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News Article
New study develops a 'core outcome set' to make new surgical techniques safer
Patient-Safety-Learning posted a news article in News
A new study has been published focusing on surgical innovation and how it could be made safer. The research set out to develop a 'core outcome set', an agreed minimum set of outcomes to measure and report for safe surgical techniques in all audits, research, and clinical practice. The study, co-led by Dr Kerry Avery, a Senior Lecturer at the University of Bristol and NIHR Bristol Biomedical Research Centre (BRC) has said "It may surprise many people to learn that surgical procedures haven’t traditionally been subject to the kind of regulation we see in other areas of medicine. But to ensure safety and improve efficiency, a core outcome set is an important step". Read full story. Source: University of Bristol, 13 July 2021 -
News Article
BBC research reveals people with disabilities forgotten during pandemic
Patient-Safety-Learning posted a news article in News
Research by the BBC finds thousands of people with disabilities had been forgotten about during the pandemic, revealing most participants experienced worsening of their disability and many said their vital appointments had been cancelled. The research found some reported attempting suicide due to the sudden changes, being isolated or not being able to access their care or support networks. Scope, one of the UK's biggest disabilities charities have said the research conducted by the BBC confirms the government failed to support people with disabilities during the pandemic. Read full story. Source: BBC, 30 June 2021 -
News Article
UB researcher developing algorithm to cut hospital readmissions for COPD patients
Patient Safety Learning posted a news article in News
To lower hospital readmission rates for patients with chronic obstructive pulmonary disease (COPD), UB pharmacy researcher David Jacobs has received a $962,000 award from the US National Heart, Lung, and Blood Institute to develop a real-time readmission risk-prediction algorithm. Through a five-year Mentored Patient-Oriented Research Career Development Award, Jacobs will combine social information with rich clinical data to build predictive models that will be integrated into patient-centric interventions and tested in clinical practices. If successful, the research will help clinicians provide individualized treatment at the transition from hospital to home for COPD patients, who experience high rates of early hospital readmission, says Jacobs. “Each year, 7.8 million hospital-discharged patients are readmitted, costing the United States $17 billion,” says Jacobs, assistant professor of pharmacy practice, School of Pharmacy and Pharmaceutical Sciences. “High readmission rates are linked to several quality-of-care and patient-safety factors, such as medication-related problems, inaccurate information transfer, and lack of care coordination with primary care,” he says. “Our focus will be to apply innovative informatic techniques to the development of risk prediction models for hospital readmissions that ultimately personalizes care management interventions.” Read full story Source: UBNow, 21 May 2021 -
News Article
Long Covid symptoms ease after vaccination, survey finds
Patient Safety Learning posted a news article in News
COVID-19 vaccines tend to alleviate the symptoms of long Covid, according to a large survey of more than 800 people that suggests mRNA vaccines, in particular, are beneficial. Although COVID-19 was initially understood to be a largely respiratory illness from which most would recover within a few weeks, as the pandemic wore on increasing numbers of people reported experiencing symptoms for months on end. There is no consensus definition of the condition of these people who have symptoms ranging from chronic fatigue to organ damage, let alone a standardised treatment plan. As vaccines hit the mainstream, concerns arose that vaccination could precipitate relapses or a worsening of symptoms. But conversely, anecdotal reports suggested that vaccines helped some people with long Covid. The analysis, which is yet to be peer reviewed, was conducted on the basis of a survey of 812 people (mostly white, female participants) with long Covid in advocacy groups in the UK and internationally who were contacted via social media. The participants (a small proportion of whom also said they had ME/CFS) were asked to wait at least a week after their first dose to avoid their responses conflating with side-effects of the vaccine. In general, those who received mRNA vaccines (Pfizer/BioNTech or Moderna) reported more improvements in symptoms, compared with those who got an adenovirus vaccine (Oxford/AstraZeneca). In particular, those who received the Moderna vaccine were more likely to see improvements in symptoms such as fatigue, brain fog and muscle pain, and less likely to report a deterioration, the analysis found. Read full story Source: The Guardian, 18 May 2021 -
