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Found 75 results
  1. Content Article
    Research conducted by a team at the University of Birmingham delves into the intricate dynamics of empathy towards patients and colleagues, revealing insights that challenge conventional wisdom. Empathy is widely recognised as a cornerstone of medical care. Increased physician empathy has been linked to better patient outcomes and satisfaction, yet there has been little exploration of its presence in surgical training. The study involved interviews with 10 surgical trainees at various stages of their careers to uncover a nuanced understanding of empathy within the profession. Contrary to the widely documented decline in empathy among medical students and professionals, participants described their experiences as a balance between empathy and the demands of surgical practice. Participants acknowledged the importance of empathy in patient care but highlighted the challenges of maintaining it amid the pressures of a surgical environment. They described a delicate balance between understanding patients’ needs and the efficiency required to manage high patient volumes and demanding workloads. The study revealed how empathy evolves throughout a surgeon’s career. Whilst some trainees experienced desensitisation to emotional stimuli, many described increased empathy as they gained more experience and exposure to patient care.
  2. Content Article
    There is currently a lack of research addressing the impact of patient suicide on GPs. This qualitative study in BMJ Open aimed to examine the personal and professional impact of patient suicide, as well as the availability of support and why GPs did or did not use it. The authors found that GPs are impacted both personally and professionally when they lose a patient to suicide, but may not access formal help due to commonly held idealised notions of a ‘good’ GP who is regarded as being unshakable. Fear of professional repercussions also plays a major role in deterring help-seeking. A systemic culture shift which allows GPs to seek support when their physical or mental health requires it is needed, and this may help prevent stress, burnout and early retirement.
  3. Content Article
    Nontechnical skills (NTS) are the behaviours and thought processes used by surgeons to make decisions, maintain awareness of the operating environment, communicate with and lead team members with the view to producing reliably safe outcomes. This qualitative research explored how surgeons deploy NTS to facilitate safe and effective outcomes from surgical interventions. The authors conclude that successfully understanding and engaging NTS is potentially more proactively useful to surgeons than feedback from more invasive techniques used by some approaches to safe operator assurance.
  4. Content Article
    Despite their widespread use, the evidence base for the effectiveness of quality improvement collaboratives remains mixed. Lack of clarity about ‘what good looks like’ in collaboratives remains a persistent problem. This qualitative study in BMJ Open aimed to identify the distinctive features of a state-wide collaboratives programme that has demonstrated sustained improvements in quality of care in a range of clinical specialties over a long period. The authors identified five features that characterised success in the collaboratives programme: learning from positive deviance high-quality coordination high-quality measurement and comparative performance feedback careful use of motivational levers mobilising professional leadership and building community.
  5. Content Article
    The EvidenceNOW: Advancing Heart Health in Primary Care trial was designed to assist primary care practices in the US in implementing evidence-based practices in cardiovascular care and building capacity for quality improvement. This qualitative study in BMC Primary Care aimed to gain a comprehensive understanding of perspectives from research participants and team members on the value of implementation strategies and factors that influenced the EvidenceNOW initiative in Virginia. Read a simplified research summary: Strategies for implementing large-scale quality improvement in primary care
  6. Content Article
    Hospitals are complex adaptive systems. They are industrial environments where it isn't always possible to expect predictable responses to inputs. Patient safety management practices need to adapt to align with the environment in which events occur. It is time to reimagine safety event reporting and management solutions that guide, not prescribe, investigations and improvement actions.
  7. Content Article
    Efforts to increase physician engagement in quality and safety are most often approached from an organisational or administrative perspective. Given hospital-based physicians’ strong professional identification, physician-led strategies may offer a novel strategic approach to enhancing physician engagement. It remains unclear what role medical leadership can play in leading programmes to enhance physician engagement. In this study, Rotteau et al. explore physicians’ experience of participating in a Medical Safety Huddle initiative and how participation influences engagement with organisational quality and safety efforts. They found that The Medical Safety Huddle initiative supports physician engagement in quality and safety through intrinsic motivation. However, the huddles’ implementation must align with the organisation’s multipronged patient safety agenda to support multidisciplinary collaborative quality and safety efforts and leaders must ensure mechanisms to consistently address reported safety concerns for sustained physician engagement.
  8. Content Article
    The aim of this study from Hutchinson et al. was to explore the reasons for and experiences of patients who make an unplanned return visit to the emergency department.
