Telford NHS Trust. He highlights the importance of implementing the findings of the review, particularly focusing on the need for a comprehensive plan to tackle workforce shortages. He also highlights the continued existence in some trusts of a culture of covering up harm, evidenced by staff at Shrewsbury being pressured not to talk to investigators, right up until the report's publication.
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- Maternity
- Patient death
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Content ArticleAre Employment Tribunals the right institution to handle whistleblowing cases? This report aims to open the debate by examining the evidence. A research team from the University of Greenwich analysed Employment Tribunal judgements in England and Wales, for cases that included a Public Interest Disclosure claim, between 2015 and 2018. A total of 603 cases were included in the analysis. Included in the study were only those cases that went to at least preliminary hearing. Cases that were withdrawn before preliminary hearing were discounted.
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- Whistleblowing
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A survivors guide to whistleblowing (19 January 2021)
Patient Safety Learning posted an article in Whistle blowing
This blog asks: What is a whistleblower? Why do whistleblowers endure all forms of retaliation for the sake of truth? What does the whistleblower's cycle of abuse often look like? How to blow the whistle without blowing your career? What might non-disclosure agreements settlements include? What do whistleblowers say about whistleblowing? What can be done to protect whistleblowers?- Posted
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- Whistleblowing
- Speaking up
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Content ArticleThis issue of Hindsight concerns ‘the new reality’ that we are facing. It includes a wide variety of articles from frontline staff and specialists in safety, human factors, psychology, aeromedical, and human and organisational performance in aviation. There are also insights from healthcare, shipping, rail, community development and psychotherapy.
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- Human factors
- Fatigue / exhaustion
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Content Article
Safe to speak up? NHS Staff Survey Results 2021
Patient Safety Learning posted an article in Culture
In this blog, Patient Safety Learning analyses the results of the NHS Staff Survey 2021, specifically focusing on responses relating to reporting, speaking up and acting on safety concerns. It reflects on the importance of staff feeling able to speak up about patient safety incidents and the implications when this is not the case. It describes the NHS’s current approach to creating a patient safety culture and emphasises the need for NHS England and NHS Improvement, in partnership with the National Guardian and Care Quality Commission, to bring forward robust and specific commitments to drive this work forward.- Posted
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- Staff safety
- Speaking up
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Content ArticleThis report published by the National Guardian’s Office shows the experience of Freedom to Speak Up Guardians amid the continued pressure of the pandemic on the healthcare sector. Although the majority of guardians who responded to the survey were positive about the culture of their organisation, the results highlight a decline in factors that make it easy for staff to speak up, including support from leadership.
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- Speaking up
- Whistleblowing
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NHS Staff Survey Results 2021 (30 March 2022)
Patient-Safety-Learning posted an article in Culture
The NHS Staff Survey is one of the largest workforce surveys in the world and is carried out every year to improve staff experiences across the NHS. It asks staff in England about their experiences of working for their respective NHS organisations. 648,594 staff responded to the survey this year. The full results of the 2021 NHS Staff Survey are published on the NHS Staff Survey website.- Posted
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- Staff factors
- Survey
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Content ArticleAt the moment, we’ve got maternity scandals day in, day out, which are pure evidence of the fact that our maternity units are just not up to scratch. They’re unsafe for mothers, unsafe for babies, and that is not acceptable. Suzanne White, a former radiographer and a clinical negligence lawyer for the past 25 years, looks at the maternity safety scandals across the NHS and considers if any lessons have been learnt.
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- Maternity
- Investigation
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Content ArticleAlthough leaders might say they value inquisitive minds, in reality most stifle curiosity, fearing it will increase risk and inefficiency. Harvard Business School’s Francesca Gino elaborates on the benefits of and common barriers to curiosity in the workplace and offers five strategies for bolstering it.
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- Staff factors
- Organisational culture
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Content ArticleThe 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.
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- Organisational Performance
- Organisational culture
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Content Article
Civility Saves Lives Infographics
Patient Safety Learning posted an article in Good practice
Civility Saves Lives have created a number of infographic each with a key message of civility. A selection are shown below and more can be found through the link at the bottom of the page.- Posted
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- Safety culture
- Organisational culture
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Content Article
How are Trusts measuring safety culture? A blog from Annie Hunningher
Annie Hunningher posted an article in Culture
Annie Hunningher highlights the difficulties in measuring an organisation's safety culture and the lack of validated measurement tools available.- Posted
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- Safety culture
- Organisational culture
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Content ArticleAn introduction to Appreciative Inquiry from NHS England and some team-based exercises for staff.
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- Organisational culture
- Communication
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Content ArticleSafety culture refers to the way patient safety is thought about, structured and implemented in an organisation. Safety climate is a subset of this, focused on staff attitudes about patient safety. In recent years, a great deal of research has explored ways to measure safety culture and safety climate in health care. There is a growing emphasis on interventions to improve organisational safety culture and staff attitudes towards safety. It is assumed that improving safety culture will directly or indirectly affect patient outcomes. This evidence scan examines whether there is any empirical evidence to support this assumption.
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- Safety culture
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Content Article
Safety culture discussion cards (Eurocontrol)
Patient Safety Learning posted an article in Good practice
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.- Posted
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- Safety culture
- Organisational culture
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Content ArticleThe Maternal and Neonatal Health Safety Collaborative (MNHSC), is providing each maternal and neonatal service with an opportunity to assess their safety culture as part of the programme of improvement work across England. Organisations within each wave of the collaborative will be given the opportunity to undertake a culture survey, and then a repeat survey after 12-18 months. The culture of an organisation, team and staff attitudes can have a tangible impact on patient safety and outcomes. There is great value in assessing the safety culture; the results can inform the local improvement plans. The organisation will be supported through the process. This document explains more about the SCORE survey, what it measures, and what it means for the team and improvement projects.
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- Organisational culture
- Maternity
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Content ArticleThis article in The Journal of Post-Acute and Long-Term Care Medicine looks at the issue of systemic racism in long-term services and supports (LTSS) including nursing homes and home- and community-based care in the USA. The authors highlight segregation and disparities, with Black, Indigenous, and persons of colour (BIPOC) users having less access to quality care and reporting poorer quality of life. The authors make a number of policy recommendations to address these health inequalities in LTSS: Targeted increases to Medicaid reimbursement tied to direct care, and targeted enhanced Medicare and/or Medicaid reimbursement to LTSS providers that serve a disproportionate share of Medicaid or underserved older adults. Pay for performance incentives should focus on improving care among LTSS providers who serve individuals with disadvantaged status because of systemic racism and that operate above and beyond a person's clinical severity and comorbidity. The Centers for Medicare & Medicaid Services (CMS) should develop an overall health equity measure which would help capture how well providers meet the needs of diverse populations. Care Compare quality scores by race and ethnicity should be used internally and shared with states to develop culturally appropriate policies. Race and ethnicity-specific quality measures should be included on state-level report cards to incentivise action among states and tailor solutions to the local context. Promote culture change in nursing homes, with an ultimate goal of creating a person-centred, homelike model of care. Expand access to Medicaid-waivered home- and community-based services. Ensure that home- and community-based services are culturally appropriate. Promote integrated home- and community-based programs that can be targeted to BIPOC users to address existing disparities in outcomes.
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- Health inequalities
- Health Disparities
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