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Found 844 results
  1. Content Article
    BMA policy recommendations on how to reduce bullying and harassment and create a more positive culture in the NHS and medical profession.
  2. News Article
    A hospital A&E department has been rated "inadequate" after warnings over urgent and emergency care. The Care Quality Commission (CQC) reported a lack of support for staff and safety concerns in Weston General hospital's A&E department. Dr Nigel Acheson, deputy chief inspector of hospitals for the South NHS , said it was "disappointing". Weston Area Health NHS Trust "fully recognises that while improvements have been made... further work is required." Read full story Source: BBC News, 17 December 2019
  3. Content Article
    This article looks a some of the research into clinician burnout and the importance of early intervention. Perhaps the 72% of doctors, in a study in 2018, who said that they would go to work even when unwell or not resilient enough to work safely provides the most powerful evidence of this being both an organisational and individual problem that needs immediate attention.
  4. Content Article
    This study from Dall'Ora et al., published in the Journal of Nursing Scholarship, explores the association between the levels of temporary nurse staffing and patient mortality. They found that heavy reliance on temporary staff is associated with higher risk for patients dying. The risk of death increased by 12% for every day a patient experienced a high level of temporary staffing – defined as 1.5 hours of agency nursing a day per patient. For an average ward, this increased risk could apply when between a third and a half of the staff on each shift are temporary staff. However, there is no evidence of harm associated with modest use of temporary registered nurses so that required staffing levels can be maintained.
  5. Content Article
    Each baby counts is the Royal College of Obstetricians and Gynaecologist's national quality improvement programme to reduce the number of babies who die or are left severely disabled as a result of incidents occurring during term labour. Watch the Each baby counts human factors video for information on how to address issues within your unit.
  6. Content Article
    In this data briefing, John Appleby looks at nursing workforce figures and questions if the NHS can balance flexibility with demand.
  7. News Article
    Industrial action by healthcare workers is intensifying as Northern Ireland's nurses take part in 24 hours of action. Health workers are staging industrial action in protest at pay and staffing levels which they claim are "unsafe". In an unprecedented joint statement, the five health trusts said the action was likely to result in "a significant risk to patient safety". Last week, the Royal College of Surgeons warned NI's healthcare system was "at the point of collapse". On Tuesday, members of the Royal College of Nursing (RCN) are refusing to do any work that is not directly related to patient care. Full details and advice on current health care services can be found on the Health and Social Care Board website. Read full story Source: BBC News, 3 December 2019
  8. Content Article
    Clinician burnout has been well-documented and is at record highs. The same issues that drive burnout also diminish joy in work for the healthcare workforce. Healthcare leaders need to understand what factors are diminishing joy in work, nurture their workforce, and address the issues that drive burnout and sap joy in work. The most joyful, productive, engaged staff feel both physically and psychologically safe, appreciate the meaning and purpose of their work, have some choice and control over their time, experience camaraderie with others at work, and perceive their work life to be fair and equitable. There are proven methods for creating a positive work environment that creates these conditions and ensures the commitment to deliver high-quality care to patients, even in stressful times.
  9. Content Article
    The ‘Productive Ward: Releasing Time to Care’ programme is a quality improvement (QI) intervention introduced in English acute hospitals a decade ago to: increase time nurses spend in direct patient care improve safety and reliability of care improve experience for staff and patients make changes to physical environments to improve efficiency. The objective of this paper, published in BMJ Quality & Safety, was to explore how timing of adoption, local implementation strategies and processes of assimilation into day-to-day practice relate to one another and shape any sustained impact and wider legacies of a large-scale quality improvement intervention.
  10. Content Article
    The current crisis of clinician burnout is a complex problem. As rates of burnout (the workplace syndrome consisting of emotional exhaustion, depersonalisation and loss of meaning) reach disturbing levels among clinicians, we continue to struggle to understand how to address workplace suffering. An under-examined area of burnout is how the increasing complexity of healthcare, combined with our tentative recognition of complexity science (the study of systems governed by interactions, dependencies and relationships), impacts the well-being of clinicians.  Please note this article, published in BMJ Quality and Safety, is paywalled.
