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Showing results for tags 'Pandemic'.
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Content ArticleMost Americans are eager to see the country re-open. In this article Nicole Saphier and Marty Makary discuss why we need to be smart about how we do it and why we need accurate statistics.
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Content ArticleThe rapid transmission of COVID-19 has resulted in an international pandemic with the cumulative death rate expected to further escalate in the months to come. The majority of deaths to date (May 2020) have been highly concentrated in certain geographic areas, placing tremendous stress on local healthcare systems and associated workforces. Healthcare is a fundamentally human endeavor; its reliability and the capacity to provide it are tested under stressful conditions and the COVID-19 pandemic is proving to be an especially difficult test for healthcare systems. Consideration of the humanness of care in the broader context of patient safety can raise awareness of how human weaknesses impact individual clinicians and care teams in ways that could degrade patient safety and quality of care and increase risk for both patients with COVID-19 and the staffs that care for them. These weaknesses are exacerbated by fatigue and burnout, absence of team trust, lack of time, medical illness, and poor psychological safety, each of which can result in reduced performance and contribute to failures such as misdiagnoses and adverse events. This article published on AHRQ's PSNet explores these weaknesses.
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Content ArticleThis month’s Letter from America looks at perspectives examining collective responses to the COVID-19 pandemic through a systems analysis lens. Letter from America is the latest in a Patient Safety Learning blog series highlighting new accomplishments in patient safety from the United States.
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Content ArticleClinician well-being is known to play a role in error prevention. This perspective from Dzau et al., published in the New England Journal of Medicine, presents a five-part strategy comprised of organisational and national elements to ensure clinicians are situated to provide safe high-quality care during crisis, such as the coronavirus pandemic, and throughout the course of their careers.
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Content ArticleThis perspective published in the The New England Journal of Medicine examines the problem of racial disparities and the COVID-19 pandemic. The Chowkwanyun and Reed highlight the importance of viewing the data emerging from the crisis in the appropriate socioeconomic and deprivation contexts to protect against ineffective compartmentalisation of the populations being affected.
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Content ArticleSystem thinking encourages the consideration of the interacting forces contributing to problems to enable the design and implementation of strategies to address the underlying conditions that perpetuate those problems. This article from Bradley et al. in eClinical Medicine provides an illustration of the various forces to be resolved to effectively respond to COVID-19. Bradley DT, Mansouri MA, Kee F, Garcia LMT. A systems approach to preventing and responding to COVID-19.
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Content ArticleThis data snapshot from Santoli et al. highlights the results of an examination of two data sets (Jan to April 2019 and Jan to April 2020) to assess the impact of the pandemic on pediatric vaccination in the United States. The authors found significant vaccination declines and highlight the importance of childhood vaccination to prevent future disease outbreaks.
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Content ArticleThis essay in The New Yorker summarises known weaknesses in US healthcare visible long before COVID-19—and discusses others more specific to the pandemic. The author suggests that efforts to change the system be informed by the COVID-19 experience. The work should not seek to return to the pre-pandemic state but instead aim to making changes based on what was revealed to improve health care delivery overall.
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Content ArticleCommunity-based workforce initiatives support vulnerable populations during uncertain times. This blog from Manchanda highlights the role community health workers, volunteers and nonprofit organisations play in COVID-19 testing and contact tracing strategy implementation, psychological support provision, and establishment of the infrastructure communities need to address challenges specific to their local challenges.
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Content ArticleResilience matters now more than ever in healthcare, with the COVID-19 pandemic putting healthcare providers and systems under unprecedented strain. In popular culture and everyday conversation, resilience is often framed as an individual character trait where some people are better able to cope with and bounce back from adversity than others. Research in the management literature highlights that resilience is more complicated than that – it’s not just something you have, it’s something you do. Drawing on research on managing unexpected events, coordinating under challenging conditions, and learning in teams, Barton et al. distill some counter-intuitive findings about resilience into actionable lessons for healthcare leaders.
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Content ArticleWatch as Dr Donna Prosser is joined by a panel of experts to discuss how the COVID-19 pandemic is affecting mental health across the globe and share some tips for effectively managing these challenges.
