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Showing results for tags 'Research'.
Found 949 results
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Content ArticleThis editorial by Barbara Fain, Chief Executive of the Betsy Lehman Center in Massachusetts, highlights the need to focus on system safety and moving away from a culture of individual blame, in order to improve patient safety. Referring to the case of nurse RaDonda Vaught who was convicted of negligent homicide for a medication error at a Tennessee hospital, Barbara looks at research that demonstrates that people generally believe the best way to reduce the likelihood of medical errors is by choosing the right doctor, and argues that this cultural belief played into Vaught's conviction. She highlights the need to use evidence-based strategies to communicate with healthcare professionals and the public about the wider picture of patient safety and systems thinking.
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Content ArticleUnderstanding how and why programmes work—not simply whether they work—is crucial. Good theory is indispensable to advancing the science of improvement. Mary Dixon-Woods and colleagues argue for the ex post theorisation programmes.
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Content ArticleAn alarming statistic shared by countless people is based on a highly problematic bit of data extrapolation and has been used to paint all of medicine as untrustworthy. In this article, Jonathan Jarry explores the evidence.
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Content ArticleDiagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). The authors from the John Hopkins University conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measured error and harm frequency, as well as assessing causal factors.
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Content ArticleThe aim of this study was to investigate the potential role of transvaginal mesh bacterial colonisation in the development of mesh-related complication (MRCs). An observational and exploratory study from Diedrich et al. was performed including 49 patients indicated for mesh removal and 20 women of whom vaginal tissue was retrieved during prolapse surgery as a reference cohort. The authors observed distinct differences in bacterial numbers and species between patients suffering from MRCs compared to a reference cohort. Bacteria were observed at the mesh-tissue interface in a biofilm. These results strongly support the potential role of bacterial mesh colonization in the development of MRCs.
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Content ArticleIn the face of record high waiting times for elective care, The King's Fund undertook research to understand the strategies that have been used to reduce waiting times in England and elsewhere in the past 20 years. Elective care waiting lists and waiting times are a product of the fluctuations in and disparities between the demand for and available supply of healthcare. Understanding the root causes of these disparities and taking corrective action to restore balance between demand and supply and optimising the conditions within the health care system is therefore considered key to any strategy to reduce waiting times and sustain them at that level.
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Content Article
NHS Atlas of Variation Series
Patient Safety Learning posted an article in Data and insight
The Atlases of Variation help to identify unwarranted variation and assess the value that healthcare provides to both populations and individuals. This is produced in collaboration with PHE, NHS England and RightCare and many other organisations. Products include Compendium atlases and themed atlases for areas such as Diagnostic Services and Liver Disease. A defining aspect of the atlases is that each of the indicator’s maps, column chart and box-and-whisker plot is accompanied by text which provides: the context for the indicator, a description of the variation and trend data, options for action and a list of evidence-based resources to support action. Interactive Atlases services can be accessed via the NHS England website. -
Content Article
Australian Atlas of Healthcare Variation Series
Patient Safety Learning posted an article in Data and insight
Mapping variation is an invaluable tool for understanding how our healthcare system is providing care. Maps of variation in care, derived from information routinely gathered by the health system, show how healthcare use differs across the country and raise important questions about why this variation might be occurring. The aim is to prompt further investigation into whether the observed variation reflects differences in people’s healthcare needs, in the informed choices they make about their treatment options, or in other factors. Each Atlas includes data, maps, graphs, clinical commentaries and recommendations for each chapter. These can be viewed or downloaded from links on the Atlas website. -
Content ArticleThis report by The Patient Experience Library looks at patient experience in urgent and emergency care (UEC), reviewing four years' worth of studies from sources including government bodies, policy think tanks, academic institutions and the local Healthwatch network.
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Content ArticleQuestions have been raised as to whether medical masks offer similar protection against Covid-19 compared with N95 respirators. This study in The Annals of Internal Medicine aimed to determine whether medical masks are noninferior to N95 respirators in preventing Covid-19 in healthcare workers providing routine care. The authors of the study conducted a multicentre, randomised, noninferiority trial at 29 healthcare facilities in Canada, Israel, Pakistan and Egypt. The study found that among healthcare workers who provided routine care to patients with Covid-19, the overall estimates rule out a doubling in hazard of PCR–confirmed Covid-19 for medical masks when compared with N95 respirators.
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Content ArticleThis study from Gotlieb et al. looked at how well adults understand common phrases clinicians use when communicating with patients. The study surveyed 215 adults in the USA and found that participants frequently misunderstood and often assigned meaning opposite to what the clinician intended. These findings suggest that use of common medical phrases may lead to confusion among patients affecting health outcomes.
