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Content ArticleThis month an inquiry will deliver its verdict on the failures of maternity care at the Shrewsbury and Telford Hospital NHS Trust, the largest maternity scandal in NHS history, involving 1,862 families. The result of this inquiry will highlight how we may need to reconfigure maternity services to ensure the highest standard of care. But what does good really look like? Is there really a way to be a safe maternity unit? At last year's Patient Safety Congress, one of the sessions aimed to answer these questions. The panel discussed behaviours and practices that constitute safe care in hospital-based maternity units, and how organisations can take practical steps to make these features a reality. Click on the video below to watch the full session.
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Content ArticleThrough her work on a range of different elements of the Midlands leadership learning offer, Emma Coller has had great success in facilitating the development of the leadership skills and behaviours needed for positive change. Here she shares her insights on the appreciative inquiry process and how it works.
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Content Article
Loughborough University and the Chartered Institute of Ergonomics & Human Factors have been working on a Human Factors Healthcare Learning Pathway since the launch of the CIEHF White Paper in 2018 and it’s finally arrived. The Learning Pathway is aligned to the National Patient Safety Syllabus and focusses on Human Factors. Human Factors is a broad, scientific, evidence-based discipline that can help people solve a wide range of problems that they face in what they do, every day. In understanding, for example, why patients struggle to use personal medical devices, the application of Human Factors in the design, implementation and evaluation of the devices or in the equipment we use, and the way people work, individually and together, will lead to more resilient, more productive, more connected and more sustainable systems and ways of working (see HEE and CIEHF report 'Human Factors and Healthcare'). Professor Sue Hignett, one of the developers of the course, explains more. -
Content ArticleThe District Nursing service typically serves a defined geographical population or neighbourhood. The service is provided in every village, town and city in the UK. It is a nurse-led service, with a team leader who normally holds an NMC recordable specialist practitioner qualification. These new workforce standards for District Nursing were developed by the Queen's Nursing Institute's International Community Nursing Observatory (ICNO) over the past eighteen months, led by its Director, Professor Alison Leary. They safety standards for the District Nursing workforce in the UK, setting out areas of risk and giving examples of major ‘red flags’ that require escalation.
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Content ArticleAll health and care professionals have an ethical responsibility to be open and honest with service users and their employers when things go wrong with a person’s care. This is otherwise known as the professional duty of candour. Learn more about the Duty of Candour on the Health and Care Professions Council website.
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Content ArticleThis study in the International Journal of Nursing Studies looked at the role of primary care nurses in coaching patients in shared decision making about their treatment. It evaluated an approach to support nurses in coaching patients, which was found to have a positive impact overall. Nurses became more aware of their own attitudes and learning needs and reported more in-depth discussions with patients. However, nurses struggled to integrate the approach in routine care and highlighted the need to receive support from their practice to implement the new approach.
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Content ArticlePatient safety is a key goal of the WHO as a central component of high-quality health systems. Increasing efforts have been made to improve quality of care in low-resource settings but identifying harms and developing strategies to deliver safe care has been given less attention. Charles Vincent and colleagues describe a ‘portfolio’ approach to safety improvement in four broad categories: prioritising critical processes, improving the organisation of care, control of risks and enhancing responses to hazardous situations that they believe is relevant to low-resource settings. They consider how practitioners, especially those in low-resource setting hospitals, might employ these strategies and focus attention on the possible roles of practitioner groups and professional associations as key to advancing patient safety through collaboration and skill development in this field.
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Content ArticleHealthcare leaders are bringing renewed attention to patient safety issues that have been overshadowed by another year of the COVID-19 pandemic. Becker's Hospital Review asked patient safety experts the following question: "If you could fix one patient safety issue overnight, what would it be and why?" Read the answers Cynthia Barnard, Vice President of Quality at Northwestern Memorial Healthcare (Chicago), Patricia McGaffigan, Vice President of Safety Programs at the Institute for Healthcare Improvement, Ana Pujols McKee Vice president and CMO and Chief Diversity, Equity and Inclusion Officer at The Joint Commission and Gary Stuck, CMO at Advocate Aurora Health gave.
