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Content ArticleQuality improvement measures can help health care organisations make health information easy to understand and health systems easy to navigate. The Agency for Healthcare Research and Quality (AHRQ) obtained consensus from experts on the usefulness, meaningfulness, feasibility, and face validity of 22 measures that can help organisations seeking to become more health literate.
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AHRQ Pharmacy Health Literacy Center
Patient Safety Learning posted an article in Medicine management
This site provides pharmacists with recently released health literacy tools and other resources from the Agency for Healthcare Research and Quality (AHRQ). Pharmacy health literacy is the degree to which individuals are able to obtain, process, and understand basic health and medication information and pharmacy services needed to make appropriate health decisions. Only 12% of adults have proficient health literacy (e.g., can interpret the prescription label correctly). Medication errors are likely higher with patients with limited health literacy, as they are more likely to misinterpret the prescription label information and auxiliary labels. Studies document an association between low literacy and poor health outcomes. -
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AHRQ's Re-Engineered Discharge toolkit
Patient Safety Learning posted an article in Discharge
The Re-Engineered Discharge (RED) Toolkit helps re-design the discharge process using health literacy and patient safety strategies. Research showed that the RED was effective at reducing readmissions and post-hospital emergency department visits. The RED Toolkit includes templates for easy-to-understand discharge instructions and post-discharge telephone calls, and guidance on delivering the RED to diverse populations. This is part of AHRQ's health literacy improvement tools to help healthcare organisations, leaders and professionals improve health literacy. -
Content ArticleWhose Shoes?® is a popular approach to coproduction and engagement, bringing in diverse voices. It is typically used with support from New Possibilities, who provide live visual recording to capture the conversations in a truly authentic way. The approach is being used in 70 NHS trusts, universities and other organisations, with excellent outcomes.
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AHRQ's easy-to-understand telehealth consent form
Patient Safety Learning posted an article in Telehealth
AHRQ's easy-to-understand telehealth consent form is part of AHRQ's Health Literacy Improvement Tools to help healthcare organisations, leaders and professionals improve health literacy. AHRQ's telehealth consent resources include a sample telehealth consent form that is easy to understand and how-to guidance for clinicians on obtaining informed consent for telehealth. The consent form includes provisions for healthcare providers that have curtailed in-person visits due to COVID-19. Clinicians can use the easy-to-understand language from the form when they are having the consent discussion and can use the form as a checklist to make sure they have covered all the information required by informed consent rules. -
Content ArticleThe AHRQ Health Literacy Universal Precautions Toolkit, 2nd edition, can help primary care practices reduce the complexity of health care, increase patient understanding of health information, and enhance support for patients of all health literacy levels. Health literacy universal precautions are the steps that practices take when they assume that all patients may have difficulty comprehending health information and accessing health services. Health literacy universal precautions are aimed at: Simplifying communication with and confirming comprehension for all patients, so that the risk of miscommunication is minimized. Making the office environment and health care system easier to navigate. Supporting patients' efforts to improve their health.
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Content ArticleThe World Health Organization (WHO) is actively exploring the role of compassion in quality health care. This Global Health Compassion Rounds (GHCR) highlighted the compelling evidence around compassion and quality care—not only for patients, but also for providers and health care organisations. Respondents offered their views of the implications of this evidence at national, district, and community levels of care.
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Content ArticleHealthcare practitioners, patient safety leaders, educators and researchers increasingly recognise the value of human factors/ergonomics and make use of the discipline's person-centred models of sociotechnical systems. This paper from Holden et al. first reviews one of the most widely used healthcare human factors systems models, the Systems Engineering Initiative for Patient Safety (SEIPS) model, and then introduces an extended model, ‘SEIPS 2.0’. SEIPS 2.0 incorporates three novel concepts into the original model: configuration, engagement and adaptation. The concept of configuration highlights the dynamic, hierarchical and interactive properties of sociotechnical systems, making it possible to depict how health-related performance is shaped at ‘a moment in time’. Engagement conveys that various individuals and teams can perform health-related activities separately and collaboratively. Engaged individuals often include patients, family caregivers and other non-professionals. Adaptation is introduced as a feedback mechanism that explains how dynamic systems evolve in planned and unplanned ways. Key implications and future directions for human factors research in healthcare are discussed.
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Content ArticleHealthcare systems are operating in an environment that is increasingly moving toward value-based payments that reward good health outcomes and patient experience. An impediment to success in this environment, however, is that both health care delivery systems and health information are extremely complicated. The level of complexity stymies many people and hinders them from making informed preventive care and self-management decisions. Health systems are finding that they cannot achieve improved patient outcomes or experiences without improving how health care professionals communicate with and support patients. Health systems have begun to respond to the mismatch between patients’ capabilities and the health literacy-related demands of the healthcare system. A new term has emerged – the health literate organisation – that describes organisations that aspire to make it easier for people to navigate, understand, and use information and services to take care of their health. Health literate organisations, in turn, need healthcare professionals who have health literacy knowledge and skills, such as being able to communicate effectively, break down health goals into manageable steps, and connect people with the resources they need to be successful Harris et al. explores health literate care in this Commentary for the National Academy of Medicine.
