Search the hub
Showing results for tags 'Radiology'.
-
Content ArticleThis report shares findings from complaints made to Parliamentary and Health Service Ombudsman (PHSO) about failings in imaging in the NHS. The majority of these complaints involve people who had cancer at the time they used imaging services. Through highlighting these complaints, the PHSO’s objective is to support NHS services to improve. It suggests that failings in imaging services can only be addressed and learned from through collaboration across clinical specialties, looking at the whole imaging journey and its intersections as part of the patient’s care pathway.
-
News Article
Trust 'failed to act' on cancer patient's X-rays
Patient Safety Learning posted a news article in News
A man who died from lung cancer might have been saved if a hospital trust had not "failed to act" on two abnormal chest X-rays, an investigation found. Growths identified in the patient's examinations were not followed up for three years and were then untreatable, the health ombudsman said. North Cumbria University Hospitals NHS Trust also failed to correctly handle a complaint from the man's daughter. The trust, which runs hospitals in Carlisle and Whitehaven, apologised. The investigation was carried out by the Parliamentary and Health Service Ombudsman (PHSO), which deals with unresolved NHS England complaints. The patient, referred to only as Mr C, was admitted twice to hospital with stroke-like symptoms in 2014 and 2015. On both occasions X-rays were carried out which found abnormal growths in his lungs, but no action was taken. In July 2017, Mr C was found to have advanced lung cancer and he died weeks later. Read full story Source: BBC News, 29 April 2021 -
Content ArticleThe need for radical investment and reform of diagnostic services was recognised at the time the NHS Long Term Plan was published in 2019. This report, commissioned by NHS England at that time, alongside a review of adult screening services, was nearing publication before the COVID-19 pandemic struck. However, while the recommendations made pre-pandemic still stand, additional actions will be needed to deliver safe, high quality diagnostic services in an endemic phase of the disease and to support the recovery of diagnostic services.
-
News ArticleThe Health Information and Quality Authority (HIQA) has today published an overview report on the lessons learned from notifications of significant incident events in Ireland arising from accidental or unintended medical exposures in 2019. In 2019, HIQA received 68 notifications of significant events of accidental or unintended medical exposures to patients in public and private facilities, which is a small percentage of significant incidents relative to the total number of procedures taking place which can be conservatively estimated at over three million exposures a year.The most common errors reported were patient identification failures, resulting in an incorrect patient receiving an exposure. These errors happened at various points in the patient pathway which, while in line with previous reporting nationally and international data, highlights an area for improvement.John Tuffy, Regional Manager for Ionising Radiation, said “The overall findings of our report indicate that the use of radiation in medicine in Ireland is generally quite safe for patients. The incidents which were reported to HIQA during 2019 involved relatively low radiation doses which posed limited risk to service users. However, there have been radiation incidents reported internationally which resulted in severe detrimental effects to patients so ongoing vigilance and attention is required." John Tuffy, continued “As the regulator of medical exposures, HIQA has a key role in the receipt and evaluation of notifications received. While a significant event is unwanted, reporting is a key demonstrator of a positive patient safety culture. A lack of reporting does not necessarily demonstrate an absence of risk. Reporting is important, not only to ensure an undertaking is compliant but because it improves general patient safety in a service and can minimise the probability of future preventative events occurring.” Read full story Source: HIQA, 9 September 2020
- Posted
-
- Radiology
- Health and safety
-
(and 3 more)
Tagged with:
-
Content ArticleSince January 2019, the Health Information and Quality Authority (HIQA) has been the competent authority for regulating medical exposure to ionising radiation in Ireland and receives incident notifications of significant events arising from accidental or unintended medical exposures. As part of its role, HIQA is responsible for sharing lessons learned from significant events. HIQA has published an overview report on the lessons learned from notifications of significant incident events in Ireland arising from accidental or unintended medical exposures in 2019. This report provides an overview of the findings from these notifications and aims to share learnings from the investigations of these incidents.
- Posted
-
- Radiology
- Patient safety incident
- (and 6 more)
-
Content ArticleThe aim of this study from H R Guly was to describe the injuries misdiagnosed as a sprain of the wrist and to determine the approximate incidence of misdiagnosis in patients diagnosed as having a sprain of the wrist. In total 57 injuries initially diagnosed as a sprained wrist had a different diagnosis (1.76% of all diagnoses of sprained wrists). This is an underestimate of the true incidence of diagnostic error. Forty two per cent of the misdiagnoses were of greenstick or torus fractures of the distal radius. Guly concluded that training for junior doctors in A&E departments should be improved—especially training in radiological interpretation. Other methods of preventing diagnostic errors by misreading of radiographs, for example, more hot reporting of radiographs by radiologists or radiographers should be considered.
-
Content ArticleIn September 2015, the Institute of Medicine (IOM) issued the report “Improving Diagnosis in Health Care,” which focused on the underappreciated problem of diagnostic error in medicine. This report builds on the IOM’s 2000 landmark report, “To Err is Human”, which specifically highlighted opportunities for improvement in diagnostically focused fields, such as radiology and pathology. One of the major recommendations of the report is that “health care organizations should adopt policies and practices that promote a nonpunitive culture that values open discussion and feedback on diagnostic performance”. Notably, the report emphasises the ineffectiveness of traditional approaches to evaluating medical error that focus on identifying individuals’ errors. In this article published in Radiology, Larson and colleagues review the recommendations set forth by the recent IOM report, discuss the science and theory that underlie several of those recommendations, and assess how well they fit with the current dominant approach to peer review. They also offer an alternative approach to peer review: peer feedback, learning, and improvement (or more succinctly, “peer learning”), which they believe is better aligned with the principles promoted by the IOM.
- Posted
-
- Diagnostic error
- Feedback
-
(and 1 more)
Tagged with:
-
Content ArticleThe Royal Society of Medicine (RSM) has exclusive interviews from leading figures in healthcare on their website, these podcasts focus on a variety of topics within medicine and healthcare, covering everything from mental health and paediatric care to the medical workforce crisis and patient safety. In this episode, Kaji Sritharan talks to Dr Dominic King, Health Lead of DeepMind about the role of Artificial Intelligence and the development and introduction of Digital Technologies into the NHS.
-
Content ArticleThe use of checklists can help to prevent incidents and should be part of a culture of patient safety. This guidance set out by the Royal College of Radiologists highlights key considerations when writing and implementing safety checklists.
- Posted
-
- AHP Allied health professionals (AHP)
- Radiology
- (and 4 more)