  9. Content Article
    Two information technology (IT)-based interventions, which aim to improve prescribing safety in primary care, have been rolled out across England over the past few years. Researchers identified five strategies which could help ensure that the systems continue to have an impact over the longer term. The first system (computerised decision support, or CDS) raises a warning when a clinician is about to prescribe a medicine that could increase a patient’s risk of harm. The second method (PINCER) is led by pharmacists; it searches people’s medical notes to identify potential errors that have already happened. Pharmacists, GPs and other clinicians work together to investigate and correct any errors. The research team examined documents, interviewed relevant professionals and carried out workshops which also involved members of the public. They identified strategies that could help ensure that these systems have an ongoing impact in primary care.
  10. Content Article
    Institutional racism within the United Kingdom's (UK) Higher Education (HE) sector, particularly nurse and midwifery education, has lacked empirical research, critical scrutiny, and serious discussion. This paper focuses on the racialised experiences of nurses and midwives during their education in UK universities, including their practice placements. It explores the emotional, physical, and psychological impacts of these experiences. The study concludes that the endemic culture of racism in nurse and midwifery education is a fundamental factor that must be recognised and called out. The study argues that universities and health care trusts need to be accountable for preparing all students to challenge racism and provide equitable learning opportunities that cover the objectives to meet the Nursing and Midwifery Council (NMC) requirements to avoid significant experiences of exclusion and intimidation.
  11. Content Article
    A ‘Just Culture’ aims to improve patient safety by looking at the organisational and individual factors that contribute to incidents. It encourages people to speak up about their errors and mistakes so that action can be taken to prevent those errors from being repeated.  Adam Tasker and Julia Jones are graduate medical students at Warwick Medical School. They wanted to explore doctors’ perceptions of culture and identify ways to foster a Just Culture, so they conducted a qualitative research study at one of the hospitals where they were doing their medical training. We asked them about why Just Culture is important in the health and care system, and what they discovered from their research.
  12. 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. Lesley talks to us about how personal stories enrich our understanding of data, drive real quality improvement and remind us that healthcare is all about people. She also explains how her own personal experience drives her work to improve healthcare experiences for patients and their families.
  13. Content Article
    This study in the journal Dove Press aimed to explore the experience of patient safety culture among South Korean advanced practice nurses in hospital-based home healthcare. 20 nurses involved in home healthcare were recruited from twelve hospitals located in three different cities throughout South Korea. The authors concluded that there were significant aspects of patient safety culture in hospital-based home healthcare, allowing for good continuity of care for patients. These aspects include communicating with caregivers, building community partnerships, understanding unexpected home environments and enhancing the safety of nurses.
  14. Content Article
    Patient lead users can be defined as patients or relatives who use their knowledge and experience to improve their own or a relative’s care situation and/or the healthcare system, and who are active beyond what is usually expected. This study in the BMJ Open aimed to explore patient lead users’ experiences and engagement during the early Covid-19 pandemic in Sweden, from 1 June to 14 September 2020. The authors recruited 10 patient lead users living with different long-term conditions and undertook qualitative in-depth interviews with each of them. They found that health systems were not able to fully acknowledge and engage with the resource of patient lead users during the pandemic, event though they could be a valuable resource as a complementary communication channel.
  15. Content Article
    Patient safety in ambulatory care settings is receiving increased attention. Based on interviews and focus groups with patients, providers, and staff at ten patient-centered medical homes, this qualitative study explored perceived facilitators and barriers to improving safety in ambulatory care. Participants identified several safety issues, including communication failures and challenges with medication reconciliation, and noted the importance of health information systems and dedicated resources to advance patient safety. Patients also emphasised the importance of engagement in developing safety solutions.
  16. Content Article
    Hughes et al. studied video consulting in the NHS during 2020–2021 through video interviews, an online survey and online discussions with people who had provided and participated in such consultations. Video consulting had previously been used for selected groups in limited settings in the UK. The pandemic created a seismic shift in the context for remote consulting, in which video transformed from a niche technology typically introduced by individual clinicians committed to innovation and quality improvement to offering what many felt was the only safe way to deliver certain types of healthcare. A new practice emerged: a co-constitution of technology and healthcare made possible by new configurations of equipment, connectivity and physical spaces. Despite heterogeneous service settings and previous experiences of video consulting, we found certain kinds of common changes had made video consulting possible. The authors used practice theory to analyse these changes, interpreting the commonalities found in our data as changes in purpose, material arrangements and a relaxing of rules about security, confidentiality and location of consultations.
