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Content ArticlePatient Safety Learning, Health Plus Care and BD are holding a series of webinars on patient safety on the frontline, exploring burning patient safety issues and engaging with frontline health care workers, clinical leaders and patient safety experts. The first of these webinars is at 11.00am (BST) on Wednesday 16 September: Responding to the treatment backlog safely. This blog sets out some of the key points to inform the webinar.
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Content Article
Eric Kutscher: First, do no harm—but did I?
Patient Safety Learning posted an article in Blogs
The cost of providing care during a pandemic is seeing firsthand the evolution of medical knowledge, and wishing current data could have guided past decisions, says Eric Kutscher in this BMJ Opinion article. -
Content ArticleHealthcare organisations are designed to achieve consistent and reproducible outcomes when faced with planned, predictable or ‘routine’ emergencies. Unfortunately, the more robust the system, the less agile it is when faced with a novel clinical crisis. This is not surprising, as it is impossible to create emergency operating procedures for every new or unforeseen catastrophe. Similarly, many surgeons in positions of leadership have limited exposure to executive decision-making or clinical expertise outside their area of specialist training. It is not unreasonable therefore for surgical leaders and their organisations to feel overwhelmed by complex and evolving crises, such as the recent COVID-19 pandemic. At such times, it is important to reflect on key strategies that can provide pragmatic, timely and cohesive means of restructuring the delivery of surgical care at an organisational level.
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Content ArticleWith evidence of the impact of COVID-19 on BAME communities, on 15 April 2020 NHS England CEO Simon Stevens convened a meeting of leaders in healthcare and representative bodies such as the British Medical Association and Royal College of Nursing to agree a plan of action to support staff. The NHS response has since been underpinned by three principles of protecting, supporting, and engaging staff.
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Content ArticleIn order to inform clinical and research practice in secondary care in light of the COVID-19 pandemic, an online survey was used to collect public opinions on attending hospitals. The survey link was circulated via the National Institute for Health Research (NIHR) Public Involvement (PPI) Leads network and social media. Data collection included self-identified risk status due to comorbidity or age, and 100 point Likert-type scales to measures feelings of safety, factors affecting feelings of safety, intention to participate in research, comfort with new ways of working and attitudes to research. Results for feelings of safety scales indicate two distinct groups: one of respondents who felt quite safe and one of those who did not. *Note: This article is a preprint and has not been peer-reviewed.
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Content ArticleCancer and multiple non-cancer conditions are considered by the Centers for Disease Control and Prevention (CDC) as high risk conditions in the COVID-19 emergency. Professional societies have recommended changes in cancer service provision to minimize COVID-19 risks to cancer patients and health care workers. However, we do not know the extent to which cancer patients, in whom multi-morbidity is common, may be at higher overall risk of mortality as a net result of multiple factors including COVID-19 infection, changes in health services, and socioeconomic factors. This paper from Lai et al. predicts estimate of excess deaths in cancer patients related to the COVID-19 emergency using data from England, Northern Ireland and US.
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Content ArticleThe COVID-19 pandemic has placed an enormous strain on health care workers, and its potential impact has implications for the physical and emotional well-being of the workforce. As hospital systems run well over capacity, facing possible shortages of critical care medical resources and personal protective equipment as well as clinician deaths, the psychological stressors necessitate a strong well-being support model for staff. In this commentary, Ripp et al. describe how an MSHS Employee, Faculty, and Trainee Crisis Support Task Force—created in early March 2020 and composed of behavioural health, human resources, and well-being leaders from across the health system—used a rapid needs assessment model to capture the concerns of the workforce related to the COVID-19 pandemic. The task force identified 3 priority areas central to promoting and maintaining the well-being of the entire MSHS workforce during the pandemic: meeting basic daily needs; enhancing communications for delivery of current, reliable, and reassuring messages; and developing robust psychosocial and mental health support options. Using a work group strategy, the task force operationalised the rollout of support initiatives for each priority area. Attending to the emotional well-being of health care workers has emerged as a central element in the MSHS COVID-19 response, which continues to be committed to the physical and emotional needs of a workforce that courageously faces this crisis.
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How the pandemic defeated America
Patient Safety Learning posted an article in Blogs
How did it come to this? A virus a thousand times smaller than a dust mite has humbled and humiliated the planet’s most powerful nation. America has failed to protect its people, leaving them with illness and financial ruin. The breadth and magnitude of its errors are difficult, in the moment, to truly fathom. Ed Yong in an article in The Atlantic highlights how despite ample warnings the country was unprepared for a pandemic, and suggests it remains unprepared for the next one. -
Content ArticleIn 2019 The King's Fund discussed the following eight key problems facing social care and called for reforms to address them: means testing: social care is not free at point of use like the NHS catastrophic costs: some people end up paying large amounts and even selling their homes to pay for care unmet need: many people go without the care and support they need quality of care: a wide spectrum of concerns, from 15-minute care visits to neglect and lack of choice and control workforce pay and conditions: staff are underpaid, leading to high vacancy rates and turnover market fragility: care providers go out of business or hand back contracts disjointed care: health and care is not integrated around the individual and causes issues such as delayed transfers of care from hospital the ‘postcode lottery’: there is unwarranted variation between places in access to care and its quality. The pandemic has shone an uncompromising light on the social care sector. In this article, Simon Bottery explores how COVID-19 has exacerbated these pre-existing challenges.
