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Found 955 results
  1. Event
    until
    This lecture will briefly outline challenges in quality and safety in healthcare, will identify the patchy history of attempts to make improvements, will emphasise the need to build and evidence base for improvement, and will outline some of the challenges and opportunities in evidence generation. Mary Dixon-Woods is Director of THIS Institute and The Health Foundation Professor of Healthcare Improvement Studies in the Department of Public Health and Primary Care at the University of Cambridge. Register
  2. Content Article
    Artificial intelligence, as a nonhuman entity, is increasingly used to inform, direct, or supplant nursing care and clinical decision-making. The boundaries between human- and nonhuman-driven nursing care are blurred with the advent of sensors, wearables, camera devices, and humanoid robots at such an accelerated pace that the critical evaluation of its influence on patient safety has not been fully assessed. Since the pivotal release of To Err is Human, patient safety is being challenged by the dynamic healthcare environment like never before, with nursing at a critical juncture to steer the course of artificial intelligence integration in clinical decision-making. This paper presents an overview of artificial intelligence and its application in healthcare and highlights the implications which affect nursing as a profession, including perspectives on nursing education and training recommendations. The legal and policy challenges which emerge when artificial intelligence influences the risk of clinical errors and safety issues are discussed.
  3. Content Article
    The Covid-19 pandemic resulted in major disruption to healthcare delivery worldwide causing medical services to adapt their standard practices. Learning how these adaptations result in unintended patient harm is essential to mitigate against future incidents. Incident reporting and learning system data can be used to identify areas to improve patient safety. A classification system is required to make sense of such data to identify learning and priorities for further in-depth investigation. The Patient Safety (PISA) classification system was created for this purpose, but it is not known if classification systems are sufficient to capture novel safety concepts arising from crises like the pandemic. This study from Purchase et al. aimed to review the application of the PISA classification system during the COVID-19 pandemic to appraise whether modifications were required to maintain its meaningful use for the pandemic context. The study found that PISA taxonomy can be successfully applied to patient safety incident reports to support the first stages in deriving learning and identifying areas for further enquiry. No incidents were identified that warranted new codes to be added to the PISA classification system, which may extend to other substantive public health crises, negating the need for additional, specific coding within such classification systems and related frameworks for similar system-wide constraints.
  4. Content Article
    Clinical trial documents are complex and may have inconsistencies, leading to potential site implementation errors and may compromise participant safety. This study characterises the frequency and type of administrative and potential patient safety interventions (PPSIs) made during the review of oncology trial documents for clinical trial implementation by centralized clinical content specialists. The study demonstrates a gap in patient safety when assessing trial documents for clinical trial implementation. One solution to address this gap is the utilisation of a centralised team of clinical specialists to preemptively review trial documents, thereby enhancing patient safety during clinical trial conduct.
  5. Content Article
    Simulation for non-pedagogical purposes has begun to emerge. Examples include quality improvement initiatives, testing and evaluating of new interventions, the co-designing of new models of care, the exploration of human and organisational behaviour, comparing of different sectors and the identification of latent safety threats. However, the literature related to these types of simulation is scattered across different disciplines and has many different associated terms, thus making it difficult to advance the field in both recognition and understanding. This paper, therefore, aims to enhance and formalise this growing field by generating a clear set of terms and definitions through a concept taxonomy of the literature.
  6. Content Article
    Researchers at the University of Hertfordshire are carrying out a study to better understand women’s negative experiences of IUD procedures. They hope this research will be used to develop new guidance for patients and professionals that reduces the risk of coil procedures being experienced as distressing. If you are aged 16+, have had a coil fitting/removal in the last 2 years in a UK health settings (GPs, sexual health clinics, gynaecologist, and any other medical setting) that you found distressing, and are able to provide a valid UK phone number (mobile or landline), then you are eligible to participate. Full details of the research and how to take part can be found via the link below or by contacting Sabrina at s.pilav@herts.ac.uk.
  7. Content Article
    This report presents findings from a rapid evidence review into improvement cultures in health and adult social care settings. The review aims to inform CQC’s approach to assessing and encouraging improvement, improvement cultures and improvement capabilities of services, while maintaining and strengthening CQC’s regulatory role. It also identifies gaps in the current evidence base.
