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Found 863 results
  1. Content Article
    Dr Robert D. Glatter, medical advisor for Medscape Emergency Medicine, Dr Megan Ranney, professor of emergency medicine and the academic dean at Brown University School of Public Health and Dr Jane Barnsteiner, emeritus professor at the University of Pennsylvania School of Nursing, discuss the tragic case involving RaDonda Vaught, who was an ICU nurse who was recently convicted in Tennessee of criminally negligent homicide and gross neglect following a medical error due to administration of the wrong medication that led to a patient's death.
  2. Content Article
    An expert committee will extend the vision for the nursing profession into 2030 and chart a path for the nursing profession to help create a culture of health, reduce health disparities, and improve the health and well-being of the US population in the 21st century. The committee will consider newly emerging evidence related to the COVID-19 global pandemic and include recommendations regarding the role of nurses in responding to the crisis created by a pandemic.
  3. News Article
    A trust board has backed the medical director who oversaw the dismissal of a whistleblower in a case linked to patient deaths. Portsmouth Hospitals University Trust told HSJ John Knighton had the full support of the organisation when asked if he faced any censure over the wrongful dismissal of a consultant who raised the alarm about a surgical technique. Jasna Macanovic last month won her employment tribunal against the trust with the judge calling its conduct “very one-sided, reflecting a determination to remove [her] as the source of the problem”. The judgment found that the disciplinary process Dr Knighton oversaw was “a foregone conclusion” and as such had broken employment rules. The nephrologist was twice offered the opportunity to resign with a good reference, once during her disciplinary hearing and again on the day the outcome of that hearing was delivered. The trust told HSJ nothing in the judgment suggested Dr Knighton should face any action about his conduct and none had been taken. It said there were no reasons to doubt his credibility or probity. The trust did not respond when asked if any apology had been offered to Dr Macanovic. A spokesperson said: “We are committed to supporting colleagues raising concerns, so they are treated fairly with compassion and respect.” Read full story (paywalled) Source: HSJ, 13 April 2022
  4. News Article
    There has been a dramatic fall in morale among midwives across multiple measures within the NHS staff survey. Although general morale deteriorated among most staffing groups in 2021, the results for midwives across numerous key measures have worsened to a far greater degree than average. It comes amid the final Ockenden report into the maternity care scandal at Shrewsbury and Telford Hospitals Trust, which raised serious concerns about short staffing and people wanting to leave the profession. The survey results, published on 31 March, suggest 52% of midwives are thinking about leaving their organisation, up 16 percentage points on the previous year. In comparison, the number of general nurses thinking of leaving was 33%, up just 5 percentage points. Chris Graham, chief executive of healthcare charity the Picker Institute, which coordinates the staff survey, described the midwifery profession as an “outlier” in the 2021 results, in terms of how their experiences compare to other groups and how their responses have changed over time. “Not only do midwives report worse experiences in many areas, but there is evidence of particularly sharp declines in some key measures,” Mr Graham said. “It appears likely that staffing shortages are a major factor here.” Read full story (paywalled) Source: HSJ, 13 April 2022
  5. Content Article
    In August 2021, University Hospitals North Midlands Trust (UHNM) commissioned brap and Roger Kline to conduct a review of bullying and harassing behaviours across the Trust. The purpose of the review was to understand: the nature of bullying/harassment within the Trust (what types of behaviour are staff being subject to?) the basis of bullying/harassment (is poor treatment linked to people’s protected characteristics or other aspects of identity (such as language spoken) the scope of bullying behaviour (how frequently are staff subject to bullying behaviours and are they concentrated in particular sites, job roles, or bands? Are staff subject to bullying from patients/visitors or primarily from colleagues?) the response to any unprofessional behaviours (do people feel confident reporting or challenging poor behaviour? If not, why?) the conditions that allow bullying behaviours to continue (what aspects of organisational culture may be contributing to the persistence of bullying? Are stress, workloads, or poor management practice roots causes?) The review was prompted by anecdotal claims of inappropriate behaviour within some parts of the Trust. (The Trust has a range of mechanisms to monitor levels of bullying and harassment, including national and local surveys, reports from the Freedom to Speak Up Guardians, Dignity at Work reports, and staff listening events.) In addition, a survey conducted by BAPIO/LNC raised concerns about the treatment of doctors and how this intersected with issues around race. As such, this review sought to explore whether the treatment of Black and minority ethnic (BME) people was different to that of White British staff. 
