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Showing results for tags 'Safety assessment'.
Found 81 results
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Content ArticleThis paper, published in BMJ Quality and Safety, investigated how often patient safety incidents occur in primary care and how often these were associated with patient harm.
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NHS Quality Accounts FAQs
PatientSafetyLearning Team posted an article in Patient safety standards
A Quality Account is a report about the quality of services offered by an NHS healthcare provider.The reports are published annually by each provider, including the independent sector, and are available to the public. Quality Accounts are an important way for local NHS services to report on quality and show improvements in the services they deliver to local communities and stakeholders. The quality of the services is measured by looking at patient safety, the effectiveness of treatments patients receive, and patient feedback about the care provided. -
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The harms of promoting ‘Zero Harm’
Claire Cox posted an article in Research papers
In their paper 'Managing risk in hazardous conditions: improvisation is not enough', Almaberti and Vincent ask "what strategies we might adopt to protect patients when healthcare systems and organisations are under stress and simply cannot provide the standard of care they aspire to". This is clearly a critical and much overdue question, as many healthcare organisations are in an almost constant state of stress from high workload, personnel shortages, high-complexity patients, new technologies, fragmented and conflicting payment systems, over-regulation, and many other issues. These stressors put mid-level managers and front-line staff in situations where they may compromise their standards and be unable to provide the highest quality care. Such circumstances can contribute to low morale and burn-out. Eric Thomas discusses this further in his Editorial published in BMJ Safety & Quality.- Posted
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Content ArticleThe Patient Safety Climate in Healthcare Organizations (PSCHO) is a tool, outlined by Singer et al. in their 2007 paper Workforce Perceptions of Hospital Safety Culture: Development and Validation of the Patient Safety Climate in Healthcare Organizations Survey (available on the Health Services Research website). Designed in the US, it is used to assess healthcare employees' perception of the safety culture in their organisation. PSCHO is available to download via the Measurement Instrument Database for the Social Sciences (MIDSS).
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AHRQ: SOPS surveys
PatientSafetyLearning Team posted an article in Incentives and techniques
The Agency for Healthcare Research and Quality (AHRQ) has produced a series of Surveys on Patient Safety Culture (SOPS™). The SOPS ask healthcare providers and other staff in hospitals, medical offices, nursing homes, community pharmacies and ambulatory surgery centres about their organisational culture’s support for patient safety. Each SOPS survey kit contains survey instruments, instructions on administering the survey and any supplemental items for those surveys. -
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Safety Climate Assessment Tool (S-CAT)
PatientSafetyLearning Team posted an article in Incentives and techniques
The Safety Climate Assessment Tool (S-CAT) is a free tool, initially developed for the construction industry by researchers at the Center for Construction Research and Training and Washington State University Vancouver. It is now available to anyone who wants tailored and actionable information to improve the safety of every employee in their working environment. The S-CAT allows you to obtain information regarding employee safety perceptions. -
Content ArticleIn 2004, the Agency for Healthcare Research and Quality (AHRQ) released the Hospital Survey on Patient Safety Culture (SOPS™ Hospital Survey) for providers and other staff to assess patient safety culture in their hospitals. Since then, hospitals across the United States and internationally have implemented the survey. In 2019, AHRQ released a new version, the SOPS Hospital Survey 2.0. The original survey is still available; however, the use of version 2.0 is encouraged.
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Content ArticleA great initiative by East Sussex Healthcare NHS Trust to reinforce the importance of basic checks to keep patients from harm when administering medicines.
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Swab safe management to prevent retained swabs
Kathy Nabbie posted an article in Improving systems of care
Implementation of the Swabsafe™ management system at the The Princess Grace Hospital following a never event. -
Content ArticleFallStop is a quality improvement programme from the Falls Prevention Team at the East Kent Hospitals University NHS Foundation Trust. It was developed in 2016 when they found there was a high rate of falls at one of their hospitals and a failure to learn from incidents. A FallStop Practitioner co-ordinates the programme and delivers training.
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Content ArticleIdentification of hospitalised patients with suddenly unfavorable clinical course remains challenging. Models using objective data elements from the electronic health record may miss important sources of information available to nurses.
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Complicated and complex systems in safety management
Claire Cox posted an article in Organisational
This blog by Adam Johns, Safety and Risk Manager for Cathay Pacific Airways, discusses the differences between complicated and complex systems and how this impacts on the way we manage safety and risk. -
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Safer staffing - guidance from NHS Improvement
Patient Safety Learning posted an article in Safe staffing levels
NHS Improvement provide general guidance and a starting point towards delivering effective safer staffing. -
Content ArticleThis report from NHS England on the National Maternity Review sets out a vision for the planning, design and safe delivery of maternity services; how women, babies and families will be able to get the type of care they want; and how staff will be supported to deliver such care.
