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Found 190 results
  1. Content Article
    Recent years have seen a surge in interest in the study of resilience in medical professionals. Concern has been expressed about the psychological wellbeing of doctors in general and of surgeons specifically, with increasing individual doctors’ resilience being suggested as a possible solution.1 However, there are potential risks as well as benefits to this focus on individual resilience. This article from Bolderston et al. explores both sides of the resilience coin, and considers potentially helpful ways of addressing psychological wellbeing and resilience in surgeons, including the development of an Acceptance and Commitment Therapy-based intervention.
  2. Content Article
    In a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In this final blog of the series, Gina shares the next steps for Safety Chats in her Trust and how they will be building more ways of supporting staff to discuss safety, to seek advice and support, and to receive clear assistance when things have gone wrong.
  3. Content Article
    Racism is a pervasive problem in Western society, leading to mental and physical unwellness in people from racialised groups. Psychology began as a racist discipline and still is. As such, most clinical training and curricula do not operate from an anti-racist framework. Although most therapists have seen clients with stress and trauma due to racialisation, very few were taught how to assess or treat it. Furthermore, clinicians and researchers can cause harm when they rely on White-dominant cultural norms that do not serve people of colour well. This paper from Racism is a pervasive problem in Western society, leading to mental and physical unwellness in people from racialized groups. Psychology began as a racist discipline and still is. As such, most clinical training and curricula do not operate from an anti-racist framework. Although most therapists have seen clients with stress and trauma due to racialisation, very few were taught how to assess or treat it. Furthermore, clinicians and researchers can cause harm when they rely on White-dominant cultural norms that do not serve people of colour well. This paper from Williams et al. discusses how clinicians can recognize and embrace an anti-racism approach in practice, research, and life in general. Included is a discussion of recent research on racial microaggressions, the difference between being a racial justice ally and racial justice saviour, and new research on what racial allyship entails. Ultimately, the anti-racist clinician will achieve a level of competency that promotes safety and prevents harm coming to those they desire to help, and they will be an active force in bringing change to those systems that propagate emotional harm in the form of racism.
  4. Content Article
    Repeated culture of safety surveys of the nursing staff at Children’s Hospital of Philadelphia’s main campus demonstrated lagging scores in the domain of nonpunitive responses to error. The hospital had tried for many years to address the problem using a variety of strategies, including small group training sessions on just culture for staff and leaders, but had met with limited success. Finally, in 2015, it committed to trying something genuinely different—even perhaps disruptive—that might actually shift the stagnant metrics. Their novel, multifaceted programme, implemented over a two-year period, yielded a 13% increase in staff rating scores that the hospital has been able to sustain over the subsequent two-year period.  The design and rollout of our program was neither simple nor smooth, but valuable lessons were learned about realistic, operational implementation of principles of psychological safety in a large and complex clinical organisation. In this paper, Neiswender et al. describe the programme and the lessons learned in the journey from idea inception to post-implementation.
  5. Content Article
    During COVID-19, clinical teams faced disruption, having to respond to challenging circumstances and high uncertainty, whilst providing quality care to patients. We know that staff psychological wellbeing affects team effectiveness and patient experience and resilience is fostered by connections between (not just within) individuals. New collaborations between clinical, service improvement and psychology teams recognised the value of introducing the psychologically-informed ‘Start Well>End Well’ team procedure into routine team processes. This evidence-based approach consists of 1) an enhanced safety briefing, 2) peer-to-peer debrief guidance and signposting for trauma-focused support, and 3) team check-out. Initially launched as a general procedure across all wards with variable uptake, a more tailored co-design and coaching approach was then piloted on 2 neurology wards over 3 PDSA cycles. Formative evaluation (focus groups and written feedback) demonstrated staff felt “cared for” whilst achieving “positive impact” through improved ways of working within new teams.
  6. Content Article
    Successful 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.
  7. Content Article
    Presentation from Julia Wood given to the Patient Safety Manager Network (PSMN) on the importance of finding joy and happiness in work and how you can support your staff.
  8. Content Article
    Moral injury is a specific kind of trauma that can happen when when people face situations that deeply violate their conscience or threaten their core values. This blog for Scientific American looks at the experience of ER doctor Torree McGowan when the Delta wave of Covid-19 hit the central Oregon region where she works. It examines the impact that moral injury has had on her mental health and her relationship with patients. The author looks at how Covid-19 hugely increased the incidence of moral injury as people in frontline roles faced ethically wrenching dilemmas every day. The growing realisation that moral injury is a separate diagnosis to other conditions such as PTSD and depression is resulting in a wider range of treatments and trauma therapies. Many of these treatments encourage people to face moral conflicts head-on rather than blotting them out or explaining them away, and they emphasize the importance of community support in long-term recovery.
