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Content ArticleHealth information technology (HIT) provides many benefits, but also facilitates certain types of errors, such as wrong-patient errors in which one patient is mistaken for another. These errors can have serious patient safety consequences and there has been significant effort to mitigate the risk of these errors through national patient safety goals, in-depth research, and the development of safety toolkits. Nonetheless, these errors persist. Kim et al. analysed 1,189 patient safety event reports using a safety science and resilience engineering approach, which focuses on identifying processes to discover errors before they reach the patient so these processes can be expanded.They analysed the general care processes in which wrong-patient errors occurred, the clinical process step during which the error occurred and was discovered, and whether the error reached the patient. For those errors that reached the patient, they analysed the impact on the patient, and for those that did not reach the patient, they analysed how the error was caught.
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Content Article
Implementation Approaches for Closing the Loop (2019)
Patient-Safety-Learning posted an article in Diagnostic error
Delayed, missed and incorrect diagnoses are common causes of errors that result in patient harm and inappropriate care. However, some diagnostic errors may be avoided by effectively using health information technology. These resources from the Emergency Care Research Institute provide information on how to implement IT processes to close the loop on diagnostic evaluations. -
Content ArticleThe panel of this HSJ webinar explored how digital solutions might help clinicians improve patient safety and what barriers there might be along the way. In a debate chaired by HSJ contributor Claire Read, the panel explored how digital solutions might help clinicians improve patient safety and what barriers there might be along the way.
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EventuntilChief executive Joe Rafferty and strategic advisor for digital programmes Jim Hughes, will discuss how Mersey Care Foundation Trust has been part of a region-wide programme to develop shared understanding of covid and other pressures. Joining them on the panel will be Rebecca Malby, professor in health systems innovation at London South Bank University, and Markus Bolton, director of Graphnet Health – which is supporting the event. In a discussion chaired by HSJ contributor Claire Read, they will explore the value of a shared understanding of which pressures and caseloads exist in an area and consider how digital technologies might play a role here. Which parties need to be involved? Which information is most important to which groups? How can worries about information governance be overcome? Register
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) report charts the emerging patient safety risks that can come with the introduction of ‘smart’ infusion pump technology into hospitals. Smart infusion pumps are the latest generation of programmable devices that administer medication. They are seen as a way of improving safety as the smart functionality aims to prevent underdoses or overdoses – they are equipped with features such as alerts or alarms to help detect problems. The investigation was launched after one NHS Trust recorded three incidents where a smart infusion pump delivered an overdose of fentanyl, a powerful pain medication. The patients weren’t harmed as it was swiftly picked up, however it emphasised the new risks that come with introducing new technology and the potential for serious medication errors. The investigation focused on the barriers to implementing the technology effectively across the NHS, rather than on the technology itself.
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Content ArticleIn this 30 minute video presentation, we hear from Dr Victoria Brazil, Professor of Emergency Medicine and Director of Simulation, Gold Coast Health Service. Dr Brazil talks through the benefits and complexities of simulation training using real life footage to illustrate key points. She suggests there are three ways healthcare can be improved using simulation: Simulation to explore Simulation to test Simulation to embed.
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Content Article
Osmond Ergonomics: Posture guides
Patient Safety Learning posted an article in Patient safety in health and care
Agile working is on the increase and here to stay. This brings its own challenges for people working in a variety of locations and environments. Technology is pervasive and our technical interactions are migrating rapidly to mobile and hand-held devices, keeping us connected and able to work almost anywhere. This inevitably affects our posture and can lead to musculoskeletal issues in the longer term. Adopting the correct posture when sitting, standing and operating mobile devices aids the prevention and management of existing musculoskeletal problems. Regular stretching exercises are even more beneficial. Osmond Ergonomics provides support tools such as these free guides. -
Content ArticleIn this review, Jane Carthey and colleagues discuss human factors research in cardiac surgery and other medical domains. The authors describe a systems approach to understanding human factors in cardiac surgery and summarise the lessons that have been learned about critical incident and near-miss reporting in other high technology industries that are pertinent to this field.