  8. Content Article
    Walkthrough analysis is a structured approach to collecting and analysing information about a task or process or a future development (for example, designing a new protocol). It is used to help understand how work is performed and aims to close the gap between work as imagined and work as done to better support human performance. Walkthrough analysis is one of the tools included in the Patient Safety Incident Response Framework (PSIRF). This guide by NHS England provides information on how to carry out walkthrough analysis. It covers: Getting started System considerations Task and tool matrix View further PSIRF content and resources on the hub.
  9. Event
    until
    Many health care professionals believe that while critical patient feedback may help improve services, positive patient feedback has no such value. But is that really true? In this, Care Opinion's 21st research chat, we welcome Dr Stefan Rennick Egglestone, who has recently led a review of research on this issue (in press with Plos One). We'll be discussing what the 68 papers in the review can tell us about the real value of positive patient feedback to staff and services. Format Care Opinion research chats are informal and friendly, and last 30 minutes in all. For the first 15 minutes we’ll discuss the research, and then invite your comments and questions via the chat box (or in person if you prefer). Who should attend Anyone with an interest can come along - you don't need to be academic, and you don't need to have read the paper. Just coming along and listening is fine. So do join us! Register for the event
  10. News Article
    Women are a third less likely to receive lifesaving treatment for heart attacks due to sexism in medicine, research shows. Research led by the University of Leeds and the British Heart Foundation (BHF) pooled NHS data from previous studies looking at common heart conditions over the past two decades. It investigated how care varied according to age and sex, finding that women were significantly less likely to receive treatment for heart attacks and heart failure. Following the most severe type of heart attack — a Stemi — women were one third less likely to receive a potentially lifesaving diagnostic procedure called a coronary angiogram. Women were significantly more likely to die after being admitted to hospital with a severe heart attack. They were also less likely to be prescribed preventative drugs that can help to protect against future heart attacks, such as statins or beta-blockers. Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist said: “This review adds to existing evidence showing that the odds are stacked against women when it comes to their heart care. Deep-rooted inequalities mean women are underdiagnosed, undertreated, and underserved by today’s healthcare system." “The underrepresentation of women in research could jeopardise the effectiveness of new tests and treatment, posing a threat to women’s health in the long-term,” she added. Read full story (paywalled) Source: The Times, 5 October 2023
  11. Content Article
    Aortic valve replacement (AVR) is a life-saving procedure for symptomatic severe aortic stenosis (AS), which relieves symptoms, increases life expectancy and improves quality of life. Little is known about the rate of AVR provision by gender, race or social deprivation level in the NHS across England. However, a large analysis examining AVR on the health service in England – the first of its kind – reveals striking inequalities in its provision. Women, black and Asian people, and those living in the poorest parts of the country are much less likely to receive the life-saving procedure, the study shows. “In this large, national dataset, female gender, black or south Asian ethnicities and high deprivation were associated with significantly reduced odds of receiving AVR in England,” the authors wrote. Dr Clare Appleby, a consultant cardiologist at the Liverpool Heart and Chest hospital NHS foundation trust and an author of the study, said public health initiatives to understand and tackle these inequalities should be prioritised. “Severe symptomatic aortic stenosis is a serious disease that causes mortality and reduces quality of life for patients,” she said. “Left untreated it has a worse prognosis than many common metastatic cancers, with average survival being 50% at two years, and around 20% at five years.” Further research and public health initiatives to understand and address inequalities in the timely provision of AVR are important and should be prioritised in England.
  12. Content Article
    This article published by the Betsy Lehman Center looks at the benefits of real-time monitoring of electronic health records (EHRs). Early adopter hospitals have demonstrated dramatic gains in safety by monitoring patients' EHR's in real time for signals of potential safety events, allowing providers to more quickly and effectively address safety gaps and improve outcomes. This monitoring is carried out by automated safety surveillance software that continuously runs in the background of EHR systems and can detect hundreds of categories of adverse events as they occur. Expert analysis then quickly helps organisations gain insight from the data, which can be used to proactively reduce safety risks and reliably measure incidence of harm over time.
  13. Content Article
    Investigative journalist and medical researcher Maryanne Demasi interviews Phillip Buckhaults, a cancer genomics expert and professor at the University of South Carolina. Professor Buckhaults describes how he decided to test for DNA contamination in vials of Pfizer and Moderna’s bivalent booster shots, hoping to debunk myths about contamination. However, his research revealed that billions of tiny DNA fragments are present in Pfizer’s mRNA vaccine. He highlights the need for further research to find out whether this poses any risk to people who have been given the vaccine, particularly around whether these fragments of DNA could trigger people developing cancer or autoimmune conditions.