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Content ArticleCataract removal and implantation of an artificial lens is the most common surgical procedure undertaken by the NHS. Insertion of an incorrect intraocular lens was the most commonly reported never event in England between April 2016 and March 2017. A never event is a serious incident that is entirely preventable. Read the Healthcare Safety Investigation Branch's report on the insertion of an incorrect intraocular lens.
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Content ArticleEnhanced Significant Event Analysis (enhancedSEA) is a NHS Education for Scotland (NES) innovation which aims to guide healthcare teams to apply human factors thinking when performing a significant event analysis, particularly where the event has had an emotional impact on staff involved.Follow the link below for:guidance on how to perform enhancedSEA the updated report format, new Guide Tools, a short e-learning module basic educational resources on human factors science and practice.Although enhancedSEA was developed and tested with primary care teams the approach is also highly suitable for any health and social care setting.
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Content ArticleThis editorial, published by the Lancet, highlights that racism is the root cause of continued disparities in health and mortality rates between black and white people in the USA and a global public health emergency. It discusses what medical journals can and must do to help.
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Content ArticleProviding patients with access to electronic health records (EHRs) may improve quality of care by providing patients with their personal health information and involving them as key stakeholders in the self-management of their health and disease. With the widespread use of these digital solutions, there is a growing need to evaluate their impact, in order to better understand their risks and benefits and to inform health policies that are both patient-centred and evidence-based. The objective of this paper, published by BMJ Quality & Safety, was to evaluate the impact of sharing electronic health records (EHRs) with patients and map it across six domains of quality of care: patient-centredness effectiveness efficiency timeliness equity safety.
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Content ArticleTelemedicine and telephone-triage may compromise patient safety, particularly if urgency is underestimated. This paper from Haimi et al., published in BMC Medical Informatics and Decision Making, aimed to explore the level of safety of a paediatric telemedicine service, with particular reference to the appropriateness of the medical diagnoses made by the online physicians and the reasonableness of their decisions.
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Content ArticleThis interview is part of the hub's 'Frontline insights during the pandemic' series where Martin Hogan interviews healthcare professionals from various specialties to capture their experience and insights during the coronavirus pandemic. Here Martin interviews an advanced specialist paramedic working in central London with four years' experience of working on the frontline.
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Content ArticlePatient Safety and Healthcare Improvement at a Glance is an overview of healthcare quality written specifically for students and junior doctors and healthcare professionals. It bridges the gap between the practical and the theoretical to ensure the safety and well-being of patients. Featuring essential step-by-step guides to interpreting and managing risk, quality improvement within clinical specialties, and practice development, this highly visual textbook offers preparation for the increased emphasis on patient safety and quality-driven focus in today's healthcare environment.
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Content Article
Peri-operative care of people with dementia, 2019
Claire Cox posted an article in Dementia
Ageing populations have greater incidences of dementia. People with dementia present for emergency and, increasingly, elective surgery, but are poorly served by the lack of available guidance on their peri-operative management, particularly relating to pharmacological, medico-legal, environmental and attitudinal considerations. These guidelines seek to provide information for peri-operative care providers about dementia pathophysiology, specific difficulties anaesthetising patients with dementia, medication interactions, organisational and medico-legal factors, pre-, intra- and postoperative care considerations, training, sources of further information and care quality improvement tools. -
Content ArticleMedication errors may cause harm, including death, and increase use of health care services. This project aims to summarise the evidence on the burden of medication error, namely the number of errors occurring in the NHS in England, the costs of those errors to the NHS and the health losses due to medication error. This involves two systematic reviews, one on the incidence and prevalence of medication errors, and the other on the costs of health burden associated with errors. Additionally, economic modelling estimates the number of errors occurring in the NHS in England each year, their costs and health consequences.
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Content ArticleWhite paper on nurse staffing levels for patient safety and workforce safety was produced in 2019 by the Saudi Patient Safety Center and the International Council of Nurses. The paper brings together evidence from a wide range of sources, covering different countries and contexts, showing that having the right numbers of nurses, in the right place and at the right time, delivers quality and safety for the populations they serve, and will help to retain nurses.
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Content ArticleMajor critical illness events, such as cardiopulmonary arrest and intensive care unit (ICU) transfer, disrupt workflow in a hospital ward. Other patients on the same ward may receive inadequate attention, especially if their care team is distracted by the emergency. Most studies have concentrated on patient-level variables associated with outcomes.This paper, published by JAMA, looks at the risk to ward occupants associated with patients on the same ward experiencing critical illness.
