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Content ArticleWhen operating on a patient, a surgeon may put swabs (pieces of gauze that come in a range of types, shapes and sizes) into the patient’s body to absorb bodily fluids such as blood. The operating theatre team count the swabs in and out, using a process known as reconciliation, to ensure all swabs are accounted for at the end of the operation. However, sometimes a swab can be unintentionally retained (left inside a patient’s body). This type of patient safety incident is known as a ‘Never Event’ – that is, an event that NHS England considers to be wholly preventable. This report is intended for healthcare organisations, policymakers, and the public to help improve patient safety in relation to retained swabs following invasive procedures.
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Content ArticleCurrently, surgical site infection surveillance relies on labour-intensive manual chart review. Recently suggested solutions involve machine learning to identify surgical site infections directly from the medical record. Deep learning is a form of machine learning that has historically performed better than traditional methods, while being harder to interpret. This study proposed a deep learning model—an explainable long short-term memory network—for the identification of surgical site infection from the medical record. The study found that the model had greater sensitivity when compared to traditional machine learning methods.
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News Article
IT system which sparked safety alert dropped by 13 trusts
Patient Safety Learning posted a news article in News
More than a dozen trusts have changed their maternity IT system – or are in the process of doing so – following a national patient safety alert. NHS England issued the alert in December, after a fault was discovered with the Euroking maternity EPR, supplied by Magentus Software. It said information recorded in the EPR could overwrite previously recorded data, meaning the system could mislead clinicians. While no cases of patient harm have been reported, NHSE instructed trusts using the system to “consider if Euroking meets their maternity service’s needs” and “ensure their local configuration is safe” by June. A spokesperson for Euroking said: “We have identified a solution to the issues raised in the NPSA [alert], which has been shared with NHSE and with our customers. We’re now meeting each customer and are working with them individually to support the changes that need to be made based on their local configurations. We will continue working with the trusts to support them meeting the deadline outlined in the NPSA. “As the NPSA outlined, it has been issued as a precautionary measure and there is no evidence of harm being caused to patients.” Read full story (paywalled) Source: HSJ, 12 April 2024 Related reading on the hub: NHS England warns electronic patient record could pose ‘serious risks to patient safety’: what can we learn? -
Content ArticleIn February 2023, the Department of Health and Social Care (DHSC) published the government’s Medical Technology Strategy. This set out how, over the next 5 to 10 years, the DHSC will ensure the health and social care system can reliably access safe, effective and innovative technologies. These technologies will enable the delivery of high-quality care, outstanding patient safety and excellent health outcomes, while making the best use of taxpayer money. One year into delivery of the medtech strategy, the DHSC present an update on their achievements towards establishing an innovation pathway, to realise our vision of right product, right price, right place.
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Content Article
Yasmine Mustafa, Co-Founder and CEO of ROAR, looks at how technology can improve healthcare for patients and staff safely, including the role of wearable technology in healthcare safety. -
News Article
Diabetes patients to be offered artificial-pancreas technology
Patient Safety Learning posted a news article in News
Tens of thousands of people with type 1 diabetes in England are to be offered a new technology, dubbed an artificial pancreas, to help manage the condition. The system uses a glucose sensor under the skin to automatically calculate how much insulin is delivered via a pump. Later this month, the NHS will start contacting adults and children who could benefit from the system. But NHS bosses warned it could take five years before everyone eligible had the opportunity to have one. This is because of challenges sourcing enough of the devices, plus the need to train more staff in how to use them. In trials, the technology - known as a hybrid closed loop system - improved quality of life and reduced the risk of long-term health complications. And at the end of last year, the National Institute of Health and Care Excellence (Nice) said the NHS should start using it. Prof Partha Kar, NHS national speciality advisor for diabetes, said the move was "great news for everyone with type 1 diabetes". "This futuristic technology not only improves medical care but also enhances the quality of life for those affected," he added. Read full story Source: BBC News, 2 April 2024 Related reading on the hub: How safe are closed loop artificial pancreas systems? -
Content ArticleThis Lancet article highlights three challenges to measuring and analysing social determinants of health (SDoH) for which data science—a cross-disciplinary set of skills to make judgements and decisions with data by using it responsibly and effectively—can be harnessed. The three challenges the authors examine are: Data necessary for capturing the exposure of interest at multiple levels appropriately are not always available nor easy to measure. SDoH are distal to individual health outcomes compared to biomedical determinants such as comorbidities. The distal placement of SDoH in relation to health outcomes results in requires long periods of time to observe their effect.