EventuntilJoin the National Academies of Sciences, Engineering, and Medicine’s Committee on Improving the Representation of Women and Underrepresented Minorities in Clinical Trials and Research as it discusses its newly released report Improving Representation in Clinical Trials and Research: Building Research Equity for Women and Underrepresented Groups. This new report makes a compelling case for why we need more equitable participation in clinical trials and clinical research, including an economic analysis on the cost of health disparities in the United States. It provides a review of the barriers to having more equitable participation in clinical trials, describes strategies to overcome those barriers, and provides actionable recommendations to drive lasting change on this issue. The webinar will take place at 11:00-13:00 EST (16:00-18:00 GMT+1) Register for the webinar
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EventuntilThis Westminster Forum is an opportunity to discuss the implementation of the NHS Long COVID plan for 2021/22, how to utilise funding set out for the expansion of services and management of Long COVID within primary care, the future outlook for Long COVID research, and the impact of new NIHR-funded projects. Key areas for discussion include: delivery of the Long COVID Plan and the utilisation of allocated funding priority areas for research to further improve understanding of Long COVID and the effectiveness of services developed for the condition care pathways within local health systems - leadership, implementation and commissioning, service development, rehabilitation, the impact of health inequalities, and integrating care Long COVID assessment clinics: - assessing progress and what more is needed to improve accessibility and support referrals from primary care - priorities for the development of services for children support for the health workforce - training and education priorities and sharing best practice in Long COVID care utilising data - scaling up its use and improving understanding of Long COVID and its prevalence involving patients - the development of Long COVID services, driving awareness of expanded online support, and improving equal accessibility to information. Agenda Register
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Event
THIS Space 2021
Patient Safety Learning posted an event in Community Calendar
untilTHIS Space, is now open for registration. It will be held online on 24 and 25 November 2021. Aiming to promote interdisciplinary and intergenerational exchange to build the field of healthcare improvement studies, THIS Space is open to all and free to attend for those in the UK and internationally. The event will create space for interaction, networking, and sharing – you can find out more about the programme here. THIS Space aims to: provide a focus for knowledge sharing in healthcare improvement stimulate innovation and fresh thinking help researchers to develop the habits, knowledge, skills, and experiences to support their professional growth connect colleagues from across different disciplines who share a common goal be a means of accelerating the development of the field of the study of healthcare. Register -
EventuntilWhile the pandemic didn’t cause all the shifts happening in healthcare, it had a major hand in accelerating and shaping the changes that will alter the healthcare landscape far into the future. Join Fierce Healthcare as we examine the tectonic transformation across healthcare. We’ll explore changing consumer expectations in access to care, the moves by major tech players and providers to reach their customers and strategies for actually paying for everything. Register
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Event
COVERSCAN Q&A
Sam posted an event in Community Calendar
untilPerspectum has launched the first study to map how COVID-19 impacts the health of multiple organs and identify at-risk features for the virus, with detailed cross-sectional imaging and genetic studies. This study is on the National Institute for Health Research (NIHR) Portfolio. Join COVERSCAN for the next live Q&A webinar. Any questions you'd like answered, send to: Perspectum.Communications@perspectum.com Register for study participant Q&A -
Event
WHO COVID-19 Vaccine research forum
Sam posted an event in Community Calendar
untilWHO will host a monthly WHO COVID-19 Vaccine research forum, starting on Tuesday 2 March 2021. This first webinar is scheduled between 14:00 – 16:00 Central European Time (CET). The agenda will be shared in advance. The goals of these ongoing meetings are: To encourage and facilitate the rapid dissemination of research protocols and emerging results. To provide regular updates against R&D Blueprint roadmap priorities with the ability to pivot given dynamic research needs. Register -
Event
Long COVID Joint Research Forum
Patient Safety Learning posted an event in Community Calendar
untilCurrently very little is known about the clinical, biological, psychological and socio-environmental impact of COVID-19. While most people may have uncomplicated recoveries, some experience prolonged or new symptoms and complications. The wide range of Long Covid symptoms documented indicates that multiple body systems are involved. Some of the more commonly reported symptoms include fatigue, breathing difficulties, joint pain, chest pain, as well as muscle weakness and neurological symptoms. These are common among both people who were hospitalised in the early phase of COVID-19 and those who were not. Systematic reviews show that people worldwide are experiencing prolonged symptoms of COVID-19. There are implications at an individual level for people’s quality of life and their ability to work, as well as at a socioeconomic level due to the risk of widening health inequalities. As well as breadth of the physical, psychological and