  14. Content Article
    The National Early Warning Score (NEWS2) is calculated using routine vital sign measures of temperature, pulse and so on. It is used by ambulance staff and emergency departments to identify sick adults whose condition is likely to deteriorate.  NEWS2 has been shown to work among the general population. However, it has been unclear if it could monitor the condition of care home residents because of their age, frailty, and multiple long-term conditions. New research from the National Institute for Health and Care Research (NIHR) shows that, among care home residents admitted to hospital as an emergency, NEWS2 can effectively identify people whose condition is likely to get worse.
  15. Content Article
    This report from Asthma + Lung UK highlights that lung diseases such as COPD, asthma and pneumonia are the third leading cause of death in England, whilst the UK as a whole has the worst death rate from lung disease in Europe. Hospital admissions for lung diseases have doubled in the last 20 years and lack of proper testing for lung diseases is having an impact on patient safety, as GPs have to "guess" diagnoses. The report highlights three areas where policy changes should be implemented in order to improve care for people affected, reduce pressure on services and deliver massive savings for the NHS: Diagnosing lung disease early and accurately  Keeping people healthy and out of hospital Providing treatments that work
  16. News Article
    A lack of diabetes checks following the first Covid lockdown may have killed more than 3,000 people, a major NHS study suggests. Those with the condition are supposed to undergo regular checks to detect cardiac problems, infections and other changes that could prove deadly. But researchers said a move to remote forms of healthcare delivery and a reduction in routine care meant some of the most crucial physical examinations did not take place during the 12 months following the first lockdown. Experts said the findings showed patients had suffered “absolutely devastating” consequences and were being “pushed to the back of the queue”. The study, led by Prof Jonathan Valabhji, the national clinical director for diabetes and obesity, links the rise in deaths to a fall in care the previous year. It showed that, during 2020/21, just 26.5% of diabetes patients received their full set of checks, compared with 48.1% the year before. Those who got all their checks in 2019-20 but did not receive them the following year had mortality rates 66% higher than those who did not miss out, the study, published in Lancet Diabetes and Endocrinology, found. The study shows that foot checks, which rely on physical appointments, saw the sharpest drop, falling by more than 37%. “The care process with the greatest reduction was the one that requires the most in-person contact – foot surveillance – possibly reflecting issues around social distancing, lockdown measures, and the move to remote forms of healthcare delivery,” the study found. Those in the poorest areas were most likely to miss out. Read full story (paywalled) Source: The Telegraph, 30 May 2022
  17. News Article
    A study conducted by NHS Education for Scotland and Health Improvement Scotland found patients felt safer by having someone listen to their experiences after adverse events. The findings were published in the BMJ and have been positively received by NHS boards across the country. Healthcare Improvement Scotland’s Donna Maclean said: “The compassionate communications training has seen an unprecedented uptake across NHS boards in Scotland, with the first two cohorts currently under way and evaluation taking place also.” Clear communication and a person-centred approach was seen as being central to helping those who have suffered from traumatic events. Researchers found many said their faith was restored in the healthcare system if staff showed compassion and active engagement. This approach is likely to enhance learning and lead to improvements in healthcare. Health boards were advised that long timelines can have a negative impact on the mental health of patients and their families. Rosanna from Glasgow, who was affected by an adverse event, said: “I believe this study and its findings are crucial to truly understanding patients and families going through adverse events. “Not only does the study capture exactly what needs to change, but it also highlights the elements that are most important to us: an apology and assurance that lessons will be learnt is all we really want. Read full story Source: The National, 30 May 2022
  18. News Article
    Covid-19 vaccination is effective for cancer patients but protection wanes much more rapidly than in the general population, a large study has found. Vaccine effectiveness is much lower in people with leukaemia or lymphoma, those with a recent cancer diagnosis, and those who have had radiotherapy or systemic anti-cancer treatments within the past year, according to the research published in Lancet Oncology. The authors of the world’s largest real world health system evaluation of Covid-19 in cancer patients highlighted the importance of booster programmes, non-pharmacological strategies, and access to antiviral treatment programmes in order to reduce the risk that Covid-19 poses to cancer patients. Peter Johnson, professor of medical oncology at the University of Southampton and joint author of the study, said, “This study shows that for some people with cancer, covid-19 vaccination may give less effective and shorter lasting protection. This highlights the importance of vaccination booster programmes and rapid access to covid-19 treatments for people undergoing cancer treatments.” Study leader, Lennard Lee, department of oncology, University of Oxford, said, “Cancer patients should be aware that at 3-6months they are likely to have less protection from their coronavirus vaccine than people without cancer. It is important that people with a diagnosis of cancer are up to date with their coronavirus vaccination and have had their spring booster if they are eligible.” Read full story Source: BMJ, 24 May 2022