  11. Content Article
    Patient safety depends on doctors’ well-being. Medicine is a tough job, but it's made it far harder than it should be by neglecting the simple basics in caring for doctors’ well-being. The well-being of doctors is vital because there is abundant evidence that workplace stress in healthcare organisations affects quality of care for patients as well as doctors’ own health. In 2018 the General Medical Council asked Professor Michael West and Dame Denise Coia to carry out a UK-wide review into the factors which impact on the mental health and well-being of medical students and doctors. The detailed practical proposals in this report provide a road map to health service leaders faced with the challenge of developing healthy and sustainable workforces.
  12. Content Article
    Mark Stuart spent five days in agony and died following a catalogue of failings by NHS staff. His parents say they have been battling for answers for four years.  They tell their story to BBC News.
  13. News Article
    Shrewsbury and Telford hospital NHS trust has uncovered dozens of avoidable deaths and more than 50 babies suffering permanent brain damage over the past 40 years. But how many more babies must die before NHS leaders finally tackle unsafe, disrespectful, life-wrecking services? The NHS’s worst maternity scandal raises fundamental questions about the culture and safety of our health service. Too many hospital boards complacently believe “it couldn’t happen here”. Instead of constantly testing the quality and reliability of their services, they look for evidence of success while explaining away signs of danger. Across the NHS there are passionate clinicians and managers dedicated to building a culture that delivers consistently high quality care. But they are undermined by a pervasive willingness to tolerate and excuse poor care and silence dissent. Until that changes, the scandals will keep coming. Read full story Source: The Guardian, 2 November 2019
  14. News Article
    In March 2015, the Morecambe Bay investigation, chaired by Dr Bill Kirkup, published its report into serious failures in care that led to the avoidable deaths of 11 babies and a mother at Furness General Hospital (FGH) between 2004 and 2012. One of the babies that died was James Titcombe's son, Joshua. The report described a seriously dysfunctional maternity unit where certain midwives pursued an “over-zealous” approach to promoting “normal” childbirth, relationships between doctors and midwives was poor, midwifery practice fell well below acceptable standards and, unforgivably, instances of avoidable harm and death were covered up – meaning lessons were not learned and similar failures were repeated year after year. The report detailed how opportunities to intervene at Morecambe Bay were missed at all levels and how the families who raised concerns were treated as problems to be managed, rather than voices that needed to be heard. More than four years later, it is both tragic and distressing to read about the litany of failures identified in the leaked interim report into care at Shrewsbury and Telford Hospital Trust (SaTH). Far from events at Morecambe Bay being a “one-off”, it is now painfully clear that not only have similar failures in care occurred elsewhere, but that they have happened on an even larger scale. James, speaking to The Independent, says "Worryingly, the reason why we are reading about these issues now isn’t because the regulatory system identified a problem and called for further scrutiny, but rather because of the extraordinary efforts of bereaved families." Read full story Source: The Independent, 21 November 2019
  15. News Article
    As many as one in three women in the UK are traumatised by their birth experiences, and one in 25 of those will go on to develop full-blown PTSD. Following the most recent scandal at Shrewsbury, Milli Hill, the founder of the Positive Birth Movement, talks to The Independent about why we need to bring human connection back into maternity services, as well as continuing to invest in the research and technology that can save the lives of those most at risk and, why, above all, we need to start listening to women. If we don’t do these things, history will only repeat itself. Milli says: "We cannot continue to see scandals like Shrewsbury and Morecambe Bay as isolated, instead we must be brave enough to view them as symptomatic of a wider problem of a maternity system that has become completely dehumanised and unable to listen to women." Read full story Source: The Independent, 20 November 2019
  16. Content Article
    Models and methods of work system design need to be developed and implemented to advance research in and design for patient safety. In this paper, Carayon et al. describe how the Systems Engineering Initiative for Patient Safety (SEIPS) model of work system and patient safety, which provides a framework for understanding the structures, processes and outcomes in health care and their relationships, can be used toward these ends. An application of the SEIPS model in one particular care setting (outpatient surgery) is presented and other practical and research applications of the model are described.
