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Content ArticleThe second annual Safety For All conference was held at the Royal College of Physicians in London on Tuesday 5th December 2023. Over 100 members of the healthcare community attended this event, including occupational health professionals, patient safety experts, frontline staff, patients and academics. The conference was hosted by the Safer Healthcare and Biosafety Network and Patient Safety Learning as part of the Safety For All campaign, supported by B. Braun, BD, Boston Scientific and Stryker. Attendees had the opportunity to hear from two keynote speakers: Lynn Woolsey, UK Deputy Chief Nurse at the Royal College of Nursing and Dr Henrietta Hughes, Patient Safety Commissioner for England. The conference was chaired and facilitated by Dr Rob Galloway, A&E Consultant at Brighton and Sussex Hospital NHS Trust, with a welcome introduction from Dr Ian Bullock, CEO of the Royal College of Physicians. There were a number of panel sessions and presentations throughout the day which are summarised in the attachment below, including on sustainability, antimicrobial resistance and antibiotic underdosing, violence at work, clinical communications, human factors, implementing the Patient Safety Incident Response Framework (PSIRF), and women's health and the menopause.
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News Article
Nearly nine in ten GPs have faced verbal abuse in the last year
Patient Safety Learning posted a news article in News
GPs have warned that the extent of verbal abuse directed at them and their practice staff ‘is increasing’, with the majority reporting that things are worse now than during the height of the Covid pandemic. A UK-wide survey of more than 2,000 doctors – of which 617 were GPs – found that 85% of GPs have reported receiving verbal abuse from patients within the last 12 months. The research conducted by Medical and Dental Defence Union of Scotland (MDDUS) also found that 15% of GPs reporting verbal abuse said they ‘had to resort to involving the police’ to deal with abusive patient situations over the past year. In the survey, GPs identified key triggers such as ‘lack of access to a face-to-face consultation’ and ‘complaints about their quality of care’ as the factors that could escalate to verbal abuse. One GP who responded to the survey said: "During a consultation with a young adult, they got very irate and demanded I just give them what they came for. "I explained they had to calm down and we would only proceed then at which they called me an ugly, fat, c**t and threatened to smash my face in. That consultation stayed with me for quite a while after that." Another said: ‘A patient smashed the surgery front door (it needed replacing) because he didn’t get what he wanted when he wanted it. "This was very scary for staff and other patients and the police didn’t even come until the next day. I felt alone, defensive and wondered why we bother to try to provide a service when some patients have already decided it isn’t good enough for them." Read full story Source: Pulse, 7 December 2023 -
Content ArticlePatient safety incidents, including medical errors and adverse events, frequently occur in intensive care units, leading to a significant psychological burden on healthcare professionals. This burden results in second victim syndrome, which impacts the psychological and psychosomatic wellbeing of these staff members. This systematic review and meta-analysis aimed to examine the occurrence of second victim syndrome among intensive care unit healthcare workers, including the types, prevalence, risk factors and recovery time associated with the condition.
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Content ArticleThis study in BMC Health Services Research mapped healthcare workers’ experiences with patient safety incidents during the second wave of the Covid-19 pandemic in Slovakia. The authors found that healthcare workers with patient safety incident experiences reported poor hospital management of patient safety culture. This might reflect missed the opportunities to strengthen their resilience during the Covid-19 pandemic.
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Content Article
Developing cultural change in healthcare: Part 1 – by Dawn Stott
Dawn Stott posted an article in Good practice
If we are to continue improving healthcare services, then developing cultural change in healthcare is crucial. Improving the quality of care, reducing medical errors and, ultimately, enhancing patient outcomes is essential for the future. Transforming the culture within healthcare organisations requires a comprehensive approach that involves leadership commitment, employee engagement, continuous education and a focus on patient-centred care. In a two-part blog for the hub, Dawn Stott, Business Consultant and former CEO of the Association for Perioperative Practice (AfPP), talks about the strategies that can help you develop cultural change in your organisation. In part one, Dawn sets out the steps to develop a programme of change to support you to achieve good solutions. -
Content ArticleThe harsh reality of surgery often involves grappling with the distressing and emotionally taxing aspects of human suffering that many people outside of healthcare never witness. When complications occur, surgeons feel the weight of their responsibility and are often alone to ruminate with negative thoughts of self-doubt, sometimes leading to anxiety and depression. This article in The American Journal of Surgery examines existing literature on Second Victim Syndrome (SVS) specifically focusing on prevalence among surgeons and factors related to different responses. The authors identify women and junior surgeons at particularly high risk of SVS and peer support as a preferred method of coping but an overall lack of institutional support highlighting the need for ongoing, open conversations about the topic of surgeon well-being.