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Content ArticleMore health systems and hospitals are looking to expand options to care for patients at home, but a new report points to some obstacles that threaten the safety of patients. ECRI, a nonprofit organisation focused on patient safety, released its annual list of the 10 leading healthcare technology hazards Wednesday. Safety challenges involving medical devices at home topped the 2024 list of technology trouble spots. ECRI also cites other challenges, including poor instruction in cleaning medical devices, sterile drug compounding, the insufficient governance of artificial intelligence in healthcare, and cybersecurity. But the concerns over the use of medical devices at home rose above all others. Marcus Schabacker, MD, president and CEO of ECRI, talked with Chief Healthcare Executive® about the potential hazards in patients using medical devices and tools at home.
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Content ArticleThis study aimed to find out whether using an artificial intelligence (AI) deterioration model decreased the risk of escalations in care during hospitalisation. The study's findings suggest that use of an AI model is associated with a decreased risk of escalations in care.
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News Article
NHS AI expansion to help tackle missed appointments and improve waiting times
Patient Safety Learning posted a news article in News
The NHS is set to roll out artificial intelligence (AI) to reduce the number of missed appointments and free up staff time to help bring down the waiting list for elective care. The expansion to ten more NHS Trusts follows a successful pilot in Mid and South Essex NHS Foundation Trust, which has seen the number of did not attends (DNAs) slashed by almost a third in six months. Created by Deep Medical and co-designed by a frontline worker and NHS clinical fellow, the software predicts likely missed appointments through algorithms and anonymised data, breaking down the reasons why someone may not attend an appointment using a range of external insights including the weather, traffic, and jobs, and offers back-up bookings. The appointments are then arranged for the most convenient time for patients – for example, it will give evening and weekend slots to those less able to take time off during the day. The system also implements intelligent back-up bookings to ensure no clinical time is lost while maximising efficiency. It has been piloted for six months at Mid and South Essex NHS Foundation Trust, leading to a 30% fall in non-attendances. A total of 377 DNAs were prevented during the pilot period and an additional 1,910 patients were seen. It is estimated the trust, which supports a population of 1.2 million people, could save £27.5 million a year by continuing with the programme. The AI software is now being rolled out to ten more trusts across England in the coming months. Read full story Source: NHS England, 14 March 2024 -
Content ArticleTechnology is advancing at a fast pace and holds significant promise for the future of healthcare and the NHS, with the potential to enhance productivity through cost, resource and time efficiencies. Yet there is a gap in practical guidance for healthcare stakeholders on how best to take this agenda forward, and what key roles are required. Systems are now in a place where people can take a large-scale view and make connections across the system to advance the technology agenda. To support them, the NHS Confederation and Google Health have developed this guide.
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Content ArticleThe role of artificial intelligence (AI) in healthcare is expanding quickly with clinical, administrative, and patient facing uses emerging in many specialties. Research on the effectiveness of AI in healthcare is generally weak, but evidence of AI improving doctor’s diagnostic decisions is emerging for some focused clinical applications, including interpreting lung pathology and retinal images. However, we must work with patients to understand how AI impacts on their care, says Rebecca Rosen in this BMJ opinion piece.
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Content ArticleThis article tells the story of how the This Is My Story (TIMS) initiative developed at John Hopkins Medicine, and how it is giving care teams a humanising window into the lives of patients who can’t speak for themselves. Initiated by Chaplain Elizabeth Tracey, who saw the toll not being able to communicate with intubated patients was having on healthcare workers during the first wave of the Covid-19 pandemic, TIMS provides healthcare teams with a short audio recording about each patient. The patient's family shares details about their loved one, such as information on hobbies, personal interests and the patient's career. Staff have reported the TIMS recordings having a big impact on how they view their patients, and the scheme has been rolled out across John Hopkins services.