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Content ArticleFor a child, coming in to hospital can be pretty scary at the best of times, but it's especially daunting at the moment with all the doctors and nurses wearing their special personal protective equipment (PPE) for coronavirus. Edinburgh Children's Hospital Charity has created a video that explains, with help of some big and small superheroes, why various outfits – such as an astronaut's helmet or a firefighter's uniform – protect workers from different types of hazards. The idea is to help children in hospital feel more at ease while staff wearing PPE are caring for them.
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Content ArticleDr Susan Whalley-Lloyd, Senior Lecturer in Human Factors/Ergonomics at Staffordshire University, discusses how the learning and research opportunities evolving from the coronavirus pandemic will add to our human factors knowledge base and gives us a unique opportunity to achieve new research in human factors and patient safety.
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Content ArticleIn this blog, Suzanne Rastrick, Chief Allied Health Professions Officer for NHS England, urges colleagues to start describing service improvements they are undertaking as part of the COVID response and considering what evidence they may need to create a case to continue the good practice. She asks 'what could we be doing now to measure impact and are we capturing data already that could be developed or utilised to demonstrate and evidence the improvements created through changes in working practices?'
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Content Article
Diagnosis: COVID Blindness (April 2020)
PatientSafetyLearning Team posted an article in Blogs
In this article, published by Diagnosis, Linden Brown reflects on his time working with COVID-19 patients. He recalls an incident where a case of sepsis was nearly missed due to what he calls 'COVID-blindness'. "In the panic of quarantine and isolation precautions, we put on cognitive blinders to our bread and butter: sepsis. Had this patient come into the hospital 2 weeks prior, he would likely have been placed on antibiotics immediately." -
Content ArticleTrisha Greenhalgh and colleagues argue that it is time to apply the precautionary principle. The precautionary principle is, according to Wikipedia, “a strategy for approaching issues of potential harm when extensive scientific knowledge on the matter is lacking.” The evidence base on the efficacy and acceptability of the different types of face mask in preventing respiratory infections during epidemics is sparse and contested. But COVID-19 is a serious illness that currently has no known treatment or vaccine and is spreading in an immune naive population. Deaths are rising steeply, and health systems are under strain. This raises an ethical question: should policy makers apply the precautionary principle now and encourage people to wear face masks on the grounds that we have little to lose and potentially something to gain from this measure? Greenhalgh and colleagues believe we should. However, there are criticisms of this view. Read the original analysis published in the BMJ and Tricia Greenhalgh's follow up paper in the Journal of Evaluation in Clinical Practice where she rebutts the criticisms received.
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Content ArticleIn this commentary published in the Journal of Patient Safety and Risk Management, Gurses et al. describe how human factors and ergonomics (HFE) can contribute to the COVID-19 pandemic response. Specifically, the authors provide an example of how HFE methodologies informed workflow redesigns implemented as part of COVID-19 pandemic preparations in an academic paediatric ambulatory clinic. They identify key mechanisms and areas where HFE can contribute to and improve the effectiveness of a pandemic response: Just-in-time (JIT) training development, adapting workflows and processes, restructuring teams and tasks, developing effective mechanisms and tools for communication, engaging patient and families to follow the recommended practices (e.g., social distancing, revised hospital visitation policies), identifying and mitigating barriers to implementation of plans, and learning from failures and successes to improve both the current and future pandemic responses.
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Content ArticleCancer diagnostics and surgery have been disrupted by the response of healthcare services to the COVID-19 pandemic. Progression of cancers during delay will impact on patient long-term survival. Sud et al., in a paper published in Annals of Oncology, found: Lockdown and re-deployment due to the COVID-19 pandemic is causing significant disruption to cancer diagnosis and management. 3-month delay to surgery across all Stage 1-3 cancers is estimated to cause >4,700 attributable deaths per year in England. The impact on life years lost of 3-6 month to surgery for Stage 1-3 disease varies widely between tumour types. Strategic prioritisation of patients for diagnostics and surgery has potential to mitigate deaths attributable to delays. The resource-adjusted benefit in avoiding delay in cancer management compares favourably to admission for COVID-19 infection.
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Content ArticleA medical student describes his experiences of working in the ICU of his local hospital during coronavirus in this Independent blog. "I was one of the first medical students at my university to be recruited to help out in local hospitals as fears grew about the NHS being overwhelmed by COVID-19."
