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Content ArticleCall 4 Concern is a patient safety initiative enabling patients and families to call for immediate help and advice when they feel concerned that they are not receiving adequate clinical attention. Here is the University Hospitals Dorset Trust's leaflet.
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Content ArticleCall 4 Concern is a patient safety initiative enabling patients and families to call for immediate help and advice when they feel concerned that they are not receiving adequate clinical attention. Here is the University Hospitals Sussex Trust's leaflet.
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Content ArticleCall 4 Concern enables patients, relatives and carers to call for help/advice from the Acute Intervention Team when they are concerned about a patient’s condition, and/or they feel that their concern is not being addressed by the ward team. County Durham and Darlington share their Call 4 Concern leaflet.
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Content ArticleThe aim of the project was to introduce and evaluate a Call for Concern (C4C) service that provides patients and relatives with direct access to the Critical Care Outreach (CCO) team, to give patients and relatives more choice about who they can consult with about their care, and facilitate the early recognition of the deteriorating ward patient. The project involved two phases: a six month pilot phase to evaluate the C4C service for feasibility, and its effects on patients, relatives and the health care teams. a three month phase implementing the C4C service onto two surgical wards to test and evaluate the findings of the feasibility phase in preparation for expansion to all hospital wards. Between 1st Sept 2009 and 23rd Sept 2010, the CCO team received 37 C4C referrals representing 0.5% of total CCO activity. Critical deterioration of a patient was prevented in at least two cases, and the service received positive feedback from patients and relatives. In the words of a relative, C4C provided: ‘…a better quality of care…and…reduces the risk of death.’
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Content ArticleCall for Concern is a patient safety service for adult inpatients, families and friends to call for help and advice if you or your family are concerned that there is a noticeable change or deterioration in condition. This service is delivered by the Critical Care Outreach team who are available 24 hours a day to help support ward teams in the care of acutely ill patients. We also offer emotional support to patients and their families who have recently been discharged from the Critical Care Unit as this can be an anxious time. When can I call? After you have spoken to the ward team or doctor but feel the healthcare team are not recognising or responding to your concern. If you have been a patient in Critical Care and are experiencing difficulties such as anxiety, bad dreams, low mood or feeling emotional.
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Content ArticleThis study in JAMA Network Open aimed to investigate how often patients who read open ambulatory visit notes perceive mistakes, and what types of mistakes they report. The results of the study showed that: 1 in 5 patients who read a note reported finding a mistake 40% perceived the mistake as serious the most common mistakes reported were mistakes in diagnoses, medical history, medications, physical examination, test results, notes on the wrong patient and sidedness. The authors suggest that patients may perceive important errors in their visit notes, and inviting them to report mistakes may be associated with improved record accuracy and patient engagement in safety.
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Content ArticleThis editorial in BMJ Quality & Safety looks at the need for urgent improvement in the test result management and communication process in primary care. The authors highlight the inconsistency in tracking and communicating test results and look at potential solutions to reduce the patient safety risks associated with test results. They look at the evidence surrounding automated alerts built into provider IT systems and giving patient direct access to test results through apps, highlighting the growing importance of patients in safeguarding their own care through actively pursuing test results.
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Content ArticleFrimley Health has launched a new service for members of the public to independently raise concerns if they believe a patient’s clinical condition is deteriorating. The Call 4 Concern programme enables friends, relatives – and the patients themselves - to make a direct referral if their concerns have not been alleviated by first speaking to the medical team. The Trust’s critical care outreach practitioners will then review the patient, liaise with the medical team and take any appropriate action. At Frimley Park Hospital, call 07717 303231. At Wexham Park Hospital call 07909 930728. The Call 4 Concern programme is available 24 hours a day, seven days a week and has previously been successfully implemented by several other NHS organisations.
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Content Article
HealthIT.Gov: SAFER guides (USA)
Patient Safety Learning posted an article in Health records and plans
The SAFER Guides consist of nine guides organiaed into three broad groups. These guides enable healthcare organisations to address electronic health record (EHR) safety in a variety of areas. Most organisations will want to start with the Foundational Guides, and proceed from there to address their areas of greatest interest or concern. -
Content ArticleNHS England have released statistics on referral to treatment (RTT) waiting times for consultant-led elective care. The statistics include patients waiting to start treatment at the end of July 2022 and patients who were treated during July 2022.