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Content ArticleThis annual report from ECRI and the Institute for Safe Medication Practices (ISMP) presents the top 10 patient safety concerns currently confronting the healthcare industry. It is a guide for a systems approach to adopting proactive strategies and solutions to mitigate risks, improve healthcare outcomes and enhance the well-being of patients and the healthcare workforce. Drawing on ECRI and ISMP’s evidence-based research, data and insights, this report sheds light on issues that leaders should evaluate within their own institutions as potential opportunities to reduce preventable harm. Some of the concerns represent emerging risks, some are well known but still unresolved, but all of them pertain to areas where organisations can make meaningful change.
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EventuntilAntipsychotic medication management and monitoring can be challenging. Join us to learn how handheld ECG devices support vulnerable patients and improve the physician and patient experience through: Comfortable, accurate, and fast ECG readings with the first personal ECG device to be recommended by the National Institute for Health and Care Excellence (NICE) More accessible and available measurements for detecting cardiac abnormalities in psychiatric services, such as a prolonged QT interval Reducing stress and anxiety among psychiatric patients with tests in familiar surroundings Key learnings: Local NHS experience: How the pandemic ushered innovation into clinical practice. How NICE recommended technology can implement new pathways and break down barriers. Register
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Content ArticleThe use of AI in medical devices, patient screening and other areas of healthcare is increasing. This Medscape article looks at some of the risks associated with the use of AI in healthcare. It outlines the difficulties regulators face in monitoring adaptive systems, the inbuilt bias that can exist in algorithms and cybersecurity and liability issues.
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Content ArticleColoplast UK is a manufacturer of ostomy, continence, urology and wound care products. They commissioned the Patients Association to conduct a project to explore and recommend ways to better engage patients and carers in policymaking and the assessment of medical technologies for intimate healthcare. The Patients Association held a roundtable meeting and case study interviews with patients with intimate healthcare conditions and other stakeholders. They also conducted a survey of third-sector organisations who represent those patients and carried out desk-based research. This report summarises the findings of the project, which include that the existing mechanisms of engagement typically adopt a “patient involvement” approach where patients and carers do not have equal status as partners in the decision-making process. The report makes a number of recommendations to improve the way in which patients and their carers are engaged.
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News Article
‘Disingenuous’ wait times on NHS App will be half those patients have to face
Patient Safety Learning posted a news article in News
Next week’s launch of the ‘Wayfinder’ waiting time information service on the NHS App will give patients “disingenuous” and “misleading” information about how long they can expect to wait for care, senior figures close to the project have warned. Briefing documents seen by HSJ show the figure displayed to patients will be a mean average of wait times taken from the Waiting List Minimum Data Set and the My Planned Care site. However, it was originally intended that the metric displayed would be the time waited by 92% of relevant patients. This is more commonly known as the “9 out of 10” measure. Mean waits are likely to be about “half the typical waiting time” measured under the 9 out of 10 metric, according to the waiting list experts consulted by HSJ. Ahead of The Wayfinder service’s launch on Tuesday, NHS trusts and integrated care boards have been sent comprehensive information on how to publicise it, including a “lines to take” briefing in case of media inquiries. This mentions the use of an “average” time but does not provider any justification for this approach. HSJ’s source said the mean average metric was “the worst one to choose” as it would be providing patients with “disingenuous” information that will leave them disappointed. They added that the 92nd percentile metric would be a “far more realistic” measure “for a greater number of people”. They concluded that “using an average” would create false expectations “because in reality nobody will be seen in the amount of time it is saying on the app.” Read full story (paywalled) Source: HSJ, 26 January 2024 -
News Article
Online GP access leaves patients lost, says report
Patient Safety Learning posted a news article in News
Online services for GPs across Surrey leave many patients feeling "helpless and lost", a new report says. Healthwatch Surrey said some patients felt "defeated" by online systems and that issues were worse in certain groups. This included people with English as a second language and those less confident with technology. Online services include booking appointments, requesting repeat prescriptions and viewing test results. Healthwatch Surrey, which gathers the views of local people on health and social care services in the county, said: "Confusion around the appointment booking process and a perception that appointments are hard, or even impossible, to book online is the issue people tell us most about." One Epsom and Ewell resident was asked by their surgery to book a blood test online. They told Healthwatch: "I tried but I couldn't understand how to do it and so I called back. "I'm in my 80s and I try to be as independent as I can, but some of these processes defeat me." Sam Botsford, contract manager at Healthwatch Surrey, said communication was key in ensuring patients knew how to use online services. She said: "People feel they're being pushed online, and that spans a range of different demographics. "It's really important for practices to identify the needs of their patients and how they can best meet those." Read full story Source: BBC News, 2 February 2024 -
Content ArticleECRI's Top 10 Health Technology Hazards for 2024 list identifies the potential sources of danger ECRI believe warrant the greatest attention this year and offers practical recommendations for reducing risks. Since its creation in 2008, this list has supported hospitals, health systems, ambulatory surgery centres and manufacturers in addressing risks that can impact patients and staff.