  6. News Article
    Patient safety and nursing groups around the country are lamenting the guilty verdict in the trial of a former nurse in Tennessee, USA. The moment nurse RaDonda Vaught realised she had given a patient the wrong medication, she rushed to the doctors working to revive 75-year-old Charlene Murphey and told them what she had done. Within hours, she made a full report of her mistake to the Vanderbilt University Medical Center. Murphey died the next day, on 27 December 2017. On Friday, a jury found Vaught guilty of criminally negligent homicide and gross neglect. That verdict — and the fact that Vaught was charged at all — worries patient safety and nursing groups that have worked for years to move hospital culture away from cover-ups, blame and punishment, and toward the honest reporting of mistakes. The move to a “Just Culture" seeks to improve safety by analyzing human errors and making systemic changes to prevent their recurrence. And that can't happen if providers think they could go to prison, they say. “The criminalization of medical errors is unnerving, and this verdict sets into motion a dangerous precedent,” the American Nurses Association said. “Health care delivery is highly complex. It is inevitable that mistakes will happen. ... It is completely unrealistic to think otherwise.” Read full story Source: The Independent, 31 March 2022
  7. News Article
    A number of London GP practices are training their receptionists to do blood tests, Pulse has learned. Professor Sir Sam Everington, a GP and chair of Tower Hamlets CCG, told Pulse that ‘lots of practices’ in the area have taken the step, including his own. Training a receptionist to carry out blood tests – which can be done in just six weeks – provides much-needed support to pressured practices, he said. Dr Everington told Pulse: ‘A lot of our receptionists have signed up to be phlebotomists and they love it because actually, phlebotomy is not just about taking blood. "You get to know all the patients with long-term conditions and so our phlebotomists know all these patients." He added that reception teams are a ‘fertile recruitment ground’ for a phlebotomist. They can ‘manage even the most terrified patients’ and have ‘amazing’ clinical skills. Dr Everington suggested that training receptionists as phlebotomists can help build trust with patients who are suspicious about having to describe their symptoms for triage by reception staff. But he said that the extra role just ‘acknowledges’ that all members of practice staff are ‘part of the clinical team’. He told Pulse: "In our practice, we all train together. We have meetings together, the whole team, and it’s acknowledging in this modern world that actually every member of your staff is a clinician – part of the clinical team – because there are always things they will do or can do that will have an impact clinically." "There isn’t a hidden supply of GPs out there in the next few years. It takes 10 years to train GPs so actually help is going to come from a wider team base." Read full story Source: Pulse, 31 March 2022
  8. News Article
    Less than half of staff at scandal-hit Shrewsbury and Telford Hospital NHS Trust feel they can speak up about concerns, according to a staff survey, as a damning report warned serious problems persist in maternity care. Shrewsbury and Telford Hospital Trust is one of the worst-performing trusts on the latest national survey of staff for the NHS. It comes after Donna Ockenden, who chaired a review into maternity failures at the trust, said her “biggest concern” was that staff had been told not to share concerns with her inquiry. Ms Ockenden told The Independent her biggest concern was “that ordinary staff on the ground are telling me they were advised not to cooperate with the Ockenden review”. The NHS staff survey, published on Wednesday, showed just 49% of staff at the trust reported they would feel safe enough speaking up about concerns in 2021 – down from 53% in 2020. Meanwhile, just 34% of staff said they feel their concerns would be addressed if there were to speak up. The trust is one of the worst three hospital trusts in the country when it comes to rising care concerns, the figures show. Only United Lincolnshire Hospitals NHS Trust and Barking, Havering and Redbridge University Hospitals NHS Trust performed worse. Read full story Source: The Independent, 31 March 2022
  9. Content Article
    In this blog, Patient Safety Learning analyses the results of the NHS Staff Survey 2021, specifically focusing on responses relating to reporting, speaking up and acting on safety concerns. It reflects on the importance of staff feeling able to speak up about patient safety incidents and the implications when this is not the case. It describes the NHS’s current approach to creating a patient safety culture and emphasises the need for NHS England and NHS Improvement, in partnership with the National Guardian and Care Quality Commission, to bring forward robust and specific commitments to drive this work forward.
  10. Content Article
    Annie Hunningher highlights the difficulties in measuring an organisation's safety culture and the lack of validated measurement tools available.
  11. News Article
    NHS staff are significantly less likely to recommend their organisations as places to work or believe they employ enough people to deliver effective care, the service’s annual staff survey has revealed. The 2021 survey results, published today, showed regression across a broad range of questions, including in areas such as motivation, morale, workload pressures and staff health. One of the biggest drop-offs in survey scores related to the question asking whether there were enough staff in their organisation for respondents to do their job properly. Only 27.2% of those surveyed said staffing was adequate, a fall of 11% points from the previous year (38.4%). Only 59.4%nof staff said they would recommend their organisation as a place to work. This represented a 7% point decline from the previous year (66.8%). The rating had steadily improved since 2017 when it was at 59.7%. While a decline was seen across all sectors, the steepest drop was found among ambulance trusts. Ambulance trusts performing worse compared to other sectors appeared to be a recurring theme across the survey. Read full story (paywalled) Source: 30 March 2022
  12. Content Article
    In this blog, Imagen Gowan* writes about her experience of volunteering at a Macmillan Information & Support Centre at her local hospital. She explains what compelled her to start volunteering and what her role involves, as well as exploring some challenges that volunteers in the NHS face. She identifies the need for more training, and greater efforts to preserve morale and a sense of belonging amongst both staff and volunteers.
  13. Content Article
    This short animation provides a commentary on stigma about mental healthcare for doctors, highlighting that a culture change is needed in the way we talk about and approach mental health in the healthcare community.