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WHO EMRO: Mental health and psychosocial stress
Patient Safety Learning posted an article in Mental health
During the COVID-19 pandemic, you might experience immense pressure and stressors. The World Health Organization has provided an infographic highlighting what stress is, how it might affect you and practical tips on what you can do. -
Content ArticleIs the Government oblivious to the avoidable harm caused to non-COVID patients as a result of disruption to health services during the pandemic? Or worse, is it trying to bury bad news? On 18 June 2020, Peter Walsh, Chief Executive, Action against Medical Accidents (AvMA), together with other organisations and experts, wrote to the Prime Minister and the First Ministers of the UK nations about avoidable harm being caused to non-COVID patients as a result of prolonged disruption to health services since the start of the COVID-19 pandemic. However, at the time of writing this blog, there has been no response to that letter Peter asks whether the failure to acknowledge the problem and ensure that it is urgently addressed, or even to show empathy with those affected, is at best irresponsible and deeply disrespectful to all those affected or at risk, or, at worst, whether it could be a conscious decision to bury bad news and avoid responsibility.
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Content ArticlePatient Safety Learning’s formal response to the Healthcare Safety Investigation Branch’s (HSIB) report looking into a safety risk concerning guidelines around the use of personal protective equipment to reduce the risk of COVID-19 transmission when delivering care in people’s homes.
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Content ArticleThis article from Michael Ollove in USA Today compares international activities responding to the COVID-19 pandemic to those of the United States to illustrate gaps and highlight areas where coordination and collaboration are desperately needed to move the US effort forward.
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As college students return, a crisis in campus care awaits
lzipperer posted an article in Coronavirus (COVID-19)
Health services in college and university campuses are under pressure to respond to COVID-19 with patient safety in mind. This article from Abelson et al. in The Seattle Times discusses weakness in university health services that undermine their ability to do so. It shares interviews with students that discuss misdiagnosis and diagnostic delays due to the impact of the pandemic. -
Content ArticleThis report from the American Association of Medical Colleges outlines 11 government-focused recommendations to support and motivate a United States collective plan to reset the response to the COVID pandemic. Informed by expert insights from a variety of fields, the document shares actionable suggestions on topics such as testing improvement, national standards on face coverings and other safety protocols, and vaccine deployment planning.
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Content Article
Letter from America: “We got trouble my friends”
lzipperer posted an article in Letter from America
In her latest Letter from America, Lorri Zipperer explores the lack of coordination that is undermining the current US response to the COVID-19 crisis and preparation for the next phase. Letter from America is the latest in a Patient Safety Learning blog series highlighting new accomplishments and patient safety challenges in the United States. -
Content ArticleWith a lot of medical care on hold during the coronavirus pandemic, Paul Landau, founder and CEO of digital cancer care company Careology, looks at the UK’s ‘next big crisis’.
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Content ArticleThe Queen’s Nursing Institute (QNI) has published a major new report on the effect of the COVID-19 pandemic on the UK’s nursing and residential homes.
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Content Article
Faded rainbows
Claire Cox posted an article in Blogs
As the colourful rainbows in people's windows are beginning to fade, is the public support for our frontline workers also fading? Has gratitude and thank you's been replaced with frustration and anger from the public? In her latest blog, critical care outreach nurse Claire reflects on the impact this is having on the wellbeing of already exhausted frontline staff. -
Content ArticleThis project, led by a team of researchers, aims to give a voice back to the critical care nurse so that there is a much greater understanding of the mental challenges of the profession and so that appropriate supportive measures can be developed that improve working conditions. In order to carry out the research, the team need volunteers to participate and share their own views and experiences of mental health and well-being in the profession. We are looking for any active critical care nurse who is open to discussing mental health and well-being to shed light on what is a too often ignored and overlooked subject. Find out more about the project and how to sign up via the link below.
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Content ArticleIn this article, published by The Justice Gap, Theo Huckle QC discusses the issue of people not receiving treatment because of diversion of pre-existing NHS resources to the fight against the COVID-19 pandemic. There are legal issues which arise about the rights of citizens to receive – and continue to receive – treatment from their health service. What are those rights and what right do Governments in the UK or the health Trusts have to reduce services and not treat existing patients because of the current global health crisis?
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Content ArticleIn this webinar, Dr Matt Inada-Kim, Consultant Acute Physician, presents his idea for a COVID-19 virtual ward. Matt talks about using tools and information to empower people to monitor themselves at home so that they know when to ask for help. Early recognition would improve the chances of survival, particularly where symptoms are less obvious but very serious with the potential for rapid deterioration, for example low oxygen levels. Matt uses a Remote Community Oximetry Care (RECOxCARE) model to frame his thinking.
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Content Article
NIHR: COVID-19 research voices
Patient Safety Learning posted an article in Blogs
Thomas Walters, a Senior Research Nurse from London, describes his experience of going back to ICU and how that’s renewed his appreciation for research. Part of the National Institute for Health Research (NIHR) COVID-19 Research Voices series. -
Content ArticlePippa Kent is one of those people who were told that from 1 August they no longer needed to shield to protect themselves from the coronavirus. While you might assume that, having been trapped inside her house for the past 18 weeks, she would embrace this newfound freedom with enthusiasm, the reality remains far from it. For those whose pre-existing medical conditions greatly increase the risk from COVID-19, there, naturally, is hesitation to embrace this sweeping change. Read Pippa's blog, published in the Guardian, on her first trips out and the fears she felt.
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Content ArticleThis is a report and survey analysis from Runnymede, the UK’s leading independent thinktank on race equality and race relations. Results show that black and minority ethnic (BME) people face greater barriers in shielding from coronavirus as a result of: the types of employment they hold (BME men and women are overrepresented among key worker roles)having to use public transport moreliving in overcrowded and multigenerational households morenot being given appropriate PPE (personal protective equipment) at work. In all of these areas, most BME groups are more likely to be over-exposed and under-protected compared with their white British counterparts.