  17. Content Article
    This qualitative study in BMC Medicine aimed to improve understanding of the reality of making and sustaining improvements in complex healthcare systems. It focused on understanding the implications of complexity theory, introducing a framework known as Successful Healthcare Improvement From Translating Evidence in complex systems (SHIFT-Evidence). This approach is accompanied by a series of ‘simple rules’ that aim to make complexity navigable (whilst recognising that it will never be simple), providing actionable guidance to both practice and research. The authors concluded that the SHIFT-Evidence framework provides a tool to guide practice and research. The ‘simple rules’ have potential to provide a common platform for academics, practitioners, patients and policymakers to collaborate when intervening to achieve improvements in healthcare.
  18. Content Article
    This study in the SA Journal of Human Resource Management aimed to develop a conceptual framework that identifies the critical success factors that affect the implementation of team coaching in organisations. The results indicate that to integrate successful team coaching into any organisation, effective analysis of an organisational context is required. This includes leadership stakeholders, team effectiveness, competency of a coach and employee engagement. The study also identified constraints that may prevent successful implementation of team coaching.
  19. Content Article
    Investigations of healthcare harm often overlook the valuable insights of patients and families. This review from Lauren et al. aimed to explore the perspectives of key stakeholders when patients and families were involved in serious incident investigations.
  20. Content Article
    To provide high quality services in increasingly complex, constantly changing circumstances, healthcare organisations worldwide need a high level of resilience, to adapt and respond to challenges and changes at all system levels. For healthcare organisations to strengthen their resilience, a significant level of continuous learning is required. Given the interdependence required amongst healthcare professionals and stakeholders when providing healthcare, this learning needs to be collaborative, as a prerequisite to operationalising resilience in healthcare. As particular elements of collaborative working, and learning are likely to promote resilience, there is a need to explore the underlying collaborative learning mechanisms and how and why collaborations occur during adaptations and responses. The aim of this study from Haraldseid-Driftland et al. was to describe collaborative learning processes in relation to resilient healthcare based on an investigation of narratives developed from studies representing diverse healthcare contexts and levels.
  21. Content Article
    Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. However, healthcare organisations often encounter difficulties in sustaining and sharing innovations. This qualitative study aimed to explore how healthcare innovators of process-based initiatives see and understand factors that either facilitated or obstructed the implementation of innovation. The authors found that even though the innovations studied were very varied, innovators often highlighted the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context.
  22. Content Article
    There has been an increase in the use of video group consultations (VGCs) by general practice staff, particularly since the beginning of the Covid-19 pandemic, when in-person care was restricted. This qualitative study in the British Journal of General Practice aimed to examine the factors affecting how VGCs are designed and implemented in general practice. Through semi-structured interviews with practice staff and patients, the authors found that: in the first year of the pandemic, VGCs focused on supporting those with long-term conditions or other shared health and social needs. most patients welcomed clinical and peer input, and the opportunity to access their practice remotely during lockdown. not everyone agreed to engage in group-based care or was able to access IT equipment. significant work was needed for practices to deliver VGCs, such as setting up the digital infrastructure, gaining team buy-in, developing new patient-facing online facilitation roles, managing background operational processes, protecting online confidentiality, and ensuring professional indemnity cover. national training was seen as instrumental in capacity building for VGC implementation.
  23. Content Article
    An increasing number of healthcare artificial intelligence (AI) applications are in development or already in use, but the safety impact of using AI in healthcare is largely unknown. This qualitative study in the journal Safety Science aimed to explore how different stakeholders (patients, hospital staff, technology developers and regulators) think about safety and the safety assurance of healthcare AI. Through a series of interviews, the authors assessed stakeholder perceptions of an AI-based infusion pump in the intensive care unit. Participants expressed perceptions about: the potential impact of healthcare AI requirements for human-AI interaction safety assurance practices and regulatory frameworks for AI and the gaps that exist how incidents involving AI should be managed. The authors concluded that there is currently a technology-centric focus on AI safety, and a wider systems approach is needed. They also identified a need for greater awareness of existing standards and best practice among technology developers.
  24. Content Article
    Rates of blood testing in primary care are rising. Communicating blood test results generates significant workload for patients, GPs, and practice staff. This study from Watson et al. explored GPs’ and patients’ experience of systems of blood test communication. The study found that methods of test result communication varied between doctors and were based on habits, unwritten heuristics, and personal preferences rather than protocols. Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety. Text messaging and online methods of communication have benefits, but were perceived by some patients as ‘flippant’ or ‘confusing’. Delays and difficulties obtaining and interpreting test results can lead to anxiety and frustration for patients and has important implications for patient-centred care and patient safety.
  25. Content Article
    This study from Pickles et al. explores experiences of women who identified themselves as having a possible breast cancer overdiagnosis.
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