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Content ArticleAs the death toll from COVID-19 rapidly increases, the need to make a timely and accurate diagnosis has never been greater. Even before the pandemic, diagnostic errors (i.e., missed, delayed, and incorrect diagnoses) had been one of the leading contributors to harm in health care. The COVID-19 pandemic is likely to increase the risk of such errors. Based on emerging literature and collaborative discussions across the globe, Gandhi and Singh propose a new typology of diagnostic errors of concern in the COVID-19 era. These errors span the entire continuum of care and have both systems-based and cognitive origins. While some errors arise from previously described clinical reasoning fallacies, others are unique to the pandemic. We provide a user-friendly nomenclature while describing eight types of diagnostic errors and highlight mitigation strategies to reduce potential preventable harm caused by those errors.
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Content ArticleThe Royal College of Midwives has put together an infographic of some of the common stresses that mothers and those working in maternity services may be experiencing and some strategies to help you cope.
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Content ArticleReturning to ‘normal’ levels of activity after the COVID-19 pandemic is expected to take some time and, even before COVID-19, there were substantial challenges with waiting times. As the NHS looks to start to recover services, this analysis from the Health Foundation looks at the context in which planned treatment will recommence. Specifically, it looks at what would have been needed – if the NHS were operating within a ‘business as usual model’ – to return to delivering the standard of 92% of patients being treated within 18 weeks, given the waiting lists and waiting times backlog that had built up by January 2020.
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Content ArticleThere is evidence of disproportionate mortality and morbidity amongst black, Asian and minority ethnic (BAME) people, including NHS staff, who have contracted COVID-19. The authors of this blog argue that this is not just an equality, diversity and inclusion issue but an urgent medical emergency and we need to act now.They look at how the NHS can support BAME staff through the COVID-19 pandemic and beyond, focusing on: protection of staff engagement with staff representation in decision making rehabilitation and recovery communications and media.
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Content ArticleHealthcare Improvement Scotland is currently working with the Scottish Government to develop COVID-19 specific Anticipatory Care Planning (ACP) templates and guidance. ACP is a person-centred approach to help people to plan for their future. The essence of ACP is to encourage individuals to think ahead to help ensure that in the event of a change in their health or care needs, including loss of capacity, the right thing is done at the right time by the right person with the right outcome. ACP can benefit many individuals, from those with early onset of long-term conditions to people with chronic and complex illnesses, to plan ahead for care needs. ACP can be beneficial to individuals towards the end of their life, however the process can be more effective if started earlier in their journey. The link below takes you to an online resource that is designed to be used in conjunction with practitioner judgement, and is not for sole use by individuals and their families without guidance.
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Content Article
COVID-19 tests: The safety implications of false negatives
PatientSafetyLearning Team posted an article in Blogs
The number of people accessing COVID-19 testing in the UK continues to increase. Health Secretary, Matt Hancock recently announced, that anyone over the age of five years old who is showing symptoms is eligible for a test [1]. However, there are concerns that the rate of ‘false negative’ test results could be as high as 30% and a significant number of people are wrongly being told they do not have the virus [2]. This could be due to the particularly difficult nature of obtaining the swab, which requires someone to take a sample from the very back of the mouth or deep from inside the nose. “Swabbing patients using the correct technique is paramount in ensuring an accurate result. Nasal swabs need to be taken from far back in the nasal pharynx and is often uncomfortable for the patient. By simply swabbing the inside of the nasal passage is not deep enough to verify that the virus is present. I am unsure that all clinical staff have been taught the correct way to swab patients.” Claire Cox, Intensive Care Outreach Nurse. Members of the public are now able to request self-testing kits to do at home if they are experiencing symptoms. If clinicians like Claire are finding the test challenging to perform on others, it is likely that patients could struggle to swab deep enough into their own nasal pharynx (7-8cm). There is a risk that as the number of people testing themselves increases, so too will the rate of false negative results. Testing is a key element of the UK’s COVID-19 infection control strategy [3]. A high, and potentially rising, rate of false negative results means that a significant number of people could be carrying the virus, wrongly reassured they are not infectious. In this blog, we look at some of the associated safety risks.
