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Found 190 results
  1. Content Article
    Psychological safety is the belief that you won’t be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes. This article by the Center for Creative Leadership explores why psychological safety is so important to foster in workplaces. It suggests eight steps toward creating more psychological safety at work and describes the four stages of psychological safety.
  2. Content Article
    The Leapfrog Group is a non-profit watchdog organisation that serves as a voice for healthcare consumers in the US, using their collective influence to foster positive change in healthcare. It provides patient safety ratings for hospitals, grading them from A to E. This article in Becker's Hospital Review highlights the patient safety priorities for 2023 of eleven US hospitals that have consistently been awarded 'A' grades by Leapfrog. Key themes include a focus on reducing healthcare associated infections, increasing psychological safety for staff and improving communication between staff and patients.
  3. Content Article
    In this blog, Matthew Wain highlights how NHS organisations can support staff with patient safety investigations, and more generally, in the face of increased pressure. He looks at missed learning opportunities, psychological impact, and the support tools and programmes available for staff. Further reading: Patient Safety Learning's Staff Support Guide: a good practice resource following serious patient harm
  4. Content Article
    Teamwork is critical in delivering quality medical care, and failures in team communication and coordination are substantial contributors to medical errors. This study in JAMA Internal Medicine aimed to determine the effectiveness of increased familiarity between medical resident doctors and nurses on team performance, psychological safety and communication. The authors found that increased familiarity between nurses and residents promoted rapid improvement of nursing perception of team relationships and, over time, led to higher team performance on complex cognitive tasks in medical simulations. They argue that medical systems should consider increasing team familiarity as a way to improve doctor-nursing teamwork and patient care.
  5. Content Article
    This BMJ Leader article from Roger Kline looks at how to tackle structural racism in the NHS, discussing psychological safety and inclusion, and the role leaders need to play.
  6. Content Article
    If a manager approaches your desk, do you feel a sense of anxiety? If your team wants to challenge an idea or offer a different perspective, do they feel free to speak up? These are both examples of psychological safety - or a potential lack thereof - in the workplace. Organisations have focused heavily on mental health and well-being at work over the last few years, but many still lack an awareness of psychological safety, how it can impact your team and the consequences of an unsafe culture. This article looks at how you can measure and improve psychological safety.
  7. Content Article
    In this blog, Steve Turner reflects on why genuine patient safety whistleblowers are so frequently ignored, side-lined or victimised. Why staff don't speak out, why measures to change this have not worked and, in some cases, have exacerbated the problems. Steve concludes with optimism that new legislation going through Parliament offers a way forward from which everyone will benefit.
  8. Content Article
    This editorial in BMJ Quality & Safety argues that patients' perceptions of their safety should not be dismissed when measuring healthcare safety. The authors argue that a differentiation between ‘feeling safe’, as defined through patient experience, and ‘being safe’, as defined through observation and evaluation using clinical outcomes selected by quality experts, creates a power differential and dynamic that degrades the role and value of patient experiences as valid patient safety indicators.
  9. Content Article
    This series of webinars by FEFO Consulting looks at how to identify psychosocial hazards at work and manage the associated risks. You can watch the four webinars on FEFO's YouTube channel: ISO 45003 vs Model code of practice – Getting started Change management – Managing psychosocial risks Mental fitness – Opening up conversations HR vs safety – Psychosocial ownership
  10. Content Article
    The Fearless Organization by Amy C. Edmondson highlights the importance of psychological safety in the workplace. This article published by Conflux, pulls out some key take home messages from the book that can help in building an organisation where staff feel safe to speak up.