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Event
IHI Forum
Sam posted an event in Community Calendar
untilThe IHI Forum is a four-day conference that has been the home of quality improvement in health care for more than 30 years. Dedicated improvement professionals from across the globe will be convening to tackle health care's most pressing challenges: improvement capability, patient and workforce safety, equity, climate change, artificial intelligence, and more. Register -
Content ArticleSurviving in Scrubs have published their first report 'Surviving healthcare: Sexism and sexual violence in the healthcare workforce' is now live. The report is an analysis of 150 survivor stories submitted to their website since they launched in 2022. It details the findings on the incidents, factors and challenges unique to healthcare that permit sexism and sexual violence in the healthcare workforce. The report contains recommendations to healthcare organisations to better support survivors and end these behaviours.
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Content ArticleCommunity pharmacies in Sweden have changed during the COVID-19 pandemic, and new routines have been introduced to address the needs of customers and staff and to reduce the risk of spreading infection. Burnout has been described among staff possibly due to a changed working climate. However, little research has focused on the pandemic's effect on patient safety in community pharmacies. The aim of this study was to examine pharmacists' perceptions of the impact of the COVID-19 pandemic on workload, working environment, and patient safety in community pharmacies.
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Content ArticleDisruptive behaviour can have a significant impact on care delivery, which can adversely affect patient safety and quality outcomes of care. Disruptive behaviour occurs across all disciplines but is of particular concern when it involves physicians and nurses who have primary responsibility for patient care. There is a higher frequency of disruptive behaviour in neurologists compared to most other nonsurgical specialties. Disruptive behaviour causes stress, anxiety, frustration, and anger, which can impede communication and collaboration, which can result in avoidable medical errors, adverse events, and other compromises in quality care. Healthcare organisations need to be aware of the significance of disruptive behaviours and develop appropriate policies, standards, and procedures to effectively deal with this serious issue and reinforce appropriate standards of behaviour. Having a better understanding of what contributes to, incites, or provokes disruptive behaviours will help organizations provide appropriate educational and training programs that can lessen the likelihood of occurrence and improve the overall effectiveness of communication among the health care team.
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Content ArticleA substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect. Leape et al. identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behaviour in the health care setting: disruptive behaviour; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behaviour; passive disrespect; dismissive treatment of patients; and systemic disrespect. At one end of the spectrum, a single disruptive physician can poison the atmosphere of an entire unit. More common are everyday humiliations of nurses and physicians in training, as well as passive resistance to collaboration and change. Even more common are lesser degrees of disrespectful conduct toward patients that are taken for granted and not recognised by health workers as disrespectful. Disrespect is a threat to patient safety because it inhibits collegiality and cooperation essential to teamwork, cuts off communication, undermines morale, and inhibits compliance with and implementation of new practices. Nurses and students are particularly at risk, but disrespectful treatment is also devastating for patients. Disrespect underlies the tensions and dissatisfactions that diminish joy and fulfilment in work for all health care workers and contributes to turnover of highly qualified staff. Disrespectful behaviour is rooted, in part, in characteristics of the individual, such as insecurity or aggressiveness, but it is also learned, tolerated, and reinforced in the hierarchical hospital culture. A major contributor to disrespectful behaviour is the stressful health care environment, particularly the presence of “production pressure,” such as the requirement to see a high volume of patients.
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Content ArticleThe pandemic is not gone but it is largely forgotten. Especially the first year, with its two devastating waves in which over 140,000 people died. The NHS reorganised itself completely to deliver care to the thousands of very sick Covid patients, alongside continuing care for other patients throughout. The system strained and buckled and staff were pushed to their limits and beyond. The impact continues today as the NHS is weaker, less resilient and with much longer waits than before. In this article, Christina Pagel looks back at the reality of the first year and its aftermath and hears anonymous testimony from staff at the NHS front line. “Staff sitting in literal cupboards crying alone because staff weren’t allowed to sit together & we couldn’t take all the death around us. It was utterly traumatising”
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Content ArticleNurse bullying has been an issue for decades and continued during the Covid-19 pandemic. Now, in the post-pandemic era, allegations of toxic behaviour are continuing to climb. Becker's spoke with Jennifer Woods, vice president and chief nursing officer at Baptist Health Hardin in Elizabethtown, Pennsylvania, and Jamie Payne, chief human resources officer at Saint Francis Health System in Tulsa, Oklahoma, to understand the increase in nurse bullying and how their health systems are working to address it.
