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Showing results for tags 'Qualitative'.
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Content ArticleThis study from McQueen et al. explored what ‘good’ patient and family involvement in healthcare adverse event reviews may involve. Nineteen interviews were conducted with patients who had experienced an adverse event during the provision of their healthcare or their family member.
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- Patient engagement
- Patient / family involvement
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Content ArticleThis study from Shepard et al. aimed to explore staff perceptions of patient safety in the NHS ambulance services. The authors interviewed 44 participants from three organisational levels, including executives, managers and operational staff. They identified five dominant themes: varied interpretation of patient safety; significant patient safety risks; reporting culture shift; communication; and organisational culture. The findings demonstrated that staff perceptions of patient safety ranged widely across the three organisational levels, while they remained consistent within those levels across the participating ambulance service NHS trusts in England. The findings suggest that participants from all organisational levels perceive that the NHS ambulance services have become much safer for patients over recent years, which signifies an awareness of the historical issues and how they have been addressed. The inclusion of three distinct ambulance service NHS trusts and organisational levels provides deepened insight into the perceptions of patient safety by staff. As the responses of participants were consistent across the three NHS trusts, the identified issues may be generic and have application in other ambulance and emergency service settings, with implications for health policy on a national basis.
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Content ArticleFewer than 1% of UK general practice consultations occur by video. This study by Trisha Greenhalgh and colleagues aims to explain why video consultations are not more widely used in general practice.
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- Telehealth
- Consultation
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Content ArticleClinician burnout in healthcare is a growing area of concern, especially as the COVID-19 pandemic stretches on. Research from the U.S. Department of Veterans Affairs and Regenstrief Institute looked at ways organisations can address burnout.
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- Fatigue / exhaustion
- Staff safety
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Content Article
Patient Safety Journal
Claire Cox posted an article in Suggest a useful website
The latest issue of the Patient Safety Journal is now out. US patient safety journal brought to you by the Patient Safety Authority, an independent agency of the Commonwealth of Pennsylvania. Each issue publishes original, peer-reviewed research and data analyses and also gives patients a voice. It's mission is to give clinicians, administrators and patients the information they need to prevent harm and improve safety.- Posted
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- protocols and procedures
- Process redesign
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Content ArticleThe importance of employee voice—speaking up and out about concerns—is widely recognised as fundamental to patient safety and quality of care. However, failures of voice continue to occur, often with disastrous consequences.
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- Whistleblowing
- Speaking up
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Content ArticleRacially and ethnically minoritised healthcare staff groups disproportionately experience and witness workplace discrimination from patients, colleagues and managers. This is visible in their under-representation at senior levels and over-representation in disciplinary proceedings and is associated with adversities such as greater depression, anxiety, somatic symptoms, low job satisfaction and sickness absence. In the UK, little progress has been made despite the implementation of measures to tackle racialised inequities in the health services. Drawing on qualitative interviews with 48 healthcare staff in London (UK), Woodhead et al. identified how micro-level bullying, prejudice, discrimination and harassment behaviours, independently and in combination, exploit and maintain meso-level racialised hierarchies.
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- Health inequalities
- Health Disparities
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Content ArticleHealthcare can be risky. Adverse events carry a high cost – both human and financial – for health systems around the world. So in an effort to improve safety, many health systems have looked to learn from high-risk industries. The aviation and nuclear industries, for example, have excellent safety records despite operating in hazardous conditions. And increasingly, the tools and procedures these industries use to identify hazards are being adopted in healthcare. One prominent example involves the Hierarchy of Risk Controls (HoC) approach, which works by ranking the methods of controlling risks based on their expected effectiveness. According to HoC, the risks at the top are presumed to be more effective than those at the bottom. The ones at the top typically rely less on human behaviour: for example, a new piece of technology is considered to be a stronger risk control than training staff. This article looks more deeply at the (HoC) approach to explore its usefulness and effectiveness in healthcare. To investigate this issue, a team of social scientists examined the risk controls introduced by four hospital teams in England and Scotland after they had identified hazards in their systems.
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- Human error
- Human factors
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Content ArticleWard audit is a specific and common form of audit and feedback used in hospitals around the world. This study in BMC Health Services Research describes the content of ward audits and how they are carried out. The authors found that ward audits can have unintended and sometimes negative consequences, often caused by punitive feedback. They highlight the need to make feedback more constructive, for example, by including suggestions for improvement.
