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Found 997 results
  1. Content Article
    Surgical smoke or surgical plume is the smoke created by electrical and cauterisation devices used in surgery. When surgical staff are exposed to this smoke, it may cause harm, with some studies finding that exposure increased cancer risk for surgeons. This study in the journal Scientific Reports aimed to compare the concentration of surgical smoke produced by different tissues and electric diathermy modes, and to measure the effectiveness of different local exhaust ventilations. The authors found that: there were varying levels of particulates given off by different devices and different tissues. in the cutting setting, all three smoke extractors had more than 96% efficiency in clearing surgical smoke. adapting an electric diathermy device with a urethral catheter is a simple and effective way to exhaust smoke in surgical operations. They highlight the need for more research to ensure surgical staff are well protected from the risks of surgical smoke.
  2. Content Article
    In its 2019 manifesto the government pledged to increase the full-time equivalent number of nurses working in the NHS by 50,000 by March 2024. But although data suggests that the NHS will hit that target, Ruth May, England's Chief Nursing Officer, has stated publicly that there are still substantial shortages in spite of this increase. This analysis by the King's Fund highlights that the supply of nurses to the NHS is not keeping up with demand, with vacancy levels remaining static in spite of an increase to the raw number of nurses. It also highlights wide regional variation in nurse shortages.
  3. Content Article
    The Culture Change Toolbox is a collection of tools and interventions for changing culture. It’s full of ideas, examples, and exercises. For each tool there are tips on how to apply it and a description of which components of culture it helps to improve. This latest version includes: the latest evidence on culture change a refreshed format with an improved flow for learning new activities and resources for teams examples from across the continuum of care.
  4. Content Article
    From April 2023 the new Health Services Safety Investigations Body will require doctors to be candid about errors that have led to patient harm. But can medics trust that material given in this “safe space” won’t be used against them?
  5. Content Article
    Repeated culture of safety surveys of the nursing staff at Children’s Hospital of Philadelphia’s main campus demonstrated lagging scores in the domain of nonpunitive responses to error. The hospital had tried for many years to address the problem using a variety of strategies, including small group training sessions on just culture for staff and leaders, but had met with limited success. Finally, in 2015, it committed to trying something genuinely different—even perhaps disruptive—that might actually shift the stagnant metrics. Their novel, multifaceted programme, implemented over a two-year period, yielded a 13% increase in staff rating scores that the hospital has been able to sustain over the subsequent two-year period.  The design and rollout of our program was neither simple nor smooth, but valuable lessons were learned about realistic, operational implementation of principles of psychological safety in a large and complex clinical organisation. In this paper, Neiswender et al. describe the programme and the lessons learned in the journey from idea inception to post-implementation.
  6. Content Article
    In this article in the Patient Safety Journal, Mayher Profita, a third-year surgical resident in Pennsylvania, describers her residency and the burnout she experienced. "The burnout was making us care less about our patients and the care they received and more about whether we made the right career choice."
  7. Content Article
    ISO 45001, Occupational health and safety management systems – Requirements with guidance for use, is the world’s first International Standard for occupational health and safety (OH&S). It provides a framework to increase safety, reduce workplace risks and enhance health and well-being at work, enabling an organisation to proactively improve its OH&S performance
  8. Content Article
    Not knowing how to unfold or even sit in a wheelchair the right way can cause a catastrophic injury to patients, visitors, volunteers, and staff of a healthcare facility. Wheelchairs are one of the most common assistive devices used in healthcare facilities, from admission to discharge. They are often found at the entrance of a facility for use by both patients and visitors with mobility issues. Hospital volunteers, transport staff, and clinical staff use wheelchairs to take patients to different care areas to have tests performed. Many facilities require that patients be transported in a wheelchair upon discharge. However, not knowing the proper method of unfolding a wheelchair or where to place your hands when sitting down in the seat can cause injuries, specifically to fingers, ranging from lacerations to amputations.
  9. Content Article
    In this blog, Bob Matheson, Head of Advice and Advocacy at the charity Protect, explains the case of Dr Chris Day and how it highlights the vital importance of reforms to UK whistleblowing law.   Protect is campaigning for Reform of whistleblowing legislation in the UK. The author highlights loopholes in UK law that Dr Day has faced throughout his long legal battle with Health Education England (HEE). These gaps mean that whistleblowers lack certain important legal rights and protections, and this in turn may prevent individuals from raising concerns.
  10. Content Article
    In this blog for the hub, Julia Wood explains why Joy in Work is so important, how you can implement it into your team ensuring you and your colleagues are happier at work, and why a happier team will improve patient care.