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Content ArticleThis study in the journal Health and Social Care Delivery Research aimed to assess the scale, scope and impact of changing the type and number of different healthcare practitioners in general practice in England. The authors undertook an analysis of employment trends, looked at motivations behind employment decisions, examined staff and patient experiences, and assessed how skill mix changes are associated with outcome measures and costs. They found that: employing clinicians who are not GPs did not reduce GPs’ workload or improve their job satisfaction. patients appreciated the longer appointments they had with other clinicians. patients wanted better information about what other practitioners can do, and how to use new booking systems.
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Content ArticleOn 31 January 2023, the clinical trial information system (CTIS) will become the single entry point for sponsors and regulators of clinical trials in the European Union (EU). The CTIS includes a public searchable database for healthcare professionals, patients and the public. This webpage contains information on how clinical trials are regulated in the EU, and what changes the CTIS will make to how clinical trials are registered, performed and regulated.
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Content ArticleMaternal Mortality Review Committees (MMRCs) in the US are multidisciplinary committees that convene at the state or local level to comprehensively review deaths during or within a year of pregnancy. MMRCs have access to clinical and non-clinical information to more fully understand the circumstances surrounding each death, determine whether the death was pregnancy-related, and develop recommendations for action to prevent similar deaths in the future. This article summarises the data from MMRCs in 36 US states between 2017 and 2019, demonstrating variations in prevalence and cause of death according to race, ethnicity and geographical area. The data suggests that over 80% of pregnancy-related deaths examined were determined to be preventable.
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Content ArticleReducing socioeconomic inequalities in cancer is a priority for the public health agenda. In this study, cancer-specific mortality data by socioeconomic status, as measured by educational level, were collected and harmonised across 18 countries in Europe and for multiple points in time over the period 1990–2015. The study found that everywhere in Europe, lower-educated individuals have higher mortality rates for nearly all cancer-types relative to their more highly educated counterparts, particularly for tobacco/infection-related cancers. However, the magnitude of inequalities varies greatly by country and over time, predominantly due to differences in cancer mortality among lower-educated groups, as for many cancer-types higher-educated have more similar (and lower) rates, irrespective of the country. Inequalities were generally greater in Baltic/Central/East-Europe and smaller in South-Europe, although among women large and rising inequalities were found in North-Europe. These results call for a systematic measurement, monitoring and action upon the remarkable socioeconomic inequalities in cancer existing in Europe.
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Content ArticleA survey conducted by the Commonwealth Fund has found that a majority of primary care doctors in the US and other high-income countries say they are burned out and stressed, and many feel the pandemic has negatively impacted the quality of care they provide. This article presents the survey results in the form of graphs with a commentary, and you can also download data from the survey.
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Content ArticleThis article from Reuters highlights the results of a survey of 1,002 people which was conducted in October 2022 by market research company Censuswide on behalf of recruitment website Indeed. The survey showed that more than three quarters of British people who have suffered persistent ill health following a Covid-19 infection have had to cut back or change the work they do.
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Content ArticleModern healthcare is burgeoning with patient centred rhetoric where physicians “share power” equally in their interactions with patients. However, how physicians actually conceptualise and manage their power when interacting with patients remains unexamined in the literature. This study from Laura Nimmon and Terese Stenfors-Hayes explored how power is perceived and exerted in the physician-patient encounter from the perspective of experienced physicians. Although the “sharing of power” is an overarching goal of modern patient-centred healthcare, this study highlighted how this concept does not fully capture the complex ways experienced physicians perceive, invoke, and redress power in the clinical encounter. Based on the insights, the authors suggest that physicians learn to enact ethical patient-centered therapeutic communication through reflective, effective, and professional use of power in clinical encounters.
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Content ArticleThis Canadian study in the Journal of Patient Safety describes an initiative that introduced system-wide changes to practice and patient safety culture in a rapid time frame. it looks at the implementation of a 'zero harm' approach to eliminate preventable harm across a wide variety of clinical areas. In less than a year, the intervention increased patient safety incident reporting by 37% while decreasing falls with injury by 39%, pressure injury rates by 37% and central line–associated blood stream infections by 34%.
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Content ArticleRadar Healthcare has published its 'Incident Reporting in Secondary Care' whitepaper – an in-depth analysis of reporting within secondary care and its effects on patient safety. It has taken a look into the current state of incident reporting: the good work being done, the concerns across the sector, and how we can all aim to improve the situation. The report was conducted using a panel provided by SERMO from its database of UK Nurses and includes the views from 100 nursing staff members working in hospital wards across the UK. Those surveyed work with hospital in-patients daily and are responsible for reporting safety and regulatory incidents involving patients to senior colleagues.