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Content ArticleThe General Pharmaceutical Council (GPhC) has written via email to pharmacists and owners of pharmacies with the GPhC’s voluntary internet pharmacy logo, to address ongoing patient safety concerns affecting the online sector. The emails highlight that over 30% of the GPhC's open Fitness to Practise cases relate to online pharmacy—a disproportionate number for the sector of the market that online services occupy. Common issues raised in these cases include: medicines being prescribed to patients on the basis of an online questionnaire alone, with no direct interaction between the prescriber and either the patient or their GP . prescribing of high-risk medications or medications which require monitoring without adequate safeguards. prescribing of medicines outside the prescriber’s scope of practice. high volumes of prescriptions being issued by the prescriber in short periods of time. The emails also recognise the benefits and risks of online pharmacies, outline how the GPhC may take enforcement action against an online pharmacy, and recommend what actions pharmacists and pharmacy owners should take in response to the patient safety concerns raised. You can view the emails in full: Email to owners of pharmacies with the internet pharmacy logo Email to pharmacists
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Content ArticleThe Irish Health Service Executive (HSE) has produced a selection of resources and guidance to help people use medicines safely. It offers information about the Know, Check, Ask campaign, encouraging members of the public to: Know your medicines and keep a list Check that you're using the right medicine the right way Ask your health professional if you're unsure The page also includes videos about: how to use the My medicines list tool designed to ensure patients and healthcare professionals know which medications and doses the patient should be taking. 5 moments for medication safety, a campaign linked to the World Health Organizations' WHO Medsafe app.
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Content ArticleThe purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) was to consider the management and care of preterm labour and birth of twins. Preterm birth—defined as babies born alive before the completion of 37 weeks of pregnancy—is one of the main causes of death, long-term conditions and disability in under-fives worldwide, and 60% of twin pregnancies result in premature birth. The reference event for this investigation was the case of Sarah, who was pregnant with twins and was overseen by an obstetrician during her pregnancy. Sarah was assessed as having a higher-risk pregnancy as she had had previous medical intervention on her cervix and was pregnant with twins. Shortly after having been discharged from a hospital with a specialist neonatal unit following suspected early labour, she went to her local maternity unit at 29+2 weeks with further episodes of abdominal tightening. Her labour did not progress as expected and a caesarean section was required to deliver the babies at 29+6 weeks. The twin girls were born well, but 23 days after their birth a scan revealed brain injury in both babies. The investigation identified several findings to explain the experience of the mother in the reference event, including the lack of scientific evidence or specific guidelines and the uncertainty associated with the clinical decision making in this scenario. This highlighted the need for further research into preterm labour as a recognised risk factor for twin pregnancies. As part of the investigation, HSIB identified that since 2019 a large volume of national work and research in the area of twin pregnancy and preterm birth has been undertaken. The investigation report sets out the work currently in progress and seeks to understand if it will address gaps in knowledge.
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Content ArticleVideo and telephone consultations have, through the course of the pandemic, become a central of daily operations across the NHS. In this blog, Ben Gadd and Amanda Nash of University Hospitals Plymouth NHS Trust share their experiences about how they are being received and the potential lessons we can learn.
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Content ArticleA Treatment Escalation Plan (TEP) is a communication tool designed to improve quality of care in hospital, particularly if patients deteriorate. TEPs aim to reduce variation caused by discontinuity of care, avoid harms caused by inappropriate treatment and promote patients’ priorities and preferences. This article in the Journal of the Royal College of Physicians of Edinburgh examines the key components of a TEP, how and why TEPs should be implemented and the outcome-related evidence to support their use.
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Content ArticleCompensation claims are a useful source of information on patient safety research. This study in The Journal of Patient Safety aimed to determine the main causes of surgical compensation claims and their financial impact on the health system. The authors analysed the frequency, causes, consequences, locations and surgical settings of compensation claims brought against the surgical area of the Murcia Health System between 2002 and 2018. The study found that the most frequent causes for claims were surgical error (42.4%) and treatment error (30.9%), and that the main surgical settings involved were orthopaedic surgery and traumatology (27.4%), gynaecology and obstetrics (25.7%) and “general surgery” (17.2%).