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News Article
Charge trusts with criminal offence for demonising whistleblowers, says HCSA
Patient Safety Learning posted a news article in News
The Hospital Consultants and Specialists Association (HCSA), a hospital doctors union, has called for an independent body to register and monitor cases where doctors raise safety concerns and for criminal charges to be brought against trusts when whistleblowers suffer harm. Naru Narayanan, president of HCSA, called for the changes after a survey found that doctors worry that speaking up about patient safety will put their careers at risk and that the creation of freedom to speak up guardians in 2016 has not increased their confidence. Read full story (paywalled) Source: BMJ, 13 November 2023 -
Content ArticleDuring the bleak early years of the Covid pandemic, if there was one thing we were all doing, it was “following the science”. This, we were repeatedly assured, was what was driving all the government’s tough decisions. We might not like all its policies but we shouldn’t, it was implied, argue. After all, it was – always – just “following the science”. But was it really? In her evidence to the Covid inquiry, former civil servant Helen MacNamara revealed that in April 2020, the then prime minister, Boris Johnson, asked the former chief executive of the NHS in England, Simon Stevens, about reports that female frontline healthcare workers were struggling with PPE that had been designed for men. Stevens is said to have “reassured” the prime minister that there was “no problem”. However, as Caroline Criado Perez highlights, report after report over decades has found that while PPE is usually marketed as gender-neutral, the vast majority has in fact been designed around a male body, and therefore neither fits nor protects women. In fact, more often than not, it’s a hindrance.
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News Article
Most foreign doctors in NHS face ‘racist microaggressions’, survey shows
Patient Safety Learning posted a news article in News
Three in five foreign doctors in the NHS face “racist microaggressions” at work, such as patients refusing to be treated by them or having their abilities doubted because of their skin colour. The widespread “thinly veiled, everyday instances of racism at work” experienced by medics trained overseas has been uncovered by a survey of more than 2,000 UK doctors and dentists. Almost three in five (58%) said they had encountered such behaviour, from colleagues as well as patients, although most did not report it because they thought that no action would be taken. Doctors affected can feel upset, humiliated, marginalised and not taken seriously as a result. The findings have raised fears that international medical graduates may choose not to work in the NHS, which is increasingly reliant on their skills given the service’s shortage of doctors. Dr Naeem Nazem, the head of medical at the medical defence organisation MDDUS, which acts for doctors accused of wrongdoing, said: “These findings show us that a worryingly large number of overseas-trained doctors working in the NHS face racist microaggressions in the course of their work, from both patients and colleagues, and that many do so regularly.” Read full story Source: The Guardian, 8 November 2023 -
Content ArticleMedical defence organisation MDDUS's latest annual member attitude survey has found that many have experienced or witnessed persistent racist microaggressions at work. Almost two-thirds of International Medical Graduate members report they’ve been subject to racist microaggressions and have little faith in being heard and the issue being taken seriously. MDDU's 'We hear you' campaign aims to be a catalyst for positive change and help rebuild confidence in the way such abuses can be reported.
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Content ArticleIn this opinion piece, BMJ journalist Clare Dyer examines how the healthcare system is grappling with the question of how Lucy Letby was allowed to get away with killing babies in plain sight for so long. She looks at culture and governance issues that meant that concerns raised by consultants were not appropriately acted on.
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Content Article
Bad management (Psychological Safety, 6 October 2023)
Patient_Safety_Learning posted an article in Staff safety
In this issue of Psychological Safety, Tom Geraghty, shares some stories of “bad” management that newsletter readers have shared with him, so we can all learn from them. A selection of the stories, chosen because they highlight key themes. Geraghty highlights the importance of self reflection and learning from our own mistakes in order to improve. Also noting that when we share our mistakes and what we’ve learned from them, the potential for learning extends beyond ourselves to everyone around us. -
Content ArticleChanges of all kinds can have a profound effect on us, both in terms of our wellbeing and performance. David Murphy has worked therapeutically with people, including front-line professionals, for over 20 years, helping them to change, and adapt to change. David talks to Steven Shorrock about dealing with traumatic events and more mundane changes.