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Content ArticleBefore the emergence of the novel coronavirus and the subsequent pandemic, the health and care system had a poor track record in adopting digital technologies at scale. However, in response to the pandemic the healthcare system rapidly implemented new tools, many technology-based, to allow healthcare to be delivered when physical contact is not possible. The approach to using digital tools in health care provision is undergoing a substantial and rapid shift. Many of the technologies adopted during the first phase of the pandemic were already well established but not widely implemented; the maturity of the technology enabled the provision of healthcare through remote consultation to be much more prevalent much more quickly. Despite this recent rapid adoption of digital technologies, the health and care system remains at the early stages of digital health, with many tools replicating physical approaches and processes rather than taking advantage of what makes digital different.
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Content ArticleThe Professional Record Standards Body (PRSB) has published a new report on lessons learned from the pandemic to support the future of digital change in health and care. Following a consultation process with 100 of its members, PRSB has published the report examining the digital transformation of services during the pandemic and it recommends how the system can use the lessons in the future. The Digital Health and Care and COVID-19 report recommendations include building on the enthusiasm for digital but reviewing and evaluating safety implications, particularly for remote and virtual consultation where both clinical risk and patient access need to be addressed. The report also includes a focus on quality in practice, including the use of apps and other digital technologies.
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Content Article
NHS e-Review platform
Patient Safety Learning posted an article in Regulatory bodies/standards/guidance
A national bespoke system, called NHS e-Review, has been developed and launched as part of the NHS Covid Incident Recovery programme. The online system has been developed to support clinicians record the clinical priority of patients on a waiting list and to identify alternative pathways for patients if required. -
Content ArticleIn this study, Avery et al. estimated the incidence of avoidable significant harm in primary care in England, and describe and classify the associated patient safety incidents and generate suggestions to mitigate risks of ameliorable factors contributing to the incidents. The study found there is likely to be a substantial burden of avoidable significant harm attributable to primary care in England with diagnostic error accounting for most harms. Based on the contributory factors we found, improvements could be made through more effective implementation of existing information technology, enhanced team coordination and communication, and greater personal and informational continuity of care.
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Content ArticleThe Clinical Command Centre is designed to optimise many aspects of day-to-day patient care and help create better patient experiences, outcomes, and lower costs. It makes sense of vast amounts of data for hospitals and healthcare systems worldwide. Today, Command Centres are also helping these systems meet the challenge of COVID-19. Currently, Bradford Teaching Hospitals NHS Foundation Trust (BTHFT) is the only Trust in Europe equipped with this technology which is likely to be crucial in dealing with any second wave of COVID-19 cases. In this video, Mel Pickup, CEO of BTHFT, shed some light on how they've been using advanced data visualisation and the vision for using it in the future. By making sense of vast amounts of operational data, the technology is enabling leadership teams to make critical, real-time decisions about patient care.
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Content ArticleAdvances in 3D printing, also called additive manufacturing, are capturing attention in the healthcare field because of their potential to improve treatment for certain medical conditions. A radiologist, for instance, might create an exact replica of a patient’s spine to help plan a surgery; a dentist could scan a broken tooth to make a crown that fits precisely into the patient’s mouth. In both instances, the doctors can use 3D printing to make products that specifically match a patient’s anatomy. The technology is not limited to planning surgeries or producing customised dental restorations such as crowns; 3D printing has enabled the production of customized prosthetic limbs, cranial implants, or orthopedic implants such as hips and knees. At the same time, its potential to change the manufacturing of medical products—particularly high-risk devices such as implants—could affect patient safety, creating new challenges for Food and Drug Administration (FDA) oversight. When 3D printing is used to manufacture a medical product at the point of care, oversight responsibility can become less clear. It is not yet apparent how the agency should adapt its regulatory requirements to ensure that these 3D-printed products are safe and effective for their intended use. The FDA does not directly regulate the practice of medicine, which is overseen primarily by state medical boards. Rather, the agency’s jurisdiction covers medical products. In some clinical scenarios where 3D printing might be used, such as the printing of an anatomical model that is used to plan surgery, or perhaps one day the printing of human tissue for transplantation, the distinction between product and practice is not always easy to discern. This issue brief explains how medical 3D printing is used in health care, how FDA regulates the products that are made, and what regulatory questions the agency faces.