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Content ArticleOperating room black boxes are a way to capture video, audio, and other data in real time to prevent and analyse errors. This article from Campbell et al. presents the results of two studies on operating room staff's perspectives of black boxes. Quality improvement, patient safety, and objective case review were seen as the greatest potential benefits, while decreased psychological safety and loss of privacy (both staff and patient) were the most common concerns.
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Content ArticleIn November 2023, the UK hosted the first global summit on artificial intelligence (AI) safety at Bletchley Park, the country house and estate in southern England that was home to the team that deciphered the Enigma code. 150 or so representatives from national governments, industry, academia and civil society attended and the focus was on frontier AI—technologies on the cutting edge and beyond. In this Lancet article, Talha Burki looks at the implications of AI for healthcare in the UK and how it may be used in medical devices and service provision. The piece highlights the risks in terms of regulation and accountability that are inherent in the use of AI.
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Content ArticleThis study in JAMA Psychiatry aimed to assess whether multivariate machine learning approaches can identify the neural signature of major depressive disorder in individual patients. The study was conducted as a case-control neuroimaging study that included 1801 patients with depression and healthy controls. The results showed that the best machine learning algorithm only achieved a diagnostic classification accuracy of 62% across major neuroimaging modalities. The authors concluded that although multivariate neuroimaging markers increase predictive power compared with univariate analyses, no depression biomarker could be uncovered that is able to identify individual patients.
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Content ArticleHealth care algorithms are used for diagnosis, treatment, prognosis, risk stratification and allocation of resources. However, bias in the development and use of algorithms can lead to worse outcomes for racial and ethnic minoritised groups and other historically marginalised populations such as individuals with lower incomes. This study aimed to provide a conceptual framework and guiding principles for mitigating and preventing bias in health care algorithms, in order to promote health and health care equity. The authors suggested five guiding principles: Promote health and health care equity during all phases of the health care algorithm life cycle Ensure health care algorithms and their use are transparent and explainable Authentically engage patients and communities during all phases of the health care algorithm life cycle and earn trustworthiness Explicitly identify health care algorithmic fairness issues and trade-offs Establish accountability for equity and fairness in outcomes from health care algorithms.
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Content ArticleThis systematic review conducted for the Agency for Healthcare Research and Quality (AHRQ) aimed to examine the evidence on whether and how healthcare algorithms exacerbate, perpetuate or reduce racial and ethnic disparities in access to healthcare, quality of care and health outcomes. It also examined strategies that mitigate racial and ethnic bias in the development and use of algorithms. The results showed that algorithms potentially perpetuate, exacerbate and sometimes reduce racial and ethnic disparities. Disparities were reduced when race and ethnicity were incorporated into an algorithm to intentionally tackle known racial and ethnic disparities in resource allocation (for example, kidney transplant allocation) or disparities in care (for example, prostate cancer screening that historically led to Black men receiving more low-yield biopsies).