  11. Content Article
    Here are some useful projects that NHS East London teams from each directorate took part in as part of demonstrating what they have learned from Cohort 3 of the Enjoying Work Learning System.
  12. Content Article
    A systematic review and meta-analysis from Hodkinson et al. examines the association of physician burnout with the career engagement and the quality of patient care globally. A joint team of British and Greek researchers analysed 170 previous observational studies of the links between burnout among doctors, their career engagement and quality of patient care. Those papers were based on the views and experience of 239,246 doctors in countries including the US, UK and others in Africa, Asia and elsewhere globally. This meta-analysis provides compelling evidence that physician burnout is associated with poor function and sustainability of healthcare organisations primarily by contributing to the career disengagement and turnover of physicians and secondarily by reducing the quality of patient care. Healthcare organisations should invest more time and effort in implementing evidence-based strategies to mitigate physician burnout across specialties, and particularly in emergency medicine and for physicians in training or residency. Read accompanying BMJ editorial here.
  13. Content Article
    The Government's Race Disparity Unit has published data relating to NHS staff reports of discrimination at work. The charts, tables and commentary on this page cover survey data from 2019, and the data from 2020 is available to download without commentary. 300 NHS organisations took part in the staff survey in 2019, including 229 NHS trusts.
  14. Content Article
    European Union Directive 2010/32/EU legally enforces a set of strategies aimed at preventing sharps injuries and determining the risk of bloodborne infections and psychological distress in healthcare workers. This article in the International Journal of Environmental Research and Public Health looks at the results of a national survey conducted in Italy in 2017 and repeated in 2021 to evaluate the progress of the Directive's implementation. The authors assessed the impact of the Covid-19 pandemic on implementation.
  15. Content Article
    This presentation provides an insight into a real life crowdfunded NHS whistleblowing case. This comes from the perspective of both a frontline NHS clinician and crowdfunder. The tactics used against Dr Day, his response to them and the effect that such a public protracted fight has had on NHS culture and ‘confidence in the system’. Potential changes are then discussed Chris is a Locum Emergency Medicine doctor working at the moment in East London. Chris is also a Claimant in a high profile whistleblowing case that has been ongoing for nearly 9 years. The case re-established statutory whistleblowing protection (in the Court of Appeal) for junior doctors in England. The case has had further media attention last month when Chris’ NHS opponents admitted to destroying evidence whilst a 16 day court hearing was in progress.
  16. Content Article
    In this blog, consultant on workforce culture Roger Kline looks at the case of Shyam Kumar, an orthopaedic consultant who was seconded as an inspector for the Care Quality Commission (CQC). After raising concerns about patient safety, harm, cover up and bullying of staff with the CQC, his secondment with them was terminated. An Employment Tribunal has found that Mr Kumar's concerns were well-founded and that he was then victimised for raising them by the CQC. The Tribunal accepted his claims that he was removed from his secondment as a CQC inspector as a result of making protected disclosures, accepted his evidence, and at a number of points did not believe the evidence provided by senior CQC staff. The blog raises the question of whether the CQC would fail on its own criteria for being a 'well led' organisation on the basis of this case. It also questions whether the CQC can credibly hold NHS organisations to account on whistleblowing after its response to having concerns raised by Mr Kumar, one of its own inspectors. The author asserts that "the CQC needs to urgently demonstrate it will apply accountability to its own decision making, and lack of support for those raising concerns, and hold its own senior leaders (up to the CEO) to account for decisions which are contrary to its own published standards."
  17. Content Article
    This literature review in The Operating Theatre Journal examines why the decision was made not to class surgical fires as a 'Never Event', even though research has identified them as a preventable hazard. The author also examines steps that could be taken to further reduce the risk of surgical fires in the NHS and other health systems. You will need to create a free online account to view this article.
  18. Content Article
    A good safety culture in healthcare is one that includes value and respect for diversity, strong leadership and teamwork, openness to learning, and staff who feel psychologically safe. In this article the Nuffield Trust use data from the NHS Staff Survey to look at safety culture in the NHS.