  11. News Article
    Women working in the NHS are suffering from serious stress and exhaustion in the wake of the coronavirus crisis, a troubling new report has found. Some 75% of NHS workers are women and the nursing sector is predominantly made up of women – with 9 out of 10 nurses in the UK being female. The report, conducted by the NHS Confederation’s Health and Care Women Leaders Network, warns the NHS is at risk of losing female staff due to them experiencing mental burnout during the global pandemic. Researchers, who polled more than 1,300 women working across health and care in England, found almost three quarters reported their job had a more damaging impact than usual on their emotional wellbeing due to the COVID-19 emergency. Read full story Source: The Independent, 25 August 2020
  12. News Article
    An independent investigation into working conditions at a unit of the NHS’s blood and organ transplant service has concluded that it is “systemically racist” and “psychologically unsafe.” The internal investigation was commissioned in response to numerous complaints from ethnic minority staff working in a unit of NHS Blood and Transplant (NHSBT) in Colindale, north London. The report, carried out by the workplace relations company Globis Mediation Group, concluded that the environment was “toxic” and “dysfunctional.” The report found evidence that ethnic minority employees had faced discrimination when applying for jobs and that white candidates had been selected for posts ahead of black applicants who were better qualified. “Recruitment is haphazard, based on race and class and whether a person’s ‘face fits,’” it said. “Being ignored, being viewed as ineligible for promotion and enduring low levels of empathy all seem to be normal,” the report noted. “These behaviours have created an environment which is now psychologically unsafe and systemically racist.” Chaand Nagpaul, BMA council chair, commented, “This report highlights all too painfully the racial prejudices and discrimination we are seeing across healthcare. We must renew efforts to challenge these behaviours and bring an end to the enduring injustices faced by black people and BAME healthcare workers here in the UK.” Read story Source: BMJ, 10 June 2020
  13. News Article
    The NHS is launching a hotline to support and advise healthcare staff during the coronavirus pandemic. Volunteers from charities including Hospice UK, the Samaritans and Shout, will listen to concerns and offer psychological support. The phone line will be open between 07:00 and 23:00 every day, while the text service will be available around the clock. The phone number is 0300 131 7000 or staff can text FRONTLINE to 85258. It comes as staff face increasing pressure to care for rising numbers of patients who are seriously ill with the virus. Read full story Source: BBC News, 8 April 2020
  14. News Article
    Matt Morgan, an intensive care doctor, describes in this Guardian article how his ICU are preparing for the coronavirus crisis. "ICUs are as prepared as they can be. Locally business as usual has made way for preparations for caring for high numbers of patients. We are finding every ventilator we may have and identifying every suitably qualified member of staff. We will work together to fill gaps as best we can. There’s a sense of anticipation about what the next eight, 10, 12 weeks are going to bring in terms of work. Anyone who works in healthcare is also a mum, dad, daughter, brother, son. We want to give everything to saving lives and work and care, but equally we’re thinking about the logistics of personal lives and elderly relatives too." Matt says his worst nightmare is having insufficient workforce and equipment to meet patient needs. Whether or not that will come to fruition is tough to predict. He also says that his ICU has a psychologist who’s doing a huge amount of thinking about putting in place wellbeing resources for staff who might be in moral distress after having to prioritise one patient over another. "If there are 500 patients and only 200 ventilators then that’s when we need national guidance from the government and other bodies. It can’t be up to individual doctors. The age of playing God is long behind us. The question is who should we be making decisions with: the public, government or within the profession?" Read full story Source: The Guardian, 13 March 2020
  15. News Article