  19. News Article
    Damage to the body’s organs including the lungs and kidneys is common in people who were admitted to hospital with Covid, with one in eight found to have heart inflammation, researchers have revealed. As the pandemic evolved, it became clear that some people who had Covid were being left with ongoing symptoms – a condition that has been called Long Covid. Previous studies have revealed that fewer than a third of patients who have ongoing Covid symptoms after being hospitalised with the disease feel fully recovered a year later, while some experts have warned Long Covid could result in a generation affected by disability. Now researchers tracking the progress of patients who were treated in hospital for Covid say they have found evidence the disease can take a toll on a range of organs. What’s more, they say the severity of ongoing symptoms appears to be linked to the severity of the Covid infection itself. “Even fit, healthy individuals can suffer severe Covid-19 illness and to avoid this, members of the public should take up the offer of vaccination,” said Prof Colin Berry, of the University of Glasgow, which led the CISCO-19 (Cardiac imaging in Sars coronavirus disease-19) study. “Our study provides objective evidence of abnormalities at one to two months post-Covid and these findings tie in with persisting symptoms at that time and the likelihood of ongoing health needs one year later,” Berry added. Read full story Source: The Guardian, 23 May 2022
  20. News Article
    "I knew I always felt different, but I didn't know I was autistic." For Rhiannon Lloyd-Williams, it would take until she was 35 to learn just why she felt different. Now research by Swansea University has found it takes on average six years longer to diagnose autism in women and girls than in males. A study of 400 participants found that 75% of boys received a diagnosis before the age of 10 - but only 50% of girls. It also found the average age of diagnosis in girls was between 10 and 12 - but between four and six for boys. Now charities in Wales are calling for greater investment into services to help better understand autism in females and speed up a diagnosis. "The parents responding to the study said there was a marked impact on the girls mental health while waiting for a diagnosis," said Steffan Davies, who carried out the research. "Girls represented in the study had a lot more pre-existing diagnosis, which suggests they are being misdiagnosed with anxiety disorders, eating disorders, and that tends to defer from the root diagnosis which tends to be autism." Autism UK said this gender gap has long been an issue and is the down to the diagnosis criteria and research used, which has been focused around young boys. "Many girls end up missing out on education, because the environment they're expected to learn in is just too overwhelming, while accessing healthcare can be difficult. Women are often not believed," said executive director Willow Holloway. Read full story Source: BBC News, 23 May 2022
  21. News Article
    Injured women are experiencing sex discrimination in the administration of a life-saving drug that cuts the risk of bleeding to death by 30%, researchers have warned. They found that female trauma victims were half as likely to receive tranexamic acid (TXA) as injured men – even though the treatment is equally effective regardless of sex. “These results are very concerning. TXA is the only proven life-saving treatment for traumatic bleeding. Women were treated less frequently than men regardless of their risk of death from bleeding or the severity of their injuries,” said Prof Ian Roberts of the London School of Hygiene and Tropical Medicine (LSHTM), who was involved in the study. “This looks like sex discrimination, and there is an urgent need to reduce this disparity, so all patients who need the drug have the chance to receive it.” “Whatever of the mechanism of injury, and whatever the bleeding risk we looked at, women were statistically less likely to receive tranexamic acid than men, apart from road traffic collisions with a very high risk of bleeding,” said Tim Nutbeam, whose research was published in the British Journal of Anaesthesia. “However, when we looked at mechanisms of injury which we tend to associate less with major trauma, such as falls from standing, women and particularly older women were much less likely to receive it.” As striking as these results are, they are not necessarily surprising, he added: “It is already known that women with chest pain are less likely to receive aspirin, less likely to be resuscitated for out of hospital cardiac arrest, and less likely to be taken to hospital by an ambulance using lights and sirens.” Read full story Source: The Guardian, 18 May 2022
  22. News Article
