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Found 259 results
  1. Content Article
    This systematic review from Willis et al., published in BMJ Leader, set out to understand what leaders and organisational cultures can learn about supporting doctors who experience second victim phenomenon; the types, levels and availability of support offered; and the psychological symptoms experienced. 
  2. Content Article
    Encouraging diversity in the NHS isn’t simply a matter of inclusion, it’s a matter of patient safety, delegates at the Healthcare Excellence Through Technology (HETT) conference have heard.
  3. Content Article
    With people living longer and with multiple chronic conditions, medical care has become more complex and is being offered in diverse settings. Over the last decades, healthcare workers have had to adapt to this changing landscape and continuously learn to improve patient safety. This article from the World Health Organization (WHO) demonstrates that it is not just healthcare workers that need to think about patient safety, it is everyone's business, from cooks to janitors.
  4. Content Article
    Presentation from Andrea McGuinness at the 'A New Strategy for Patient Safety - Insight, Involvement, Improvement' conference held in Manchester on the 16 October 2019.
  5. Content Article
    Presentation from Dr Cicely Cunningham from the Doctors' Association UK at the 'A New Strategy for Patient Safety - Insight, Involvement, Improvement' conference held in Manchester on the 16 October 2019.
  6. Content Article
    For the fourth year, the Health Quality Council of Alberta (HQCA), in partnership with the Patient and Family Advisory Committee (PFAC), held the Patient Experience Awards programme to recognise and help spread knowledge about initiatives that improve the patient experience in accessing and receiving healthcare services in Alberta, Canada. Applications spanned all corners of the province and came from a wide variety of care settings, and ranged from “elegantly simple” to complex in nature. The initiatives described reflected the diverse healthcare needs of Albertans and were equally diverse in their approach to healthcare improvement. However, they all had one thing in common: A desire to make change and deliver a better patient and family member experience.
  7. Content Article
    Involvement in an adverse event or error can have serious effects on health care workers. Spotlighting how operating room culture can deter individuals from seeking help, this commentary emphasises the importance of assisting perioperative nurses immediately after a harmful mistake.
  8. Content Article
    Published in BMJ Quality and Safety The term ‘second victim’ refers to the healthcare professional who experiences emotional distress following an adverse event. This distress has been shown to be similar to that of the patient, the ‘first victim’. The aim of this study was to investigate how healthcare professionals are affected by their involvement in adverse events with emphasis on the organisational support they need and how well the organisation meets those needs.
  9. Content Article
    Chronic diseases account for an estimated 86% of deaths and 77% of the disease burden in the WHO European Region, as measured by disability-adjusted life-years. These diseases, including cardiovascular diseases, cancer, diabetes, obesity and chronic respiratory diseases, are now the largest cause of death and disability worldwide. This development is bringing about a fundamental shift in health systems and health care and thus in the roles of patients.
  10. Content Article
    In this blog post, Vince discusses the challenges registrants face when something goes wrong, and why employers and regulators should be doing more to reassure professionals that openness is best for everyone.
  11. Content Article
    Disrespectful and unsafe behavior by physicians and advanced practice medical professionals can undermine health care teams, but research shows that often a simple conversation to make an individual aware of their action can promote self-reflection and change. A Vanderbilt University Medical Center study published in The Joint Commission Journal on Quality and Patient Safety examined data from the Co-worker Observation Reporting System (CORS), a system of peer reporting of perceived disrespectful and unsafe conduct that was established at VUMC in 2011.
  12. Content Article
    The All Party Parliamentary Group (APPG) for Whistleblowing was launched in July 2018 to look at the case for an Independent Office for the Whistleblower. The APPG have set an ambitious workplan aiming to take back the UK’s lead on this legislation, proposing to deliver world class, gold standard draft legislation – a global solution to a global problem. The objectives of the APPG for Whistleblowing are: Influencing policies and decisions that affect whistleblowers globally. Drafting legislation to ensure effective protection for whistleblowers. Commissioning and publishing research, based on our work with whistleblowers and relevant groups and stakeholders across all sectors. Engaging our supporters in campaigns to influence decisions affecting whistleblowers. Giving whistleblowers safe platforms to speak out on issues affecting them. Promoting positive social attitudes towards whistleblowing. Encouraging MPs to promote positive recognition for whistleblowers. Supporting and upskilling MPs and their staff to identify and manage constituent whistleblower cases.