    Every week for nearly a year, Lorraine Shilcock attended an hour-long counselling session paid for by the NHS. She needed the therapy, which ended in November, to cope with the terrifying nightmares that would wake her five or six times a night, and the haunting daytime flashbacks. Lorraine, 67, a retired textile worker from Desford, Leicester, has post-traumatic stress disorder (PTSD). Her psychological scars due to a routine NHS medical check, which was supposed to help her, not leave her suffering. In October 2018, Lorraine had a hysteroscopy, a common procedure to inspect the womb in women who have heavy or abnormal bleeding. The 30-minute procedure, performed in an outpatient clinic, is considered so routine that many women are told it will be no worse than a smear test and that, if they are worried about the pain, they can take a couple of paracetamol or ibuprofen immediately beforehand. Yet for Lorraine, and potentially thousands more women in the UK, that could not be further from the truth. Many who have had a hysteroscopy say the pain was the worst they have ever experienced, ahead of childbirth, broken bones, or even a ruptured appendix, commonly regarded as the most agonising medical emergency. Yet most had no warning it would be so traumatic, leaving some, like Lorraine, with long-term consequences. But, crucially, it is entirely avoidable. Do you have an experience you would like to share? Join our conversation on the hub on painful hysteroscopy. We are using this feedback and evidence to help campaign for safer, harm-free care. Read full story Source: Mail Online, 3 March 2020
  16. News Article
    Five years after launching a plan to improve treatment of black and minority ethnic staff, NHS England data shows their experiences have got worse. Almost a third of black and minority ethnic staff in the health service have been bullied, harassed or abused by their own colleagues in the past year, according to “shameful” new data. Minority ethnic staff in the NHS have reported a worsening experience as employees across four key areas, in a blow to bosses at NHS England, five years after they launched a drive to improve race equality. Critics warned the experiences reported by BME staff raised questions over whether the health service was “institutionally racist” as experts criticised the NHS “tick box” approach and “showy but pointless interventions”. Read full story Source: The Independent, 18 February 2020
  17. News Article
    Mothers-to-be must be respected and listened to by medics, regulators have said, after warnings that pleas for pain relief in labour have been ignored. The intervention by the Nursing and Midwifery Council (NMC) follows an investigation by The Sunday Telegraph. Last week it was revealed that six NHS trusts were in breach of medical guidance which says pain relief should be provided at any point of labour if it is requested. Women said they were told “‘It’s not called labour for nothing, it’s meant to be hard work” as doctors refused their pleas. The findings prompted the Health Secretary to order an investigation. Today Andrea Sutcliffe, Chief Executive of the NMC, which regulates nurses and midwives said such actions should not be tolerated. In a letter to The Telegraph she said: "As the regulator for nursing and midwifery professionals, we know that all women deserve to have their views, preferences and decisions respected during pregnancy and birth." The watchdog recently published updated standards for midwives, which she said underlined this point. "Enabling women to make safe, informed decisions about the care they receive, including choices about pain relief during birth, is at the heart of our new Future Midwife Standards," the Chief Executive continued. Ms Sutcliffe said midwives should work "in partnership" with women in labour. "While midwives don’t administer epidurals, they do play a key role in helping women to make informed choices and advocating on their behalf to make sure those choices are understood and respected by the wider care team," she said. Read full story Source: The Telegraph, 2 February 2020
  18. News Article
    Women in labour are being denied epidurals by NHS hospitals, amid concern that a “cult of natural childbirth” is leaving rising numbers in agony. Last night, Matt Hancock, the Health Secretary, promised an investigation, and action to ensure women’s choices were respected, pledging to make the NHS maternity services the world-leader. An investigation by The Sunday Telegraph found hospitals refusing clear requests from mothers-to-be, in breach of official guidelines from the National Institute for Health and Care Excellence (NICE). Mr Hancock said all expectant mothers should be able to make an informed choice, knowing their choice would be fully respected. “Clinical guidance clearly state that you can ask for pain relief at any time – before and during labour – and as long as it is safe to do so this should never be refused. I’m concerned by evidence that such requests are being denied for anything other than a clinical reason,” he said. “It's vital this guidance is being followed right across our NHS, as part of making it the best place in the world to give birth. Women being denied pain relief is wrong, and we will be investigating.” One mother, describing her experience at one NHS Hospital said: "It made me feel unsafe psychologically - I couldn't speak up, I couldn’t say what I wanted to say, I couldn’t advocate for myself medically because people were ignoring or belittling me. It feels that in childbirth, it’s a given that the doctor is taking their personal beliefs with them to the table, whereas in any other area of healthcare that would be unacceptable." Read full story Source: The Telegraph, 26 January 2020