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Content ArticleMedications and specifically fall-risk-increasing drugs (FRIDs) are associated with increased risk of falls: reducing their prescription may improve this risk. This study from Cox et al. explored patient characteristics associated with FRID use, prevalence and type of FRIDs and changes in their prescriptions among older people with arm fractures over 6 months. The study found that more than one FRID prescription had a significantly higher number of co-morbidities and medications and higher rates of male gender, polypharmacy, frailty and sarcopenia. The most frequently prescribed FRIDs were antihypertensives, opioids and antidepressants. Use of FRIDs among older people with upper limb fragility fractures was high. Although overall use decreased over time, 59% were still on 1 or more FRID at the 6-month follow-up, with trends to stop opioids and start antidepressants. Older people presenting with upper limb fractures should be offered a structured medication review to identify FRIDs for targeted deprescribing.
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Content ArticleThis paper in the Journal of Patient Safety and Risk Management addresses the issue of untested products being used on the basis of 'equivalent' products having undergone regulatory testing. Manufacturers of competing products often use each other’s evidence, arguing that the published evidence is generally applicable even if the original tests and trials were performed on only one specific product. In this study, the authors looked at prophylactic dressings for pressure injury prevention to demonstrate how patient safety may be compromised if study conclusions are projected onto unstudied products.
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News ArticleResearchers in the US have found a genetic link between people with African ancestry and the aggressive type of breast cancer. They hope their findings will encourage more black people to get involved in clinical trials in a bid to improve survival rates for people with the disease. Triple negative breast cancer (TNBC) is more common in women under 40 and disproportionately affects black women. A study published in the journal JAMA Oncology found that black women diagnosed with TNBC are 28% more likely to die from it than white women with the same diagnosis. Now a new study has confirmed a definitive genetic link between African ancestry and TNBC. Lisa Newman, of Weill Cornell Medicine, has been part of an international project studying breast cancer in women in different regions of Africa for 20 years. She says representation of women with diverse backgrounds on clinical trials is absolutely critical. "Unfortunately, African-American women are disproportionately under-represented in cancer clinical trials and we see this in the breast cancer clinical trials as well," says Dr Newman. "If you don't have diverse representation, you don't understand how to apply these advances in treatment. "Part of it is because there is some historic mistrust of the healthcare system. "We do continue to see systemic racism in the healthcare delivery system where it has been documented, tragically, that many cancer care providers are less likely to offer clinical trials to their black patients compared with their white patients."
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News ArticleResearchers are calling on five million UK adults to join what they hope will be one of the biggest studies in the world, to create the most detailed picture ever of the nation's health. The aim is it to find better ways to prevent, spot and treat illnesses like cancer and dementia early on. It will involve collecting health and genetic data and creating a long-term repository of health information. Our Future Health is part-funded by government, industry and charities. They hope to get their first set of results in the next few years. Chairman of the programme, Prof Sir John Bell, said the ambition is to use the results to fundamentally shift the focus of healthcare systems to earlier diagnosis and prevention. Invitations will go out this autumn to more than three million people in London, West Yorkshire, West Midlands and Greater Manchester. Over time it will be open to all UK adults. Volunteers will: fill in questionnaires about their lifestyles and any health problems have blood tests for measurements such as blood sugar and cholesterol have their height, weight and blood pressure measured take genetic tests consent to share their NHS records. According to the plans the information will be used in a number of different ways. Scientists will collate and combine this information and store it so that people cannot be identified, building up a bank of health and genetic data. Read full story Source: BBC News, 24 October 2022
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News Article
New research collaboration to improve patient safety
Patient Safety Learning posted a news article in News
University College London Hospitals (UCLH) is to host to a new collaboration researching patient safety, after being awarded £3 million in funding from the National Institute for Health and Care Research. The NIHR Central London Patient Safety Research Collaboration (PSRC) aims to improve safety in Surgical, Perioperative, Acute and Critical care (SPACE) services, which treat more than 25 million NHS patients annually. Perioperative care is care given at and around the time of surgery. Amongst the highest risk clinical settings are SPACE services because of the seriousness of the patients’ conditions and the complex nature of clinical decision making. Further risks arise at the transitions of care between SPACE services and other parts of the health and social care system. The research team led by UCLH and UCL will develop and evaluate new treatments and care pathways for SPACE services. This will include new interventions such as surgical and anaesthetic techniques, and new approaches to predicting and detecting patient deterioration. They will also help the NHS become safer for patients through the development of innovative approaches to organisational learning, and to how clinical evidence is generated. The PSRC’s learning academy will support the next generation of patient safety researchers through a comprehensive programme of funding, mentoring and peer support. The team includes frontline clinicians, policy makers and world-leading academics across a range of scientific disciplines including social and data science, mechanical and software engineering. Patients and the public representing diverse backgrounds are key partners in the collaboration. Professor Moonesinghe said: “We have a great multidisciplinary, multiprofessional team ready to deliver a truly innovative programme to improve patient safety in these high-risk clinical areas. As a uniquely rich research environment, UCLH and UCL are well placed to lead this work, and we are looking forward to collaborating with clinicians and patients across the country to ensure impact for the whole population which the NHS serves.”