  17. Content Article
    HindSight is a magazine produced by the Safety Improvement Sub-Group (SISG) of EUROCONTROL. It is produced for Air Traffic Controllers and is issued by the Agency twice a year. Its main function is to help operational air traffic controllers to share in the experiences of other controllers who have been involved in ATM-related safety occurrences.  The current Editor in Chief is Dr Steven Shorrock.
  18. Content Article
    In recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes.
  19. Content Article
    The direction of hospital design is taking a turn for the practical as a surge of institutions are updating their infrastructure and responding to demands for more outpatient facilities. Beyond aesthetics, hospitals are seeking architectural updates that improve safety, patient and staff satisfaction, and friendliness to the environment. Infection control, lighting conditions, noise level, air quality, and patient room design are just some of the factors that are considered. 
  20. Content Article
    In Wales, like in England, the government has come under pressure over the poor performance of parts of the service. The Betsi Cadwaladr Health Board is the largest in Wales. It also has the worst A&E waiting times and has been in special measures for three years. Its hospital in Bangor, Ysbyty Gwynedd, serves 193,000 people, from tourists visting Snowdonia to the many retirees who live in North Wales. In this film, Saleyha Ahsan, looks at how the department tries to cope with unrelenting demand for patient space.
  21. Content Article
    Team-targeted rudeness may underlie performance deficiencies, with individuals exposed to rude behaviour being less helpful and cooperative. The objective of this paper, published by The Official Journal of the American Academy of Pediatrics, was to explore the impact of rudeness on the performance of medical teams. In conclusion,  rudeness had adverse consequences on the diagnostic and procedural performance of the neonatal intensive care team members. Information-sharing mediated the adverse effect of rudeness on diagnostic performance, and help-seeking mediated the effect of rudeness on procedural performance.
  22. Content Article
    Doctors and nurses must adapt their routines and improvise their actions to ensure continued patient safety, and for their roles to be effective and to matter as new technology disrupts their working practices. Research from Lancaster University Management School on the use of a computerised physcian order entry system in a hospital in Saudi Arabia, published in the Journal of Information Technology, found electronic patient records brought in to streamline and improve work caused changes in the division of labour and the expected roles of both physicians and nursing staff. These changes saw disrupted working practices, professional boundaries and professional identities, often requiring complex renegotiations to re-establish these, in order to deliver safe patient care. Managers implementing these systems are often quite unaware of the unintended consequences in their drive for efficiency.
  23. Content Article
    When an adverse event occurs in healthcare, the consequences can be catastrophic for patients and their families. In the aftermath of such events there are multiple needs, expectations and demands. This blog from our Patient Safety Learning website, looks at the case in which Dr Hadiza Doctor Bawa-Garba was convicted of manslaughter. 
  24. Content Article
    Presentation from Dr Helen Highham at the 'A New Strategy for Patient Safety - Insight, Involvement, Improvement' conference held in Manchester on the 16 October 2019.
  25. Content Article
    Healthcare systems are under stress as never before. An ageing population, increasing complexity and comorbidities, continual innovation, the ambition to allow unfettered access to care and the demands on professionals contrast sharply with the limited capacity of healthcare systems and the realities of financial austerity. This tension inevitably brings new and potentially serious hazards for patients and means that the overall quality of care frequently falls short of the standard expected by both patients and professionals. The early ambition of achieving consistently safe and high-quality care for all1 has not been realised and patients continue to be placed at risk. In this paper published in BMJ Quality & Safety, Amalberti and Vincent discuss the 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.
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