    The parents of a teenage girl who died from an allergic reaction to a Pret a Manger baguette have set up a clinical trial to make "food allergies history". Nadim and Tanya Ednan-Laperouse's daughter Natasha, 15, died in 2016 after eating a baguette containing sesame, to which she was allergic. The trial will investigate if everyday food products can be used as treatment. It is a unique opportunity to establish immunotherapy as a practical treatment, according to an expert. The trial, set up by the family from Fulham in west London, will see whether commonly available food products, such as milk and peanuts, can be used under medical supervision to treat those with food allergies. After a 12-month desensitisation period, those involved will be tracked for two further years. Mr and Mrs Ednan-Laperouse's daughter died in 2016 after she ate an artichoke, olive and tapenade baguette containing sesame seeds, bought from a Pret a Manger at Heathrow Airport. The wrapper did not have any allergy information, and, as it was made on the premises, this was not required by law at the time. In October, "Natasha's Law" was brought in, making allergy information a requirement for food made on site. Read full story Source: BBC News, 18 May 2022 Related articles on the hub Why allergies are the Cinderella service of the NHS – a blog by Tim McLachlan
  23. News Article
    More than half of people hospitalised with Covid-19 still have at least one symptom two years after they were first infected, according to the longest follow-up study of its kind. While physical and mental health generally improve over time, the analysis suggests that coronavirus patients discharged from hospital still tend to experience poorer health and quality of life than the general population. The research was published in the Lancet Respiratory Medicine. “Our findings indicate that for a certain proportion of hospitalised Covid-19 survivors, while they may have cleared the initial infection, more than two years is needed to recover fully,” said the lead author, Prof Bin Cao, of the China-Japan Friendship hospital in China. Until now, the long-term health effects of Covid-19 have remained largely unknown, as the longest follow-up studies to date have spanned about a year. The absence of pre-Covid-19 health status data and comparisons with the general population in most studies also made it difficult to determine how well patients with Covid-19 have recovered. “Ongoing follow-up of Covid-19 survivors, particularly those with symptoms of long Covid, is essential to understand the longer course of the illness, as is further exploration of the benefits of rehabilitation programmes for recovery,” said Cao. “There is a clear need to provide continued support to a significant proportion of people who’ve had Covid-19, and to understand how vaccines, emerging treatments and variants affect long-term health outcomes.” Read full story Source: The Guardian, 11 May 2022
  24. News Article
    Women and babies in the UK are “dying needlessly” because of a lack of suitable medicines to use in pregnancy, according to a report that calls for a radical overhaul of maternal health. A “profound” shortage of research and the widespread exclusion of pregnant and breastfeeding women from clinical trials means hardly any new drugs are approved for common medical problems in pregnancy or soon after childbirth, the report finds. Meanwhile, scarce or contradictory information about the safety of existing medicines women may be taking for continuing conditions can make it impossible to reach a confident decision on whether or not to continue them in pregnancy, the experts add. “While pregnancy in the UK is generally considered safe, women and babies are still dying needlessly as a direct result of preventable pregnancy complications,” the authors say. Each year, 5,000 babies in the UK are either stillborn or die shortly after birth, while about 70 women die of complications in pregnancy. The Healthy Mum, Healthy Baby, Healthy Future report draws on evidence from patient groups, clinicians, researchers, lawyers, insurance specialists and the pharmaceutical industry, it proposes “urgent” changes to transform women’s access to modern medicine. The report highlights the “profound lack of research activity” and up-to-date information that leaves pregnant women and their physicians in the dark about whether to continue with certain medicines in pregnancy. Some epilepsy drugs, for example, can increase the risk of birth defects, but coming off them can put the woman at risk of severe seizures, which can also harm the baby. Lady Manningham-Buller said the situation “urgently needs to change”, with the report setting out eight recommendations to prevent needless deaths. Read full story Source: The Guardian, 12 May 2022
  25. News Article
    Covid-19 vaccines are safe for pregnant women to take and can even reduce the risk of stillbirths, according to a new study. Researchers at St George’s University of London and the Royal College of Obstetricians and Gynaecologists collated data from studies and trials involving over 115,000 vaccinated pregnant women. They found that pregnant women – who are more likely to become serious ill if they catch Covid-19 – are 15% less at risk of stillbirth if vaccinated. “We wanted to see if vaccination was safe or not for pregnant women,” said Asma Khalil, professor of obstetrics and maternal fetal medicine at London’s St George’s Hospital in London to The Guardian. “It is safe, but what’s surprising, and it’s a positive finding, is that there was a reduction in stillbirths.” “So far, most of the data on vaccines in pregnancy have been about protecting the pregnant woman herself from Covid. Now we have evidence that the vaccines protect the baby too,” she added. Read full story Source: The Independent, 10 May 2022
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