  19. Content Article
    This webpage highlights press coverage of the Chris Day whistleblowing hearing which took place in June 2022. Dr Day's case originates in 2013, when he initially raised concerns about unsafe staffing levels at Woolwich Hospital ITU, run by Lewisham and Greenwich NHS Trust. Following this, senior management in the Trust made allegations about his conduct, he believes as a result of his whistleblowing action. As a result Health Education England (HEE) deleted Dr Day's training number, meaning he was unable to progress to become a consultant. Dr Day has been campaigning for a public hearing of the case since 2016, and believes HEE, Lewisham and Greenwich NHS Trust and other authorities have spent large amounts of money attempting to 'crush' his case and prevent it from being heard. The tribunal hearing finally took place in June 2022 and featured revelations about Trust staff deliberately deleting emails relevant to the case, partisan briefings made to senior NHS management about Dr Day and inaccurate press statements from the Trust.
  20. Content Article
    This statement from Chair Peter Wyman addresses allegations of bullying and racism within NHS Blood and Transplant as reported in The Times on 21 August 2022. In the statement, Peter Wyman says, "I cannot overstate the importance we place in ensuring we have a strong, positive and inclusive culture so we can serve the public and patients who need us.  “Issues of racism and bullying came to light in parts of our organisation two years ago after an in-depth staff listening exercise. We’ve moved on a lot in the past two years. Our actions have included providing a safe way for staff to raise and discuss issues by appointing a Freedom to Speak Up Guardian, improving recruitment processes to be more inclusive, matured how we manage conflict and grievances and refreshing our code of conduct so we all know the behaviours that are expected of us. We continue to measure progress through ongoing staff engagement.   “We are making progress but like every good organisation we should always be challenging ourselves to do even better. In particular, I want to ensure we have a culture that enables each of us to be our best, that encourages everyone to speak up without fear or favour if they see something wrong or something which might be done better. I want a culture where everyone is valued for who they are and what they contribute. "There can be no place for any form of discrimination, bullying or harassment.”
  21. Content Article
    In this blog for The King's Fund, Richard Murray examines the issues that are pushing the NHS into crisis and causing the lowest levels of public satisfaction since the 1990s. The primary cause of this emergency is the workforce crisis, an existing trend that has been accelerated by the Covid-19 pandemic. He examines the approaches that have been taken to similar crises in the past, and highlights the importance of the workforce plan that is due to be released by NHS England and Health Education England towards the end of the year.
  22. Content Article
    Covid-19 has posed a huge challenge to the delivery of safe care, both when infection rates were at their highest levels and in terms of its long-term impact on health and social care systems.[1] The pandemic has magnified existing patient safety issues, created new ones, and exposed safety gaps which require systemic responses. This month the World Health Organization (WHO) has published a new report, Implications of the Covid-19 pandemic for patient safety: A rapid review.[2] The review aims to create a greater understanding of the impact of the pandemic on patient safety, particularly in relation to diagnostic services, treatment and care management. In this blog, Patient Safety Learning, one of the international organisations who contributed to this review, provides an overview and reflections on some the key themes and issues raised in this review.
  23. Content Article
    During COVID-19, clinical teams faced disruption, having to respond to challenging circumstances and high uncertainty, whilst providing quality care to patients. We know that staff psychological wellbeing affects team effectiveness and patient experience and resilience is fostered by connections between (not just within) individuals. New collaborations between clinical, service improvement and psychology teams recognised the value of introducing the psychologically-informed ‘Start Well>End Well’ team procedure into routine team processes. This evidence-based approach consists of 1) an enhanced safety briefing, 2) peer-to-peer debrief guidance and signposting for trauma-focused support, and 3) team check-out. Initially launched as a general procedure across all wards with variable uptake, a more tailored co-design and coaching approach was then piloted on 2 neurology wards over 3 PDSA cycles. Formative evaluation (focus groups and written feedback) demonstrated staff felt “cared for” whilst achieving “positive impact” through improved ways of working within new teams.
  24. Content Article
    Governments in England, Scotland and Wales recently withdrew covid sick leave for NHS staff. These changes to sick pay provision for staff on Covid-related sick pay is hard to understand at a time when Covid-19 infections are going up exponentially and many NHS organisations are reporting increasing numbers of staff off sick. Evidence is emerging that your chances of on-going issues (Long Covid) following a covid infection increase with each re-infection. Given this you might expect that NHS organisations were ensuring their infection control guidelines guaranteed staff were fully protected against Covid-19. However, in many Trusts this does not appear to be the case. Throughout the pandemic many NHS organisations seem to have focused on following Government guidelines about PPE requirements and ignored their obligations under Health and Safety Legislation. This has resulted in on-going shortcomings in protecting staff at work. This is discussed by Professor Raymond Agius and colleagues in a BMJ blog.
  25. Content Article
    Presentation from Julia Wood given to the Patient Safety Manager Network (PSMN) on the importance of finding joy and happiness in work and how you can support your staff.
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