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EventThis conference focuses on patient involvement and partnership for patient safety including implementing the New National Framework for involving patients in patient safety, and developing the role of the Patient Safety Partner (PSP) in your organisation or service. This conference will enable you to: Network with colleagues who are working to involve patients in improving patient safety. Reflect on patient perspective. Understand how to implement the June 2021 National Framework for Involving Patients in Patient Safety. Improve the way you recruit, work with and support Patient Safety Partners. Develop your skills in embedding compassion and empathy into patient partnership. Understand how you can improve patient partnership and involvement after serious incidents. Identify key strategies for support patients, their families and carers to be directly involved in their own or their loved one’s safety. Learn from case studies demonstrating patient partnership for patients safety in action. Examine methods of involving patients to improve patient safety in high risk areas. Self assess and reflect on your own practice. Gain CPR accreditation points contributing to professional development and revalidation evidence. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/patient-involvement or email kate@hc-uk.org.uk hub members receive a 20% discount. Email infor@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #PatientPSP2022
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News ArticleEntire hospital units could be forced to shut because of staff quitting in protest at the government’s order that they must all be vaccinated against COVID-19, a senior NHS leader has warned. Chris Hopson, the chief executive of NHS Providers, said that at one hospital trust in England, 40 midwives were refusing to get jabbed, raising fears that the maternity unit may have to close. “Trust leaders are acutely aware that, from April onwards, when Covid vaccinations will become mandatory, decisions by staff to remain unvaccinated could – in extreme circumstances – lead to patient services being put at risk,” said Hopson. “If sufficient numbers of unvaccinated staff in a particular service in a particular location choose not to get vaccinated, the viability and/or safety of that service could be at risk.” Hopson did not name the trust. But he cautioned that its maternity unit is “one representative example” of potential closures on grounds of patient safety that the government’s decision to compel NHS staff in England to be vaccinated or risk losing their job could lead to. Hopson said: “I was talking to a [trust] chief executive who said that 40 of the midwives on their midwifery service … were saying they were not prepared to be vaccinated. Those staff, given their skills and their expertise, are not easily redeployed but they’re also extremely difficult to replace." Read full story Source: The Guardian, 20 December 2021
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Content ArticleThe WHO Academy’s mobile learning app was developed specifically for health workers and is designed to enable them to expand their life-saving skills to battle COVID-19. It delivers mobile access to a wealth of COVID-19 knowledge resources developed by WHO, including up-to-the-minute guidance, tools, training, and virtual workshops to support health workers in caring for patients infected by COVID-19 and in protecting themselves as they do their critical work. With content in seven languages – Arabic, Chinese, English, French, Portuguese, Russian and Spanish – the app focuses on providing health workers with critical, evidence-based information and tools to respond to the pandemic.
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Content ArticleThe launch of Barts Health quality strategy in November 2019 was an important moment for the trust. The 24 page document set out how they would use quality improvement (QI) methodology to become a good and outstanding group of hospitals. Within weeks of the strategy however, the world had changed with COVID-19. How they worked, where they worked and the things they were working on were flipped on their head. Despite this, colleagues across Barts Health have continued to apply the QI skills they had learnt since the WeImprove programme began three years ago. Examples include setting up family liaison hubs for patients in critical care and establishing a network of blood test locations across the boroughs to reduce visits to the hospitals.
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Content ArticleHigh Reliability Organisations (HRO), including healthcare and aviation, have a common focus on risk management. The human element is a ‘weak link’ which may result in accidents or adverse events taking place. Surgeons and other healthcare professionals can learn from aviation's rigorous approach to the role of human factors (HF) in such events, and how we can minimise them. Air Accident Investigation Branch (AAIB) reports show that fatal accidents are frequently caused by pilots flying outside their own personal limits, those of the aircraft or environment. Similarly, patient morbidity or mortality may occur if surgeons work outside personal their capability, with poor procedure selection and patient optimisation, or with a team or theatre environment not suited to the procedure. The authors of this study introduce the personal limitations checklist – a tool adapted from aviation that allows surgeons to define their limits in advance of any decision to operate, and develop critical self-reflection. It also allows management of patient expectations, shared decision making, and flattening of team hierarchy. The minimum skills, patient characteristics, team and theatre resources for any given procedure to proceed are defined. If the surgeon is ‘out of limits’, redressing these factors, seeking additional assistance, or thorough patient consenting may be required for the safe conduct of the procedure. The authors explore external pressures that could cause a surgeon to exceed both personal and organisational limits.