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- Hospital ward
- Audit
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Content ArticleIn this systematic review published in BMJ Open, the authors analyse and compare the focus of 694 studies about safety culture in hospitals. The review identifies 11 key themes relating to safety culture across the studies. The authors suggest that the wide range of methods and tools available highlights a persistent lack of consensus in defining patient safety. They also highlight the value of qualitative and mixed method approaches in providing context and meaning to quantitative surveys that assess safety culture.
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- Safety culture
- Safety assessment
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Content ArticleMany diagnostic mistakes are caused by reasoning errors, but lack of feedback makes it difficult for healthcare providers to make improvements in this area. This paper, published in BMJ Quality & Safety, describes the reason for and process of developing 'The Diagnosis Learning Cycle', a new model for feedback and improvement in diagnosis. The model is based on theory and knowledge from both outside and within the field of healthcare. It proposes a standardised feedback mechanism that includes concrete measures of factors such as reasoning and confidence.
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- Process redesign
- Clinical process
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Content ArticleThe COVID-19 pandemic has imposed extraordinary strains on healthcare workers. But, in contrast with acute settings, relatively little attention has been given to those who work in mental health settings. Liberati et al. aimed to characterise the experiences of those working in English NHS secondary mental health services during the first wave of the pandemic.
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- Mental health
- Qualitative
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Content ArticleThe positive deviance approach seeks to identify and learn from those who demonstrate exceptional performance. This study from Baxter et al. sought to explore how multidisciplinary teams deliver exceptionally safe care on medical wards for older people. Based on identifiable qualitative differences between the positively deviant and comparison wards, 14 characteristics were hypothesised to facilitate exceptionally safe care on medical wards for older people. This paper explores five positively deviant characteristics that healthcare professionals considered to be most salient. These included the relational aspects of teamworking, specifically regarding staff knowing one another and working together in truly integrated multidisciplinary teams. The cultural and social context of positively deviant wards was perceived to influence the way in which practical tools (eg, safety briefings and bedside boards) were implemented. This study exemplifies that there are no ‘silver bullets’ to achieving exceptionally safe patient care on medical wards for older people. Healthcare leaders should encourage truly integrated multidisciplinary ward teams where staff know each other well and work as a team. Focusing on these underpinning characteristics may facilitate exceptional performances across a broad range of safety outcomes.
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- Organisational Performance
- Organisational culture
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Content ArticleGP practices are usually run separately from hospitals. In some places in England and Wales, the NHS organisations responsible for managing hospitals are now also running local GP practices. It is difficult in some areas for practices, which are small organisations, to recruit GPs and keep going. It is also desirable to coordinate GP services with hospital care. For these reasons, it may help if the organisations managing hospitals also run GP practices.
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- GP practice
- Organisation / service factors
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News Article
Using Twitter to assess patient takes on patient experience
Clive Flashman posted a news article in News
A qualitative study of Twitter hashtags revealed power hierarchies can damage the patient experience and clinician relationship. In an analysis of a popular Twitter hashtag, researchers found that patients largely take umbrage when they feel their doctor does not believe their ailment or knowledge about their healthcare, and when they perceive a power hierarchy between themselves and their clinician. Although not as many patients are using Twitter to get peer feedback on certain providers (the Binary Fountain poll showed only 21% of patients do this), the social media website still holds a lot of power, researchers from the University of California system explained. Twitter is a large platform that hosts social discourse. Healthcare professionals use Twitter to disseminate public health and patient education messages and to network, while 61% of patients use Twitter to learn more about their health, as well. Read full article Source: Patient Engagement HIT, 29 October 2020- Posted
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- Patient
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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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- Patient engagement
- Collaboration
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Content ArticleAccessing social care and social support services is key to support the well-being of people living with dementia (PLWD) and unpaid carers. COVID-19 has caused sudden closures or radical modifications of these services, and is resulting in prolonged self-isolation. The aim of this study from Giebel et al., published in Aging and Mental Health, was to explore the effects of COVID-19 related social care and support service changes and closures on the lives of PLWD and unpaid carers. Fifty semi-structured interviews were conducted with unpaid carers. The study found that PLWD and carers need to receive specific practical and psychological support during the pandemic to support their well-being, which is severely affected by public health restrictions.