  9. Content Article
    The NHS Patient Safety Strategy aims to monitor and support the development of a strong patient safety culture within the NHS, creating an environment where individuals feel they will be treated fairly and compassionately if they speak up. In this publication, NHS England collates insights from focus groups held with NHS organisations that are rated by the Care Quality Commission as outstanding or good for its ‘Safe’ assessment domain. The insights reflect what they have done to support a patient safety culture within their organisations.
  10. Content Article
    The National Institute for Clinical Excellence (NICE) defines psychosocial assessment following self-harm as ‘a comprehensive assessment including an evaluation of the person’s needs, safety considerations and vulnerabilities that is designed to identify those personal psychological and environmental (social) factors that might explain an act of self-harm’. NICE advises that all people who self-harm should be offered a psychosocial assessment at an early stage. Psychosocial assessment should include biological factors alongside psychological and socio-environmental aspects and is often termed ‘biopsychosocial assessment’. The aim of this document from the Centre for Suicide Research is to provide clinicians with guidance to help them conduct a comprehensive psychosocial assessment. To support this, associated signposting to supporting evidence and useful reading is included.
  11. Content Article
    Racism is unacceptable and it has no place in health and care. But we know that it exists and that the impact on staff can be devastating. All registered professionals have responsibility under the Nursing and Midwifery Council (NMC) Code to challenge discriminatory behaviour, creating an environment where people are treated as individuals and with dignity and respect. This resource is firmly rooted in our professional Code and it is designed to support nurses, midwives and nursing associates, providing advice on the action you can take if you witness or experience racism. It also supports those in leadership roles to be inclusive leaders. This document provides practical examples of how, as nursing and midwifery professionals, you can recognise, and challenge racial discrimination, harassment, and abuse. It also highlights other useful resources and training materials that will support you to care with confidence. This document is a resource for individuals at all levels. This resource does not replace existing NHS England policies and procedures for speaking up and managing racism. It is a resource to support best practice in line with organisational policies and procedures.
  12. Content Article
    This programme from the Advancing Quality Alliance (Aqua) provides participants with the tools, skills and knowledge to oversee the successful implementation of a safety culture survey in organisations. Participants of this programme will develop a working knowledge of safety culture theory and the Agency for Healthcare Research and Quality (AHRQ) safety culture survey alongside the support that Aqua provides to enable deployment and analysis of the survey. This programme links directly to Aqua’ safety offers, including Psychological Safety, Human Factors and Improvement Practitioner programmes.
  13. Content Article
    The Resilient Surgeon is a podcast by The Society of Thoracic Surgeons in the US. In this episode, Dr Michael Maddaus interviews Dr Amy Edmondson, a scholar of leadership, teamwork and organisational learning. Dr Edmondson defines psychological safety as a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns or mistakes. It makes a team a safe place for interpersonal risk-taking. In this podcast, she explains how psychological safety is the key to unlocking high quality conversations that result in improved team outcomes.
  14. Event
    This webinar from the International Society for Quality in Healthcare (ISQua) presents research that takes an in-depth look at what psychological safety means for health workers, how it differs within and across teams and how it is influenced by leaders and by team characteristics and team dynamics. Register
  15. Content Article
    Those who have read Professor Edmondson's book "The Fearless Organization" will know that psychological safety is required for team high-performance. Psychological safety is defined as "a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes". If you do not feel safe in a group, you are likely to keep ideas to yourself and avoid speaking up, even about risks. Furthermore, if mistakes are held against you, you then look to avoid making mistakes and so stop taking risks, rather than making the most out of your talents. Low psychological safety, therefore, gets in the way of both team performance, innovation, learning, and personal success. For you to be successful in your team, and "as a team", psychological safety is the enabler. In collaboration with professor Amy C. Edmondson, The Fearless Organization has developed 'The Fearless Organization Scan'. This scan maps how team members perceive the level of psychological safety in their closest context. To improve team performance, it helps to know the Psychological Safety levels in your team, as this is a critical predictor of how your team will learn and work together. By improving the level of psychological safety, you significantly increase the likelihood of team success.
  16. Content Article
    Identifying improvements in maternity care to help reduce the risk of delays in crucial interventions during labour when a baby is suspected to be unwell is the focus of this latest Healthcare Safety Investigation Branch (HSIB) report. The report was compiled after a review of 289 of our maternity investigations into intrapartum stillbirths, neonatal deaths and potential severe brain injuries. In 14.9% of the cases the delay was a contributory factor. The review identified issues such as inadequate staffing, poor infrastructure and high workload as contributory factors to the delays. Evidence from national reports confirms that such delays are a recognised patient safety risk. 