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Content ArticleThe COVID-19 pandemic resulted in an unprecedented reduction in the delivery of surgical services worldwide, especially in non-urgent, non-cancer procedures. A prolonged period without operating (or ‘layoff period’) can result in surgeons experiencing skill fade (both technical and non-technical) and a loss of confidence. While senior surgeons in the UK may be General Medical Council (GMC) validated and capable of performing a procedure, a loss of ‘currency’ may increase the risk of error and intraoperative patient harm, particularly if unexpected or adverse events are encountered. Dual surgeon operating may mitigate risks to patient safety as surgeons regain currency while returning to non-urgent operating and may also be beneficial after the greatly reduced activity observed during the COVID-19 pandemic for low-volume complex operations. In addition, it could be a useful tool for annual appraisal, sharing updated surgical techniques and helping team cohesion. This paper explores lessons from aviation, a leading industry in human factors principles, for regaining surgical skills currency. We discuss real and perceived barriers to dual surgeon operating including finance, training, substantial patient waiting lists, and intraoperative power dynamics.
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Content ArticleReal-time training during global emergencies is critical for effective preparedness and response. The WHO COVID-19 channel provides learning resources for health professionals, decision-makers and the public for the outbreak of coronavirus disease (COVID-19). As the outbreak continues to evolve, new resources will be added and existing courses will be updated to best reflect the changing context.
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News Article
CQC criticises care scandal trust for 'unsafe staffing'
Patient Safety Learning posted a news article in News
The trust at the centre of a maternity scandal does not have enough midwifery staff to keep women and babies safe, a Care Quality Commission (CQC)inspection has revealed. East Kent Hospitals University Foundation Trust relied on community midwives to fill slots at its acute unit, with some of them working 20-hour days after being called in to help cover and feeling outside of their competence. The trust had suspended a midwife-led unit and diverted women in labour to other hospitals – and when the CQC raised the understaffing issue at its inspection in July, it suspended its home birth service. But the CQC found that the number of midwives and maternity workers on duty rarely matched planned numbers and managers rarely calculated staffing numbers accurately, with some elements of the workload not being factored in. Lack of staff meant there was a risk to the safe assessment and monitoring of women and babies at the trust’s William Harvey Hospital in Ashford. Unqualified staff were having to deal with telephone queries from women who needed advice and support. Read full story (paywalled) Source: HSJ, 15 October 2021 -
Content ArticleThis cross-sectional study in BMJ Quality & Safety examines the association of hospital nursing skill mix with patient mortality and quality of care. The study analysed patient discharge data, hospital characteristics and nurse and patient survey data from adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. The authors found that a bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. They suggest that having a higher proportion of assistive nursing personnel without professional nurse qualifications reduces the skill mix and may: contribute to preventable deaths erode quality and safety of hospital care contribute to hospital nurse shortages.
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Content ArticleHealth Education England, Loughborough University and a range of partners have developed the new Human Factors Healthcare Learning Pathway in response to the NHS Patient Safety Syllabus 2021. It is the first ever system-wide Patient Safety Syllabus and is available as e-learning short courses that can be completed as a Learning Pathway (Levels 1-3) or individually. Fully accredited by the Chartered Institute of Ergonomics and Human Factors (CIEHF) and the CPD Certification Service, the Pathway offers a complete programme for health and social care staff to: develop competence and capability in Human Factors (Ergonomics) focus their knowledge on patient safety and staff wellbeing. Level 1 is available for free on the NHS Education for Scotland TURAS system and Health Education England's e-Learning for Healthcare platform Selected Level 2 modules are available to book on the Loughborough University Healthcare Learning Pathway webpage
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Content Article
NHS Learning hub
Patient Safety Learning posted an article in Suggest a useful website
A new NHS digital platform enabling the health and care workforce to contribute and share a wide variety of learning resources for other learners to use. -
Content ArticleSince 2015 Quomodus has developed the digital course 'Diathermy – a practical guide to electrosurgery' for surgeons and other professional users of electrosurgery. The 30-minute course covers the history of electrosurgery, indication and proper use, adverse effects and complications associated with the use of diathermy. The course has been tested and quality assured by health professionals in Scandinavia. The course is flexible, user friendly and applies to all models of diathermy equipment currently on the market.