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News Article
Seven NHS hospital trusts to receive share of £8.7m for e-prescribing
Patient Safety Learning posted a news article in News
A further £8.7million is to be dished out to seven NHS hospital trusts to introduce digital records and e-prescribing. The money is part of a £78million investment which was announced in February 2018 and aims to accelerate the roll out of electronic prescribing systems across the NHS. The latest funding is part of the third wave of the investment, which will be handed out over three years. In 2018/ 19, £16.2 million was awarded, £29.4 million was given in 2019/20 and another £12 million will be invested later this year. The seven trusts which will benefit from this latest round of finding are: Portsmouth Hospitals NHS Trust (£1.7m) Solent NHS Trust (£988,000) Sussex Community NHS Foundation Trust (£637,000) United Lincolnshire Hospitals NHS Trust (£1.26m) North Cumbria Integrated Care NHS Trust (£2m) East Lancashire Hospitals NHS Trust (£1.6m) Birmingham Community NHS Trust (£531,000) National director of patient safety, Dr Aidan Fowler, said: “Patient safety is of paramount importance and is something we are continuously looking at ways to improve, whether through new technology, such as the introduction of electronic prescribing, or by building a safety culture where all NHS staff feel supported and safe to speak up.” Read full story Source: Digital Health, 1 October 2020 -
News Article
Need for tech to reduce medication error and improve patient safety
Patient Safety Learning posted a news article in News
Omnicell UK & Ireland, a leading provider of automated healthcare and medication adherence solutions, hosted a health summit on the eve of World Patient Safety Day, to discuss the impact of medication errors on patients and the NHS. The session focussed on the role technology can play in preventing such issues. The summit, this year held via webinar, comes off the backdrop of the Department of Health and Social Care disclosing that in England 237 million mistakes occur every year at some point in the medication process. These errors cause serious issues for patient safety, but also place a significant cost burden on an already stretched NHS. The 2019 Patient Safety Strategy published by NHS England and NHS Improvement also found the NHS failed to save 11,000 lives a year due to safety concerns with the cost of extra treatment needed following incidents being over £1bn. A number of high-profile panel members answered a series of questions from the audience on solutions and best practice to improve patient safety with the aim of debating and sharing ideas on how to meet challenges and the impact of COVID-19. One of the panelists, Patient Safety Learning's Chief Digital Office Clive Flashman, agreed with the other panel members that the NHS had become more collaborative and familiar with technology since Covid: “We’ve seen a definite increase in telehealth and telemeds. Covid has forced cultural blockers that were there before to be removed out of necessity. There has been a growth in robotic pharmacy automation to free up staff time from high volume administration tasks to do more complex work that adds value for patients.” But with the second-wave of COVID-19 still a very real threat he advised: “We don’t want to wait until the next wave to learn a lesson – we need to learn lessons now. Quality Improvement Leads should be focussed on what went right and what went wrong over that period between March and May. They need to be looking at what we can learn from that now and what we can do differently next time. If we don’t do that, we won’t succeed in the second wave where we might fail.” Ed Platt, Automation Director, Omnicell UK & Ireland, added: “Challenges within the NHS throughout Covid has forced them to embrace technology and drive innovation." "It’s important that when things go back to normal, we don’t go back to the same status quo. We need to invest in the right infrastructure in hospitals so unnecessary demands and stress are not put on pharmacy, supply managers and nurses so they are free to focus on patient care not administration tasks." Read full story Source: NHE, 17 September 2020 You can watch the webinar on demand here -
Content ArticleThe COVID-19 crisis has created a watershed moment for the NHS, demanding a reappraisal of how essential services are delivered to the public. Even prior to COVID-19, the NHS recognised a pressing need to rethink healthcare using user-centred design principles, based on populations, not organisations. With the advent of the pandemic that pressing need has become an operational imperative. Digital capability has been and will continue to be a key part of transformation, but will only work when aligned with reforms in other key enablers such as financial flow, workforce planning and regulation. Many industries have already made the shift to enabling collaboration and innovation through more agile models of delivery by embracing technologies like artificial intelligence (AI), internet of things (IoT) and/or flexible and secure forms of (multi) cloud storage. Health, on the other hand, until now has introduced new technologies with the objective of improving existing pathways and service delivery models. There is now an opportunity to reimagine healthcare, driving true transformation enabled by digital capabilities.