social complications, there is a need to understand the causes (aetiology) of the symptoms and complications experienced. It is also vital to be able to identify people at higher risk of Long Covid, as well as interventions that might reduce that risk, and support rehabilitation and recovery. There is an urgent need for robust scientific studies into the long-term impact of COVID-19 in both adults and children, and for healthcare providers to be informed to support prevention, assessment, rehabilitation and interventions to improve recovery and patient outcomes. With this need in mind, ISARIC and GloPID-R are organising the Long Covid Forum on December 9 and 10, 2020 in collaboration with the Long Covid Support. The objectives of the forum will be: to gain a better understanding of Long Covid; the science and the personal impact to define research gaps for funders and researchers to take forward. Register -
Content ArticleDespite under-reporting, health workers (HWs) accounted for 2-30% of the reported COVID-19 cases worldwide. In line with data from other countries, Jordan recorded multiple case surges among HWs. This study from Tarif et al. looked at infection prevention and control risk factors in HWs infected with Covid-19. Study findings confirmed the role of hand hygiene as one of the most cost-effective measures to combat the spreading of viral infections.
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Content ArticleAn analysis of data from nearly 154 000 US veterans with SARS-CoV-2 infection provides a grim preliminary answer to the question: What are COVID-19’s long-term cardiovascular outcomes? The study, published in Nature Medicine by researchers at the Veterans Affairs (VA) St Louis Health Care System, found that in the year after recovering from the illness’s acute phase, patients had increased risks of an array of cardiovascular problems, including abnormal heart rhythms, heart muscle inflammation, blood clots, strokes, myocardial infarction, and heart failure. What’s more, the heightened risks were evident even among those who weren’t hospitalised with acute COVID-19.
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Content ArticleCancer screening involves testing for early signs of cancer in people without symptoms. It can help spot cancers at an early stage, when treatment is more likely to be successful, or in some cases prevent cancer from developing the first place. The screening test for bowel cancer is the faecal immunochemical test, or FIT, that looks for tiny traces of blood in your poo. These tests are sent to everyone in the eligible population every two years. In this blog Jacob Smith from Cancer Research UK looks at the importance of increasing bowel cancer screening in socioeconomically deprived communities, where there is a higher incidence of bowel cancer and death from bowel cancer. This is partly due to lower levels of participation in screening. The blog highlights the results of a recent study carried out by the University of Sheffield to determine which interventions may be successful in reducing health inequalities related to bowel cancer screening. Modelling found that re-inviting non-participants to take part in screening each year was a highly effective intervention, and it is estimated that this approach would prevent over 11,000 bowel cancer deaths over the lifetime of the current English population aged 50-74.
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Content ArticleRates 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.
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Content ArticleThere 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.
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Content ArticleThis online community has been set up by the Care Quality Commission (CQC) to engage with members of the public on a range of topics related to the CQC's work as regulator of health and social care services in the UK. The site invites people to get involved in different ways, for example: by sharing expertise, experience and thoughts through discussions. by reviewing documents. by taking part in polls and surveys. by contributing to idea boards. When signing up, you can either use your own name or your organisation’s name, and you'll be asked to choose what groups you represent and what sectors you work in or use.
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Content ArticleThe Indian Liver Patient Dataset (ILPD) is used extensively to create algorithms that predict liver disease. Given the existing research describing demographic inequities in liver disease diagnosis and management, these algorithms require scrutiny for potential biases. Isabel Straw and Honghan Wu address this overlooked issue by investigating ILPD models for sex bias. They demonstrated a sex disparity that exists in published ILPD classifiers. In practice, the higher false negative rate for females would manifest as increased rates of missed diagnosis for female patients and a consequent lack of appropriate care. Our study demonstrates that evaluating biases in the initial stages of machine learning can provide insights into inequalities in current clinical practice, reveal pathophysiological differences between the male and females, and can mitigate the digitisation of inequalities into algorithmic systems. An awareness of the potential biases of these systems is essential in preventing the digital exacerbation of healthcare inequalities.