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Content Article"Healthcare systems need to act in equal measures to both enable the recovery of patients and families it has harmed, and to protect future patients.... Yet providing what is set out in the Duty of Candour to harmed patients has not been framed as providing care to make sick or injured people better and/or to minimise their pain and suffering." In this blog, Jo Hughes explains why we need to reframe the Duty of Candour and explores what needs to change.
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Content ArticleThe NHS workforce has a remarkable record in providing safe, effective and equal care for everyone. But, like many healthcare systems around the world, the NHS is facing significant day-to-day challenges, made worse by the outbreak of COVID-19 and the resulting effects on health and social care. The NHS should only offer tests, treatments and procedures, often referred to as interventions, that the best available evidence shows is the most appropriate and clinically effective. Research evidence shows that some interventions are not clinically effective or only effective when they are performed in specific circumstances. And as medical science advances, some interventions are superseded by those that are less invasive or more effective. At both national and local levels, there is a general consensus that more needs to be done to ensure that the least effective interventions are not routinely performed, or only performed in more clearly defined circumstances. Earlier this year, NHS England and NHS Clinical Commissioners launched a new programme focusing on items that should not be routinely prescribed in primary care. 31 interventions were identified and the public invited to comment on them. The consultation period is complete and the responses that have been submitted will be considered and a final recommendation made later in the year.
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Content ArticleWhat Your Patient Is Thinking (WYPIT) is a BMJ series led and edited by patients and carers. The articles are written by patients and carers and are a key part of The BMJ’s campaign to increase partnership with patients and public in healthcare. They contain messages that are thought provoking, and challenging for clinical readers of The BMJ, who mainly consist of doctors from across the world. Articles can be about any aspect of patient or carer experiences. This might include what it is like for you to live with your condition or as a carer or your experience of an appointment or procedure. This might be in relation to a single healthcare appointment to those from a lifetime of managing a long term health condition. It is important for the piece to include lessons for doctors. They can focus on a particular aspect of care or treatment, offer a new angle on a familiar situation, or ask controversial questions from the patient or carer's perspective. They can be triggered by good or bad experiences but all of them should give healthcare professionals and, or policy makers practical things that they can do differently tomorrow as a result of reading the article. The BMJ patient and clinical editors will work with you to develop your piece and to suggest specific questions to prompt reflection and action from the readership, that follow from the key points of your article. Guidance if you would like to contribute to the "What Your Patient is Thinking" series.
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Content ArticleThe NHS has been fighting for our lives for the last few weeks and months. Throwing all its resources at the COVID-19 pandemic. The millions of health and care workers involved have been magnificent and we must resource them better for the future. And it’s been up to us, the general public, how far and how fast the virus spreads. There will still be a vital role for us when this pandemic is over because the NHS can’t by itself deal with many of today’s major health problems such as loneliness, stress, obesity, poverty and addictions. It can only react, doing the repairs but not dealing with the underlying causes. There are people all over the country who are tackling these causes in their homes, workplaces and communities. People like the Berkshire teachers working with children excluded from school, the unemployed men in Salford improving their community; and the bankers tackling mental health in the City. They are not just preventing disease but creating health. And they take pressure off the NHS, so it is always there when we need it. Health is made at home challenges us to set aside our normal assumptions and take off our NHS spectacles to see the world differently and take control of our health. And it calls for a new partnership between the NHS, government and the general public to build a healthy and health creating society.
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Content ArticleThe NHS should learn lessons from health creators that use a holistic approach to health and wellbeing, creating conducive environment for people to flourish, says Nigel Crisp in this blog for HSJ. Creating health is about creating the conditions for people to be healthy and helping them to be so. It’s what parents do and good teachers and schools – creating healthy, resilient, confident individuals. One of they ways health creators do things differently from the usual NHS and public sector approach is their emphasis on relationships – people get things done primarily through building relationships rather than by just following systems.Their approach is vision and goal-led (rather than plan-led) so people learn by doing, being experimental, adaptable and entrepreneurial. And it is about doing things that have meaning and purpose and not just about processes, checklists and plans. Read Nigel's book: Health is made at home, hospitals are for repairs
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Incontinence is often described as the last medical taboo. Everyone from medics and patient representative groups, researchers and charities, to social scientists, marketeers and psychologists agree that it is a condition cloaked in shame, silence and stigma.[1] But how does that impact on patient safety? And are there any measures that could prevent potential harm? In this blog, best-selling author Luce Brett explains why it’s so important to shatter the stigma surrounding incontinence, a condition affecting 34% of women in the UK.[2] Drawing on research from her recent book, and her own insight as a patient, Luce highlights how we can improve health outcomes for patients by simply talking about it more. -
Content ArticleEuropean drug regulations aim for a patient-centered approach, including involving patients in the pharmacovigilance (PV) systems. However many patient organisations have little experience on how they can participate in PV activities. The aim of this study published in Drug Safety, was to understand patient organisations’ perceptions of PV, the barriers they face when implementing PV activities, and their interaction with other stakeholders and suggest methods for the stimulation of patient organisations as promoters of PV.