  19. News Article
    One in six women who lose a baby in early pregnancy experiences long-term symptoms of post-traumatic stress, a UK study suggests. Women need more sensitive and specific care after a miscarriage or ectopic pregnancy, researchers say. In the study of 650 women, by Imperial College London and KU Leuven in Belgium, 29% showed symptoms of post-traumatic stress one month after pregnancy loss, declining to 18% after nine months. The study recommends that women who have miscarried are screened to find out who is most at risk of psychological problems. "For too long, women have not received the care they need following a miscarriage and this research shows the scale of the problem," says Jane Brewin, Chief Executive of miscarriage and stillbirth charity Tommy's. "Miscarriage services need to be changed to ensure they are available to everyone and women are followed up to assess their mental wellbeing with support being offered to those who need it, and advice is routinely given to prepare for a subsequent pregnancy." Read full story Source: BBC News, 15 January 2020
  20. Content Article
    In a previous blog, 'What is a Whistleblower',[1] Hugh drew attention to negative perceptions of whistleblowers in the eyes of some people. A crossword and clues were published on the hub to emphasise how wrong such perceptions are and how damaging they can be, with serious patient safety implications.[2] This follow-up outlines the nature of the journey travelled by some NHS staff who have spoken up and the problems which still exist with NHS whistleblowing culture. It provides a link to an attached file which contains the answers to each clue. The attachment also shows the completed crossword in larger, easier-to-read, format than the small illustration in this blog. There is a further link to companion notes which expand on the answer to each clue. These notes contain more detail about the realities of speaking up. They reinforce the link between hostility towards those who speak up and an ongoing series of patient safety scandals.[7-21]
  21. Content Article
    This issue of Hindsight concerns ‘the new reality’ that we are facing. It includes a wide variety of articles from frontline staff and specialists in safety, human factors, psychology, aeromedical, and human and organisational performance in aviation. There are also insights from healthcare, shipping, rail, community development and psychotherapy. 
  22. Content Article
    Second victims are healthcare providers involved in an unexpected adverse event, medical error or injury affecting a patient, who become victims in the sense they are traumatised by it. The purpose of the 'European Researchers' Network Working on Second Victims' is to Introduce an open dialogue among stakeholders about the theoretical conceptualisation and practical consequences of the second victims’ phenomenon based on a cross-national collaboration that integrates different disciplines and approaches. It facilitates discussion and share scientific knowledge, perspectives, and best practices concerning the consequences of adverse events in the healthcare workforce and to implement joint efforts to tackle with the second victims’ phenomenon.
  23. Content Article
    In this opinion piece, hub topic lead Saira Sundar looks at the culture of misogyny we have inherited in the medical profession, particularly in the obstetrics and gynaecology area of medicine. We hear time and time again women speaking up about being mistreated and/or disbelieved by medical professionals, resulting in delays in diagnosis and serious harm. However, there is a real change being forced by women themselves, with the public increasingly questioning and insisting on improvement and the right to be heard.
  24. Content Article
    This blog is prompted by a recent newspaper crossword in which one of the clues, quadruplicated, was 'Whistle-blower'. The four answers were, respectively, 'canary', 'snitch', 'telltale' and 'betrayer'. The blog draws attention to negative perceptions of whistleblowers in the eyes of some people. It emphasises how wrong these perceptions are and how damaging this can be, with serious patient safety implications. In this blog I provide a crossword counterpoint (attached below to solve), which seeks to support learning about the realities of hostility against some staff who speak up in the NHS. I will share a follow-up blog which contains the solution to this crossword and seeks to provide further education on this topic where there is so much confusion and misunderstanding.
  25. Content Article
    Posters submitted to the Learning from Excellence Conference. The posters were grouped into three sessions, based on the topic of the poster and the session theme.
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