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- Virus
- Secondary impact
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Content ArticleDementia is a cause of disability and dependency associated with high demands for health services and expected to have a significant impact on resources. Care policies worldwide increasingly rely on family caregivers to contribute to service delivery for older people, and the general direction of health care policy internationally is to provide care in the community, meaning most people will receive services there. Patient safety in primary care is therefore important for future care, but not yet investigated sufficiently when services are carried out in patients’ homes. In particular, we know little about how family carers experience patient safety of older people with dementia in the community.
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News Article
New patient safety research by Northumbria University achieves global accolades
Clive Flashman posted a news article in News
Looking to improve practice through learning Errors, mishaps and misunderstandings are surprisingly common in medicine and around one in 10 patients suffer avoidable harm, impacting on patients, their families, health care organisations, staff and students. However a research project seeking to improve patient safety across Europe, led by Newcastle-based Northumbria University, has received international acclaim as it looks to improve practice through learning. The SLIPPS (Shared Learning from Practice to improve Patient Safety) project is Co-funded by the Erasmus+ Programme of the European Union, and is led by Professor Alison Steven, a Reader in Health Professions Education at Northumbria University. Professor Steven has a longstanding interest in the use of education to raise standards of care and ensure patient safety. Considering the rapid spread of Covid 19, she says improving patient safety and standards of care across Europe and beyond, has never been more important. Read full article here -
Content ArticleWhen patients give feedback to healthcare providers, the topic of "communication" often features prominently. That is because when people are feeling vulnerable, the way they are spoken to, and the words that are used, matter a great deal. There can be few experiences that are more distressing than the death of a baby. So we need to think very carefully about how bereaved parents are spoken to. This paper looks at clinical terms such as "miscarriage", "stillbirth" and "neo-natal death" and finds that "These categorisations based on gestational age and signs of life may not align with the realities of parental experience". This study, published by the International Journal of Obstetrics and Gynaecology, explored the healthcare experiences of parents whose babies had died just before 24 weeks of gestation. Those interviewed "felt strongly that describing their loss as a "miscarriage" was inappropriate and did not adequately describe their lived experience".
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- Communication
- Patient factors
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Content ArticleTechnology is often viewed as either positive or negative. On one hand weight loss apps are usually seen as a positive influence on users. From the sociocultural perspective, on the other hand, media and technology can negatively impact body satisfaction and contribute to eating disorders; however, these studies fail to include weight loss apps. While these apps can be beneficial to users, they can also have negative effects on users with eating disorder behaviours. Yet few research studies have looked at weight loss apps in relation to eating disorders. In order to fill this gap,these researchers conducted interviews with 16 women with a history of eating disorders who use(d) weight loss apps. While findings suggest these apps can contribute to and exacerbate eating disorder behaviours, they also reveal a more complex picture of app usage. Women’s use and perceptions of weight loss apps shift as they experience life and move to and from stages of change. This research troubles the binary view of technology and emphasises the importance of looking at technology use as a dynamic process. This study contributes to the understanding of weight loss app design.
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- Eating disorder
- Service user
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Content ArticleMuch policy focus has been afforded to the role of 'whistleblowers' in raising concerns about quality and safety of patient care in healthcare settings. However, most opportunities for personnel to identify and act on these concerns are likely to occur much further upstream, in the day-to-day mundane interactions of everyday work. Using qualitative data from over 900 hours of ethnographic observation and 98 interviews across 19 English intensive care units (ICUs), the authors of this paper, published in Social Science & Medicine, studied how personnel gave voice to concerns about patient safety or poor practice.
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- Whistleblowing
- Reporting
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Content ArticleWith the aim of examining current and potential practice in relation to soft intelligence, the authors conducted and analysed 107 in-depth qualitative interviews with senior leaders, including managers and clinicians, involved in healthcare quality and safety in the English National Health Service. This study, published by Science Direct, found that participants were in little doubt about the value of softer forms of data, especially for their role in revealing troubling issues that might be obscured by conventional metrics.
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- Patient engagement
- Qualitative
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Content ArticleThe aim of this qualitative service evaluation, published by Nursing in Critical Care, was to map the barriers and facilitators to the escalation of care in the acute ward setting and identify those that are modifiable. This service evaluation identified barriers and facilitators to the escalation of care in the acute ward setting. Unlike other studies, we found that re‐escalation or tracking of deterioration was problematic. Patients identified as being at a higher risk of escalation failure included complex patients, outliers, and patients with multiple care teams.
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Content ArticleThis study, published in Risk Management and Healthcare Policy, analyses staffs perception of a safety culture and their knowledge of safety measures in the hospitals of Saudi Arabia.
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- Safety assessment
- Qualitative
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