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Content Article
BMJ - Scan first, ask questions later? (18 August 2022)
Patient-Safety-Learning posted an article in Diagnosis
In this opinion piece in The BMJ, consultant radiologist Giles Maskell examines changes to the ways in which medical imaging is used in the health service. He states that imaging used to be ordered, when necessary, at the end of a diagnostic process, whereas now many doctors are asking for scans before they will see a patient for the first time. The article highlights some of the implications of this shift in practice, including on screening service capacity and on the interpretation of test results. -
Content Article
HSE Ireland - My Medicines List leaflet (January 2020)
Patient-Safety-Learning posted an article in Medication
This leaflet produced by the Irish Health Services Executive (HSE) provides a central place for patients to record information about their medications. It acts as a reference point for patients to use when discussing their medications with a healthcare professional and includes a reminder of the Know, Check, Ask campaign, aimed at reducing medication errors in the community. -
Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Soojin talks to us about how her personal experience of harm motivated her to work in healthcare and campaign for patient safety, the power of collaboration in improving healthcare safety and how healthcare workers can take steps to improve their own patient interactions. -
Content Article
NHS Scotland waiting times
Patient Safety Learning posted an article in Dashboards and presentations of data
Information on waiting times for local health boards and specialties in Scotland. This site shows information on waiting times for planned (elective) care. This site does not show information for emergency (unscheduled) care. The statistics shown here relate only to any treatment as an inpatient or day case covered by the Treatment Time Guarantee (TTG). A small number of specialist treatments are not covered by the TTG. -
Content ArticleOnline patient feedback is becoming increasingly prevalent on an international scale. However, limited research has explored how healthcare organisations implement such feedback. This research from Baines et al. sought to explore how an acute hospital, recently placed into ‘special measures’ by a regulatory body implemented online feedback to support its improvement journey.
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Content ArticleSafety reporting systems are widely used in healthcare to identify risks to patient safety. But, their effectiveness is undermined if staff do not notice or report incidents. Patients, however, might observe and report these overlooked incidents because they experience the consequences, are highly motivated, and independent of the organsation. Online patient feedback may be especially valuable because it is a channel of reporting that allows patients to report without fear of consequence (e.g., anonymously). Harnessing this potential is challenging because online feedback is unstructured and lacks demonstrable validity and added value.
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Content ArticleSuccessful adoption of novel noncontact physiological measurement and physical monitoring requires analysis of how they support patient care. Lloyd-Jukes et al. review available technologies and present their vision-based patient monitoring and management system, supported by a framework enabling its integration within clinical workflows. The framework links tasks such as assessing patients to elements of the patient journey (eg, risk factors and early warning signs). The system enabled insights from patient activity reports and noncontact vital sign measurements. It supports staff in ensuring patients' health follows desired trajectories, avoiding adverse events, making observations without disrupting patients' rest, intervening proactively, and learning from incidents.
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Content ArticleThe US's response to monkeypox fails to put patients and their care at its centre, writes Eric Kutscher in the BMJ opinion article. As a primary care and addiction medicine physician, Kutscher has been dismayed by the number of patients he has treated over the past few weeks who’ve been infected with the vaccine-preventable monkeypox virus. Most have been in considerable pain and required strong analgesics, with some unable to even sit because of their skin lesions. Yet for many, the most agonising and scarring aspect of their infection is not their physical symptoms, but the complete removal of their humanity by the medical response to monkeypox. As a medical and public health community, we are exhausted after Covid-19, and our compassion fatigue is showing in our policies and procedures for monkeypox. The spread of the virus to previously non-endemic countries was only recently declared a public health emergency of international concern by the World Health Organization. Unlike with Covid-19, this is not a novel virus—we have the appropriate diagnostic testing, treatment, and even vaccines that we need. Yet, just as we have failed to deploy these tools to assist in outbreaks in African nations, we are now also failing our patients from a sexual minority—patients who are already underserved and justifiably mistrusting of a medical system.
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Content ArticleThis article explores political barriers to integrated care, arguing that improving the US healthcare system requires the pursuit of three aims: improving the experience of care, improving the health of populations and reducing per capita costs of health care.