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Content ArticleThe General Medical Council has published an updated guide on Decision making and consent, which comes into effect on 9 November 2020. The guidance aims to support doctors to practise shared decision making and help their patients to make healthcare decisions that are right for them. New features include: a focus on taking a proportionate approach, acknowledging not every paragraph of the guidance will be relevant to every decision seven key principles which summarise the guidance a new section to help doctors find out what matters to patients so they can share relevant information to help them decide between viable options suggestions for how other members of the healthcare team can support decision making.
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Content ArticleOne year ago, on 2 October 2019, we officially launched the hub at our annual conference. To celebrate this special occasion, we want to update you on how the hub has grown and the impact it’s having, both on the people using it directly and on patient safety more broadly. To date, the hub has over 1,000 members from 450 organisations and from over 40 countries. It’s home to over 3,000 pieces of content, has had 45,000 unique visitors and has been accessed 70,000 times. Although we are delighted with these numbers and continued growth of the hub, we are most proud of the relationships the hub is facilitating and the good work that is happening as a result. We launched the hub so that all members of the public – from patients to clinicians – could share their insight and experiences of patient safety. By working together with users of the hub, we aim to highlight patient safety concerns and take action so that real change can happen as we journey towards the patient-safe future. Wonderfully, we are beginning to achieve these aims. Here are some of the ways the hub has been making an impact.
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HSIB: Submit a patient safety concern
PatientSafetyLearning Team posted an article in Investigations and complaints
The Healthcare Safety Investigation Branch (HSIB) has launched an online form for submitting a patient safety concern. The form should take around 20 minutes to complete. You can tell them about something that has happened or something that might happen. Something that has happened: this could be a one-off or a series of events where something potentially dangerous has happened, whether or not someone was actually harmed. Something that might happen: this could be a safety risk or an unsafe condition that, if not corrected, might lead to an incident which could cause harm. Follow the link below to find out more about the process, read their privacy notice or request the form in an alternative format. Note: HSIB can investigate events or risks that occurred within NHS-funded care in England after 1 April 2017. -
Content ArticleInfographic from the Patient Safety Movement on what is needed when a patient is harmed and why we need to involve patients and families throughout the process.
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Content ArticleThe Safe Airway Society is the interprofessional airway society for Australia and New Zealand. Its members represent a wide range of health professions including Anaesthetists, Intensivists, Anaesthetic technicians, Emergency Physicians, Nurses, Rural Doctors, Surgeons and Paramedics. Through innovative collaboration, the Safe Airway Society aims to create resources, including consensus guidelines, promote education and training with an emphasis on human factors and team performance, and improve systems through research and standardisation of practice. The Safe Airway Society aims to build an environment where safe and effective airway management prevails across all professions and for all patients. This video explains more.
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Content ArticleAnimated video explaining why it is important to give feedback about the health and social care you receive in England
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Content ArticleSteve Turner and colleagues have been working on ways to put people in charge of their own healthcare. Nowhere is this more important than for people with a variety of conditions or illnesses. Their approach involves people attending a group session on medicines, and then having the option of reviewing their medicines individually in a 3/4-hour session with two health professionals (e.g. a prescriber and a pharmacist). They provide people with their own notes in the form of a written action plan, which they can share with clinicians. Benefits identified to date include improved adherence with medicines; improved quality of life; reduced unnecessary medicines; identification and actions on previously unreported patient safety issues; a potential reduction in ‘bouncing’ referrals, less missing information and fewer unnecessary contacts with services. Steve explains more about Patient Led Clinical Education© and Patient Led Clinical Medicines Review™ in this blog.
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Content ArticleThe World Health Organization designated September 17 as World Patient Safety Day — a day, every year, to raise awareness of healthcare safety and reiterate its importance. This year the Patient Safety Movement hosted a four-hour virtual event as part of their #uniteforsafecare public awareness campaign. They organised the event to bring the public into the fold as well as unite patients, advocates, health workers and leaders together globally — working to ensure patient and health worker safety internationally. Here are 11 takeaways for the public, patients and their families from the #uniteforsafecare virtual event.
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Content ArticleIn this statement, published by the World Health Organization, Professor Martin McKee, European Observatory on Health Systems and Policies highlights the importance of working with patients to understand Long COVID. "We need to work with patients and their families to develop new care pathways, including rehabilitation and online support tools. We need to look at employment rights, sick pay policies and access to benefit packages for those affected. And we need much more research, again with patients fully involved in deciding what questions to ask and how to answer them." Follow this link to read the full statement.
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