  13. Content Article
    The D5 ward was visited as part of the University Hospital Southampton's Care Quality Commission (CQC) inspection and was verbally fed back to have a different ‘feel’ to other wards in the trust. It was felt that the ward was chaotic and lacked clear leadership, on top of this there were some safety concerns raised by both the inspection team and from adverse event reports that were being submitted by the ward.
  14. Content Article
    Malcolm's Story, produced by Karen Harrison, Tissue Viability Nurse at Hull University Teaching Hospitals NHS Trust, is a video of Malcolm, his daughter and his wife sharing their experiences of Malcolm being a patient in our Trust and developing a hospital acquired pressure ulcer while in our care. 
  15. Content Article
    Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust Patient Safety Team's values became a golden thread to improve patient safety by 'Sharing How We Care' – a monthly patient safety newsletter and annual conference.
  16. Content Article
    This short video from the Derbyshire Community Health Services NHS Foundation describes the importance of speaking up, what the process is and how speaking up will improve patient safety.
  17. Content Article
    The National Patient Safety Agency developed the Incident Decision Tree to help NHS managers in the UK to determine a fair and consistent course of action toward staff involved in patient safety incidents. Research shows that systems failures are the root cause of the majority of safety incidents. Despite this, when an adverse incident occurs, the most common response is to suspend the clinician(s) involved, pending investigation, in the belief that this serves the interests of patient safety. The Incident Decision Tree supports the aim of creating an open culture, where employees feel able to report patient safety incidents without undue fear of the consequences. The tool comprises an algorithm with accompanying guidelines and poses a series of structured questions to help managers decide whether suspension is essential or whether alternatives might be feasible. 
  18. Content Article
    This is the Freedom to Speak Up Guardian job description. Use it for reference or for a template to advertise for a Freedom to Speak Up Guardian in you trust/sector.
  19. Content Article
    "Looking back down the path of another person’s journey is not the same thing as making the trip yourself." What a great quote! It is so true. Henriksen and Kaplan discuss hindsight bias, outcome knowledge and adaptive learning in this paper published in BMJ Quality & Safety in 2003.
  20. Content Article
    See how incivility affects all of us in the NHS and how that can impact patient safety. Join the staff of Epsom and St Helier University Hospitals NHS Trust on their journey as they reflect on the real-life effects of both incivility and active kindness.  This video was devised, filmed and produced by the Elena Power Simulation Centre.
  21. Content Article
    The fair treatment of staff supports a culture of fairness, openness and learning in the NHS by making staff feel confident to speak up when things go wrong, rather than fearing blame. Supporting staff to be open about mistakes allows valuable lessons to be learnt so the same errors can be prevented from being repeated. In any organisations or teams where a blame culture is still prevalent, this guide will be a powerful tool in promoting cultural change.
  22. Content Article
    A Just Culture guide helps NHS managers ensure staff involved in a patient safety incident are treated fairly, and supports a culture of openness to maximise opportunities to learn from mistakes.
  23. Content Article
    This short video describes how the staff at NHS Imperial College Healthcare are at the heart of patient safety and showcases some of the achievements of their teams in improving patient safety.
  24. Content Article
    A team of ward nurses from Merseyside took part in the 2018–19 cohort of the Innovation Agency's coaching for culture programme. The team, led by ward manager Sharon Mcloughlin, were all from the Dott Ward at The Walton Centre NHS Foundation Trust, a specialist trust in north Liverpool dedicated to providing comprehensive neurology, neurosurgery, spinal and pain management services.
  25. Content Article
    NHS at 70: The Story Of Our Lives is a national programme of work supported by The National Lottery Heritage Fund and led by The University of Manchester recording stories from people who worked and were cared for by the NHS since its creation in 1948. These stories will be available on the public Digital Archive and will provide a lasting resource for audiences to discover NHS history through the voices of the people who have worked and were cared for by the NHS since 1948.
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