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Showing results for tags 'Patient / family involvement'.
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Content Article
UK Covid-19 Inquiry: Opening statement (21 July 2022)
Patient Safety Learning posted an article in Covid-19 Inquiry
In her opening statement, Baroness Heather Hallett, Chair of the UK Covid-19 Inquiry, has set out her approach to running it. The Inquiry will consider and report on the preparations and the response to the pandemic in England, Wales, Scotland and Northern Ireland. The Terms of Reference provide the broad outline of the issues the Inquiry will investigate. -
Content ArticlePatient (or lived experience) leadership involves those affected by life-changing illness, injury or disability becoming equal partners in NHS decision-making. Patient leadership champion David Gilbert picks out the most significant developments in a field of increasing relevance to the NHS.
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Content Article
Published on 19 October 2022, the report of the investigation into maternity and neonatal services at East Kent Hospitals NHS Foundation Trust revealed a series of serious patient safety failings between 2009 and 2020, which resulted in avoidable harm to patients and deaths. The investigation found that if nationally recognised standards had been followed, the outcome could have been different in 97 of the 202 cases reviewed. In this article, Patient Safety Learning analyses the findings of this report from a broad patient safety perspective, focusing on five key themes that are consistent with many other serious patient safety inquiries and reports in recent years. It sets these in their wider context and highlights the need for a fundamental transformation in our approach to patient safety if similar scandals are to be prevented in the future.- Posted
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Content ArticleThe aim of integrated care is to improve people’s outcomes and experiences of care by bringing services together around people and communities. This means addressing the fragmentation of services and lack of co-ordination that people often experience by providing person-centred, joined-up care. This practical guide aims to provide partners working in integrated care systems (ICSs) with ideas on how they can ensure they identify and meet the needs of the people they serve.
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Content ArticleIn this Guardian article, parents reveal their heart-wrenching struggles to access NHS services, which have sometimes been too late to help their children.
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Content ArticleThe REACH Toolkit provides information, resources and quality improvement (QI) tools for managers and clinicians to improve patient, carer and family recognition and escalation of clinical deterioration in NSW health services. The resources can be adapted to suit local needs including initial program implementation, to review and improve current practices or to support current practice.
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Content ArticleREACH is a system that helps patients, carers and family members to escalate their concerns with staff about worrying changes in a patient's condition. It stands for Recognise, Engage, Act, Call, Help is on its way. REACH was developed by the New South Wales Government Clinical Excellence Commission in collaboration with local health districts and consumers. It builds on the surf life‐saving analogy for recognition and appropriate care of deteriorating patients by encouraging patients, carers and their families to 'put their hands in the air' to signal they need help.
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Content ArticleRyan Saunders is a little boy who died in 2007 from an undiagnosed streptococcal infection, which led to Toxic Shock Syndrome. According to the Queensland Clinical Excellence Division, when Ryan’s parents were worried he was getting worse, they did not feel their concerns were acted on in time. This blog outlines Ryan's Rule, a process introduced by the Queensland Department of Health to try and prevent similar events happening in future. Ryan's Rule allows patients and their families and carers to escalate serious concerns about their own or a family member's condition.
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Content ArticleMaternity costs make up the largest cost to the NHS in value of claims. The Early Notification Scheme provides a faster and more caring response to families whose babies may have suffered severe harm. 'The second report: The evolution of the Early Notification Scheme' provides an overview of progress made since the report into the first year of the scheme, which was published in 2019. The report updates on the progress of the key recommendations which were made in the first report and reflects on modifications and improvements made to the scheme since its launch five years ago. It provides an analysis of the main clinical themes, based on a small cohort of cases, and makes recommendations to further improve outcomes for affected families.
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Content Article
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On his last day in office at the Healthcare Safety Investigation Branch (HSIB), outgoing Chief Investigator Keith Conradi wrote to the Secretary of State for Health and Social Care reflecting on his time at HSIB. He outlined concerns about the approach of the Department of Health and Social Care (DHSC) and NHS England to patient safety work carried out by HSIB and the need to introduce a safety management system approach at all levels of healthcare. Patient Safety Learning also shared our thoughts on the issues raised in this letter and we were keen to explore these issues, and Keith’s experience as HSIB’s first Chief Investigator, in greater depth. Here, Patient Safety Learning provides an overview of the recent interview we had with Keith Conradi on this subject. The full transcript of the interview is available to download in the attachment at the end. -
Content ArticleIn February 2020 the UK Government commissioned Dr Bill Kirkup to undertake a review into maternity and neonatal care services between 2009 and 2020 in two hospitals, the Queen Elizabeth The Queen Mother Hospital (QEQM) at Margate and the William Harvey Hospital (WHH) in Ashford. Both these services fall under the East Kent Hospitals NHS Foundation Trust. The report found that over this period those responsible for these services too often provided clinical care that was suboptimal and led to significant harm, failed to listen to the families involved, and acted in ways which made the experience of families unacceptably and distressingly poor. It identifies four key areas for action which must be addressed to improve patient safety in maternity and neonatal care services.
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Content ArticleThis article* is an update from Dr Henrietta Hughes, Patient Safety Commissioner for England.
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Content ArticleThis article* is an update from Dr Henrietta Hughes, Patient Safety Commissioner for England.