  17. Content Article
    The aim of this study from Choi et al. was to investigate the scope and severity of the second victim problem among nurses in South Korea by examining the experiences and effects of patient safety incidents (PSIs) on them. The study found a considerable number of nurses experienced psychological difficulties due to PSIs at levels that could interfere with their work. The effect of PSIs on nurses with direct experience of PSIs was greater compared with those with indirect experience. There need to be psychological support programmes for nurses to alleviate the negative effects of PSIs.
  18. Content Article
    Speaking up protects patient safety and improves the lives of workers. When things go wrong, we need to make sure that lessons are learnt and things are improved. If we think something might go wrong, it’s important that we all feel able to speak up so that potential harm is prevented. Even when things are good, but could be even better, we should feel able to say something and should expect that our suggestion is listened to and used as an opportunity for improvement. Freedom to Speak Up is about encouraging a positive culture where people feel they can speak up and their voices will be heard, and their suggestions acted upon. Follow the below link to access training modules that explain in a clear and consistent way what speaking up is and its importance in creating an environment in which people are supported to deliver their best. It will help you understand the vital role you can play and the support available to encourage a healthy speaking up culture for the benefit of patients and workers. The training has been developed by the National Guardian and Health Education England for anyone who works in healthcare.
  19. Content Article
    In September this year, as part of World Patient Safety Day, Patient Safety Learning asked people, via social media and the hub, to name three things staff most needed to be safe. We gathered your responses and are now pleased to present an image which shows the most common themes. According to the responses we received, the four themes that became most obvious – the four things you think staff most need to be safe – are: Compassionate leaders and role models who prioritise their staff’s wellbeing A respectful, supportive team with good communication and united by a common purpose A safe and just culture that invites staff to speak up Psychological safety, protecting staff from burnout.
  20. Content Article
    In this blog for the Guardian, a well respected surgeon tells of the time they were admitted to the intensive care unit of the hospital where they worked following a suicide attempt. The surgeon explains how depression is a lot more common in medicine than realised but how it is still stigmatised, even within the medical profession. Many medical staff often display signs of depression differently to others and keep working right up until they break; work brings comfort from the feelings of hopelessness and worthlessness. Very few have the opportunity to attend counselling, since this would require taking time off work.  "I would be smiling and laughing on the outside, but on the inside was a continuous mantra of self-loathing that kept getting louder. I pushed myself harder, took extra shifts, tried to put my head down and just get through it. One day, I had had enough. The pain had become physical as well as mental, and the idea of having to live any longer was unbearable."
  21. Content Article
    Older people and people with an intellectual disability who receive long-term care are considered particularly vulnerable to infection outbreaks, such as the current coronavirus pandemic. The combination of healthcare concerns and infection-related restrictions may result in specific challenges for long-term care staff serving these populations during infection outbreaks. This review from Embregts et al. aimed to: (1) provide insight about the potential impact of infection outbreaks on the psychological state of healthcare staff and (2) explore suggestions to support and protect their psychological well-being. They found that research into support for long-term care staff during an infection outbreak is scarce. Without conscious management, policy and research focus, the needs of this professional group may remain underexposed in current and future infection outbreaks. The content synthesis and reflection on it in this article provide starting points for new research and contribute to the preparation for future infection outbreaks.
  22. Content Article
    If psychological safety is the number one variable in team performance then how do you improve it? Where do you start? What are the key actions you can take to increase the level of psychological safety in your environment? This guide from Leader Factor has 120+ behaviours you can use to have a higher level of psychological safety. You can download the guide by filling in the online form.
  23. Content Article
    Right now, healthcare workers are facing an extremely challenging situation, doing important and difficult work. Taking care of your mental health and managing feelings might be taking a back seat. 'Our Frontline' offers round-the-clock one-to-one support, along with a collection of resources, tips and ideas chosen to support your mental health as you do your work to protect us all and keep the country going. To talk by text, text FRONTLINE to 85258 any time. To talk by phone for free, call 0800 069 6222 from 7am to 11pm if you’re in England, or call 116 123 any time if you’re elsewhere in the UK. It’s all in confidence, with trained volunteers. The link below gives some more details about the help that’s available, and some other things that Our Frontline think you’ll find useful. 
  24. Content Article
    We all want passionate employees. We want them to care about their jobs and go that extra mile for our company. We also want them to have the confidence to speak up if they think it’s necessary — whether it’s to question a given workplace process or ask a question about the nature of their SMART objectives. Of course, not all employees will stand up and make themselves be heard. So what makes some employees suffer in silence while others are emboldened to stand out from the crowd? The answer is psychological safety. A psychologically safe workplace cultivates a work environment where team members have the freedom to speak out. This environment thrives on mutual respect and encourages co-workers to share their ideas and thoughts without the fear of being shot down or ignored. The obvious effects of psychological safety are better employee wellbeing and mental health. . Stuart Hearn, a performance management specialist, gives his three examples of change that can improve the level of psychological safety in the workplace.
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