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Content Article
Personal Care Institute
Patient Safety Learning posted an article in Staff - clinical, non-clinical, social care
The Personalised Care Institute (PCI) is changing the lives of patients by helping to empower them with the knowledge, skills and confidence to feel more in control of their mental and physical health. It does this by educating and inspiring health and care professionals to deliver universal personalised care that takes into account an individual’s strengths, needs and expectations, in order to deliver the right care for them. IPC set the standards for evidence-based personalised care training, providing a robust quality-assurance and accreditation framework for training providers and commissioners along with a central learning hub for health and care professional learners. -
EventuntilWhat will the new world of work look like in the NHS post-pandemic is the crucial question being examined in an HSJ webinar. The webinar will bring together a panel of experts to discuss what skills NHS staff will need as the world of work changes, with the likelihood that some work that has been done face-to-face will be virtual. On the panel will be Elspeth Griffiths, director of HR, workforce and OD for NHS South Central and West Commissioning Support Group, Kate Jarman, director of communications and corporate affairs, Milton Keynes University Hospital, Henrietta Mbeah-Bankas, head of blended learning and digital literacy project lead, Health Education England and Rosalind Penny, director of HR & OD, Integrated Care System for Buckinghamshire, Oxfordshire and Berkshire West. Chairing the discussion will be HSJ senior correspondent Annabelle Collins. This HSJ webinar, in association with NHS South, West and Central Commissioning Support Unit, will look at how the working lives of NHS staff – both clinical and non-clinical – will change, how to upskill existing staff with new skills and make their lives mote satisfying, and whether there are easy wins NHS organisations can aim for. Register
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Content Article
Imperial College London: MSc in Patient Safety
Patient Safety Learning posted an article in Medical students
A fully online Master’s in Patient Safety has been launched by Imperial College London and Bayer Pharmaceuticals. The course aims to develop global leaders and changemakers in patient safety who can catalyse improvements and innovation in healthcare practice across the globe. The programme, now open to UK and international applicants for the next academic year, is a refreshment of Imperial’s previous Patient Safety MSc offering, designed to enable a more flexible approach to learning and respond to emerging healthcare needs in light of the coronavirus pandemic. The new course aligns with the updated World Health Organization’s Patient Safety Curriculum. It features best-practice frameworks from healthcare systems around the world, as well as real-world insights and case studies from a pharmaceutical setting. The programme is delivered through a combination of online learning, group learning and live virtual teaching sessions from world-leading experts in the field. Students will also have the opportunity to apply their learnings through the completion of a research study addressing a patient safety challenge. -
Content ArticleVarious research articles have reported that the science of Human Factors is of vital importance in improving human-machine systems. However, what is lacking is a fundamental historical outline of why Human Factors is important. This article from deWinter and Hancock provides such a foundation, using arguments ranging from pre-history to post-COVID.
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Content Article
Non-Technical Skills for Surgeons (NOTSS)
Patient Safety Learning posted an article in In surgery
The non-technical skills of surgeons (NOTSS) play a significant role in patient safety. The aim of the NOTSS project was to develop and test an educational system for assessment and training of non-technical skills in the intra-operative phase of surgery. NOTSS is a behaviour rating system based on a skills taxonomy that allows valid and reliable observation and assessment of four categories of surgeons' non-technical skill: situation awareness, decision making, communication & teamwork, and leadership. These are the essential non-technical skills surgeons need to perform safely in the operating room and NOTSS allows measurement of several ACGME (Accreditation Council for Graduate Medical Education) competencies, including professionalism, interpersonal and communication skills, and systems-based practice. The skills taxonomy can be used to structure training and assessment in this important area of surgical competence.