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News Article
Birmingham NHS trust sacks staff after sexual harassment claims
Patient Safety Learning posted a news article in News
A hospital trust has dismissed three members of staff following complaints of sexual harassment. The sackings by University Hospitals Birmingham (UHB) NHS Trust were revealed at the launch of its sexual safety charter on Monday. Sexual safety was one of the areas highlighted in a review of the trust's culture. UHB said sexism, misogyny and sexual harassment would not be tolerated in the workplace. The trust has been subject to three enquiries following a BBC investigation into its culture. The second of these investigations, by Prof Mike Bewick, identified a new line of inquiry into allegations of misogynistic behaviour and sexual harassment. Prof Bewick said the trust had begun formal investigations and there was a widening of the scope of the enquiry to accommodate the sensitive nature of these concerns. Read full story Source: BBC News, 19 October 2023 -
News ArticleThousands of complaints made against nurses and midwives were rejected by the watchdog without investigation last year as it battles a huge backlog amid concerns rogue staff are being left unchecked. The Nursing and Midwifery Council has rejected hundreds more cases a year since 2018, including 339 where nurses faced a criminal charge, 18 for alleged sexual offences and 599 over allegations of violence in 2022-23, according to data shared exclusively with The Independent. The new figures come after The Independent revealed shocking allegations that nurses and midwives accused of serious sexual, physical and racial abuse are being allowed to keep working because whistleblowers are being ignored and that the NMC was failing to tackle internal reports of alleged racism. And now, a new internal document, obtained by The Independent, reveals more staff have come forward to raise concerns since our expose. Former Victims’ Commissioner Dame Vera Baird KC said the backlog of complaints was “worryingly high” and called for urgent action to tackle it. Read full story Source: The Independent, 19 October 2023
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EventuntilThis session is aimed at understanding what causes burnout, the impact and how to prevent/overcome it. Listening to stories from 2 Doctors and understanding the emotions, impact and consequence of burnout can help others look out for the signs and try to prevent it. Through talking and opening up, we hope to raise the awareness of burnout. It is real, can cause trauma and is linked to our wellbeing needs in the workplace. Guest speakers are: Dr Jess Morgan, Paediatrician Dr Chris Healey, Gastroenterologist Please join this session to learn from each other, listen and talk about wellbeing needs in the workplace. This is an open session to everyone, it will be healthcare based but is transferable. It is a free space and a social movement that has one agenda: To help staff flourish in the workplace. Sign up for the session. Joining instructions for this virtual event will be emailed directly to you closer to the date The basic needs at work campaign is based on research and simple QI methodology to address basic needs. It doesn't need to be complicated, but it does need to stick! The Basic Needs at Work resources can be found here
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Content ArticleHealthcare services regularly receive patient feedback, most of which is positive. Empirical studies suggest that health services can use positive feedback to create patient benefit. This study in Plos One aimed to map all available empirical evidence for how positive patient feedback creates change in healthcare settings. The researchers included 68 papers describing research conducted across six continents, with qualitative (n = 51), quantitative (n = 10), and mixed (n = 7) methods. Only two studies were interventional. Most outcomes described were desirable. These were categorised as: short-term emotional change for healthcare workers (including feeling motivated and improved psychological wellbeing) work-home interactional change for healthcare workers (such as improved home-life relationships) work-related change for healthcare workers (such as improved performance and staff retention). Some undesirable outcomes were described, including envy when not receiving positive feedback. The impact of feedback may be moderated by characteristics of particular healthcare roles, such as night shift workers having less interaction time with patients. The researchers called for further interventional research to assess the effectiveness and cost-effectiveness of receiving positive feedback in creating specific forms of change such as increases in staff retention. They also suggest that healthcare managers may wish to use positive feedback more regularly, and to address barriers to staff receiving feedback.
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Content ArticleDoctors are dying by suicide at higher rates than the general population—somewhere between 300 to 400 physicians a year in the US take their own lives. This article in The Guardian looks at why so many surgeons are dying to suicide and what can be done to stop the trend. It examines how the culture of working long hours and the expectation to be 'superhuman' leads surgeons to suppress their symptoms and avoid seeking help for mental health issues. The article also tells the story of US surgeon and President of the Association of Academic Surgery Carrie Cunningham, who has lived with depression, anxiety and a substance abuse disorder for many years.