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Content ArticleThis special Patient Safety Network Perspective compiles findings and insights into a series of case studies from interviews and written responses from leaders at three different health systems who had to increase their telehealth capacities in response to the COVID-19 pandemic.
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Content ArticleAn overview of the industry study by MxD and IAAE between February and June 2021 funded by FDA Office of Counterterrorism and Emerging Threats. The aim of the study was to gain an initial baseline to deepen FDA’s understanding of the factors that impact a manufacturer’s decision to invest in and adopt digital technologies by illuminating both perceived and demonstrated barriers from technical, business, and regulatory perspectives, and related cybersecurity considerations.
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Content ArticleProgress enables the creation of more automated and intelligent machines with increasing abilities that open up new roles between humans and machines. Only with a proper design for the resulting cooperative human–machine systems, these advances will make our lives easier, safer and enjoyable rather than harder and miserable. Starting from examples of natural cooperative systems, the paper from Flemisch et al. investigates four cornerstone concepts for the design of such systems: ability, authority, control and responsibility, as well as their relationship to each other and to concepts like levels of automation and autonomy.
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Content ArticleThe review by the Cabinet Office's Major Projects Authority (MPA) on the NHS National Programme for IT.
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Content ArticleIn healthcare, digital solutions have been adopted with zeal, but there is paucity of evidence for benefits and harms of these solutions. The impact, immediate or long term, of digital applications on healthcare has not been assessed. With the overwhelming numbers and types of digital solutions, it is becoming increasingly important to develop evidence-based insights for the integration of these solutions in routine medical care. Digitalisation can certainly empower and enable patients and physicians to achieve health objectives. The World Health Organization has released guidance for digital health after a critical review of available evidence for the benefits, harms, acceptability, feasibility, resource use and equity considerations of digital health interventions. This guidance can potentially inspire and impact future research endeavours for digital applications. Tarveen Jandoo reviews the guidance in context of the current research situation and insights are shared for researchers engaged in the design and assessment of digital interventions.
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Content ArticleSystems and software engineering contribute not only to advancing and improving the delivery of healthcare but also to doing it more safely than has been the case in the past.
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Content ArticleScienceDirect uses heuristic and machine-learning approaches to extract relevant information from their extensive collection of content. They compile this information on a topic-by-topic basis providing the reader both depth and breadth on a specific area of interest. This collection of research and data focuses on biomedical technology assessments.
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Content ArticleThis article from Peden et al. reviews of some of the key topics and challenges in quality, safety, and the measurement and improvement of outcomes in anaesthesia. Topics covered include medication safety, changes in approaches to patient safety, payment reform, longer term measurement of outcomes, large-scale improvement programmes, the ageing population, and burnout. The article begins with a section on the success of the specialty of anaesthesia in improving the quality, safety, and outcomes for our patients, and ends with a look to future developments, including greater use of technology and patient engagement.