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Content ArticlePrevious research has shown that visitors can decrease the risk of patient harm; however, the potential to increase the risk of patient harm has been understudied. Sanchez et al. queried the Pennsylvania Patient Safety Reporting System database to identify event reports that described visitor behaviours contributing to either a decreased or increased risk of patient harm. The study provides insight into which visitor behaviours are contributing to a decreased risk of patient harm and adds to the literature by identifying behaviours that can increase the risk of patient harm, across multiple event types.
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Content ArticleOne of the reasons why patient safety may be put at risk during healthcare interventions is a lack of staff adherence to patient safety guidelines. There could be a relationship between staff’s adherence to patient safety guidelines and their perceived level of reward for their work and/or motivation. This study from Asmoro et al. examined the relationship between reward and adherence to patient safety guidelines, and between motivation and adherence to patient safety guidelines, among nurses working in emergency departments (EDs) in Indonesia. They found that ensuring ED nurses are motivated for their work by offering rewards – such as a decent salary, a supportive workplace environment and career progression opportunities – is important to enhance their adherence to patient safety guidelines.
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Content ArticleThe NHS in England has introduced a range of policy measures aimed at fostering greater openness, transparency and candour about quality and safety. This study looks at the implementation of these policies within NHS organisations, with the aim of identifying key implications for policy and practice.
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Content ArticleThe aim of this study from Avery et al. was to determine the prevalence and nature of prescribing errors in general practice; to explore the causes, and to identify defences against error. The study involved examination of 6,048 unique prescription items for 1,777 patients. Prescribing or monitoring errors were detected for 1 in 8 patients, involving around 1 in 20 of all prescription items. The vast majority of the errors were of mild to moderate severity, with 1 in 550 items being associated with a severe error. The following factors were associated with increased risk of prescribing or monitoring errors: male gender, age less than 15 years or greater than 64 years, number of unique medication items prescribed, and being prescribed preparations in the following therapeutic areas: cardiovascular, infections, malignant disease and immunosuppression, musculoskeletal, eye, ENT and skin. Prescribing or monitoring errors were not associated with the grade of GP or whether prescriptions were issued as acute or repeat items. A wide range of underlying causes of error were identified relating to the prescriber, patient, the team, the working environment, the task, the computer system and the primary/secondary care interface. Many defences against error were also identified, including strategies employed by individual prescribers and primary care teams, and making best use of health information technology.
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Content ArticleThis observational study in The Lancet Public Health analysed the effects of outsourcing health services to private, for-profit providers. The authors evaluated the impact of outsourced spending to private providers on treatable mortality rates and the quality of healthcare services in England, following the 2012 Health and Social Care Act. The authors found that: an annual increase of one percentage point of outsourcing to the private for-profit sector corresponded with an annual increase in treatable mortality of 0·38% in the following year. changes to for-profit outsourcing since 2014 were associated with an additional 557 treatable deaths across the 173 CCGs in England. They conclude that private sector outsourcing corresponded with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of health-care services.
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Content Article
Impact of adverse events on surgeons (April 2022)
Patient Safety Learning posted an article in Surgery
Surgeons are affected negatively when things go wrong. They may experience guilt, anxiety and reduced confidence following adverse events, which may lead to formal investigation and sanction. Medical errors have been linked with burnout, depression, suicidal ideation and reduced quality of life. This research from Turner et al. explores the impact of adverse events on UK surgeons’ health and wellbeing. Surgeons completed an online survey that involved recalling an error-based or complication-based event and answering questions regarding health, wellbeing and support seeking. -
Content ArticleThis report by researchers at the University of Birmingham is the first granular analysis of the known and hidden waiting lists for elective procedures in England. There has been previous analysis of the NHS waiting list, but it has been based on the overall waiting list and has included patients waiting for all types of consultant-led care, including outpatient clinic visits and non-surgical treatments. The authors of this report have used procedure-level data to produce estimates for the need for elective procedures.