  14. Content Article
    Debriefing is a process of communication that takes place between a team following a clinical case. It identifies errors as well as areas of excellence for both teams and individuals. This article in BMJ Open Quality describes a quality improvement project in an emergency department in Ireland, which aimed to introduce hot debriefing following all cardiac arrests.
  15. Content Article
    Primary care is a crucial part of every healthcare system, but the US spends less on primary care and more on specialty care than other high-income countries. The results of this are burnout, high staff turnover and physician shortages. These were all major problems before Covid-19, that have been worsened by the pandemic. In this episode of The Commonwealth Foundation's podcast The Dose, host Shanoor Seervai asks Asaf Bitton, MD, executive director of the health innovation center at Ariadne Labs, what it will take to rebuild the USA's broken primary care system.
  16. Content Article
    Civility Saves Lives have created a number of infographic each with a key message of civility. A selection are shown below and more can be found through the link at the bottom of the page.
  17. Content Article
    Earlier this month The BMJ and the Nuffield Trust hosted a roundtable discussion about the workforce crisis. It took in a wide range of perspectives, but the message was clear: the workforce crisis is urgent, it is affecting staff morale and wellbeing, it is damaging patient care, and it requires immediate action. It’s not just a UK problem; it’s a global crisis, but some countries are better at recognising the relation between staff morale and wellbeing, better patient care and economic growth. Simply put, your economy won’t grow if your population is unhealthy; your population won’t be healthy if your health professionals are demoralised and unwell.
  18. Content Article
    This article by the British Medical Association (BMA) looks at the pressures GPs face that are leading to an increasing number leaving the profession. Several GPs from around the UK share their personal experience of unsustainable workloads and burnout, and the impact this has had on their health and wellbeing. The article highlights the impact of changes to the system on doctors at different career stages, including the increasing number of older GPs who are retiring early due to the intense pressure of their role.
  19. Content Article
    In July 2019, NHS England and NHS Improvement launched the NHS National Patient Safety Strategy. A key element of this is the development and implementation of a patient safety syllabus, which was created by Academy of Medical Royal Colleges (AoMRC) based on a proactive approach to the prevention of harm. UCLPartners is working in partnership with the Chartered Institute for Ergonomics and Human Factors’ (CIEHF) Lantern Group to support Trusts across London to assess their readiness to implement the syllabus through the development of an organisational self-assessment tool. This work has been commissioned by Health Education England (HEE). The organisational self-assessment tool has been developed alongside a Facilitator’s Guide. 
  20. Content Article
    In this opinion piece for BJGP Life, GP Chris Lowe explores potential problems with electronic access to primary care. He describes his own experience of e-consultation and warns of the potential of such technologies to make life harder for staff. He also raises concerns that rather than widen access to GPs, online access makes appointments less accessible for certain populations, and that introducing too many new technologies too quickly may cause experienced GPs to retire early.
  21. Content Article
    This blog is prompted by a recent newspaper crossword in which one of the clues, quadruplicated, was 'Whistle-blower'. The four answers were, respectively, 'canary', 'snitch', 'telltale' and 'betrayer'. The blog draws attention to negative perceptions of whistleblowers in the eyes of some people. It emphasises how wrong these perceptions are and how damaging this can be, with serious patient safety implications. In this blog I provide a crossword counterpoint (attached below to solve), which seeks to support learning about the realities of hostility against some staff who speak up in the NHS. I will share a follow-up blog which contains the solution to this crossword and seeks to provide further education on this topic where there is so much confusion and misunderstanding.
  22. Content Article
    Focused practice is an approach to primary care where a family doctor or GP chooses one or more specific clinical areas as a major part-time or full-time component of their practice. In recent years, there has been a global increase in focused practice and a decline in offering a comprehensive scope of practice in primary care. This Canadian study in the British Journal of General Practice looked at factors influencing family doctors' decisions to work in focused practice. The authors of the study concluded that: both early-career and resident family doctors unanimously saw focused practice as a way to avoid the burnout or exhaustion they associated with comprehensive practice in the current structure of the healthcare system. more research is needed to understand the implications of family physician choices of focused practice within the physician workforce.
  23. Content Article
    Healthcare professionals need clearer guidance on responding to racism in paediatric settings, argue Zeshan Qureshi and colleagues.
  24. Content Article
    People like being treated well. A civil approach to relationships in the healthcare workplace – any workplace – has merit, but there are many questions to explore. While most doctors interact with others in a civil manner most of the time, anyone can experience lapses occasionally. When the many dimensions of civility are considered more closely, it appears that there is much that can be learned about the causes of incivility and the strategies that can be adopted to foster civil behaviour, even at times of risk. Physician Health Programme offers a series of articles below as Five Fundamentals of Civility for Physicians.
  25. Content Article
    The Covid-19 pandemic has stretched healthcare staff like never before. Tom Moberly reports on a roundtable discussion hosted by The BMJ as part of the 2022 Nuffield Trust summit, looking at why workers leave the NHS and how staff wellbeing and retention can be improved.
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