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Content ArticleThis article* is an update from Dr Henrietta Hughes, Patient Safety Commissioner for England.
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Content ArticleA fit and proper person review into the conduct of former Shrewsbury and Telford Hospital Trust chair Ben Reid, who left in August 2020, has been published by the board. The report follows complaints about Mr Reid’s conduct from the family of baby Kate Stanton-Davies, who died in the trust’s care and whose case – alongside that of Pippa Griffiths – sparked the original Ockenden inquiry.
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Content ArticleThe journalist Merope Mills voices her anger at her daughter Martha's preventable death in this Woman's Hour programme.
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Content Article
Mother knows best – a blog by Dr Abha Agrawal
Patient Safety Learning posted an article in Patient stories
Dr Abha Agrawal shares with the hub her family's experience of going into hospital and demonstrates how patients and families can be true partners in patient safety.- Posted
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Content ArticleThe World Health Organisation's third World Patient Safety Day took place on 17 September. This year’s theme was medication safety. In this blog, Clare Wade, Assistant Director of Casework at the Parliamentary and Health Service Ombudsman (PHSO) discusses the impact of medication errors and gives examples of poor practice.
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Event
Deteriorating Patient Summit
Patient Safety Learning posted an event in Community Calendar
The Deteriorating Patient Summit focuses on recognising and responding to the deteriorating patient through improving the reliability of patient observations and ensuring quality of care. The conference will include National Developments including the recent recommendations from the Royal College of Physicians on NEWS2 and COVID-19, and implementing the recommendations from the Healthcare Safety Investigation Branch Report Investigation into recognising and responding to critically unwell patients. The conference will include practical case study based sessions on identifying patients at risk of deterioration, improving practice in patient observations, responding to the deteriorating patient, improving escalation and understanding success factors in escalation, sepsis and COVID-19, involving patients and families in recognising deterioration, and improving the communication and use of NEWS2 in the community, including care homes, and at the interface of care. Follow the conference on Twitter #deterioratingpatient Register -
Content ArticleThere has been an identified need for greater patient and family member involvement in healthcare. This is particularly relevant in an intensive care unit (ICU), as the family provides a key communicative and practical link between patient and clinician. Family members have been deemed a positive beneficial influence on ICU care and recovery processes, yet they themselves are often emotionally affected after discharge. There has been no standardised evidenced-based approach which explores research on family member involvement and the range and quality of contributions remain unclear. This study from Xyrichis et al. undertook a systematic review to assess the evidence base for interventions designed to promote patient and family member involvement in adult intensive care settings and develop a comprehensive typology of interventions for use by clinicians, patients and carers. The review provides valuable and rigorous insight into the range and quality of interventions available to promote patient and family member involvement in ICU. This is the first step towards addressing the absence of a synthesis of research for this context, and will, in addition, develop a typology of available interventions that will help service users and clinicians make informed decisions about the approaches to patient and family member involvement which they might want to adopt.
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Content ArticleThe call for meaningful patient and family engagement in healthcare and research is gaining impetus. Healthcare institutions and research funding agencies increasingly encourage clinicians and researchers to work actively with patients and their families to advance clinical care and research. Engagement is increasingly mandated by healthcare organizations and is becoming a prerequisite for research funding. In this article, Burns et al. review the rationale and the current state of patient and family engagement in patient care and research in the ICU. The authors identify opportunities to strengthen engagement in patient care by promoting greater patient and family involvement in care delivery and supporting their participation in shared decision-making. They also identify challenges related to patient willingness to engage, barriers to participation, participant risks, and participant expectations. To advance engagement, clinicians and researchers can develop the science behind engagement in the ICU context and demonstrate its impact on patient- and process-related outcomes. In addition, the authors provide practical guidance on how to engage, highlight features of successful engagement strategies, and identify areas for future research. At present, enormous opportunities remain to enhance engagement across the continuum of ICU care and research.
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Content ArticleHealthcare is in the midst of significant change, with substantial shifts in emphasis and priorities. Patient-centered care has become central to the core goals of better health, better quality, and lower costs while highlighting the necessity of incorporating patients’ efforts, needs, and perspectives into healthcare at all levels. Patient and family engagement (PFE) is critical to patient-centered care, and important theoretical and empirical work has identified key elements and implications of PFE, especially for management of chronic illnesses and preference-sensitive clinical decision making. Brown et al. believe that the ultimate goal of active, mutually respectful partnership among clinicians and patients/families is urgent and important. However, consistent terminology and definitions of PFE are still lacking. This deficit is particularly striking in intensive care units (ICUs), which pose special challenges to outpatient models of PFE: the emotional stakes are high, time is greatly compressed, surrogates play a central role, and the specter of death often dominates decision making.
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Content ArticleIn this blog, Patient Safety Learning sets out its response to NHS England and NHS Improvement’s draft Framework for involving patients in patient safety. We commend the intention and share thoughts on our perspective on this important patient safety issue. We make proposals for how to strengthen patient engagement and co-production.
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Content ArticleThis Royal College of Nursing (RCN) publication highlights the specific needs of children and young people undergoing day surgery, outlining pre- and post-operative aspects of care and preparation, parental involvement and facilitating discharge.
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Content ArticleThe Canadian Patient Safety Institute (CPSI) outlines the process in Canada if you have a question or a concern about the healthcare services you have received.
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