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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Claire talks to us about her role as a Patient Safety Lead and why she thinks the new Patient Safety Incident Response Framework will make her work more practical and patient-centred. She also describes why she set up the Patient Safety Management Network and highlights why patient safety roles would benefit from more standardisation across trusts.- Posted
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Content ArticleThis book is a resource for the coaches who provide health IT-related assistance for primary care practices to support their QI and practice transformation efforts. The audience for this handbook includes both the health IT-focused coaches who support QI work as well as the practice facilitators/coaches who have the necessary background, interest, and skills to provide clinical health IT support. Although the handbook is primarily intended for external coaches working with primary care practices, the content could also be useful for practice-based staff responsible for addressing health IT needs related to QI. The handbook assumes readers already have a basic level of comfort with EHR use and with extracting and using electronic data for QI.
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Content ArticleJunior doctors can struggle with decision-making in emergency departments because they worry about “looking silly” in front of senior colleagues, a study has found. A team from the Healthcare Safety Investigation Branch (HSIB) looked at missed or delayed diagnosis of conditions in A&E. They specifically examined cases of pulmonary embolism and focused on diagnostic decision-making using applied cognitive task analysis. Interviews with medical staff found a number of factors which were common among expert level doctors. These included being aware of life-threatening conditions and seeking to rule them out, being comfortable in expressing doubt and seeking out peers to challenge their diagnosis. Junior staff on the other hand often tried to fit symptoms to specific conditions and had a fear of making wrong a diagnosis. Some said they were afraid of “looking silly in front of a senior”. The study, presented at an online session at the Ergonomics & Human Factors 2022 conference, suggested looking at how younger staff can be supported in improving their decision-making. HSIB investigator Nick Woodier, who presented the study, said: “Decision-making is a skill, commonly developed in healthcare through experience without formal training or opportunities to practise it.” You can view the presentation from the link below.
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Content ArticleA new multinational survey, on more than 1,300 patients, caregivers and healthcare professionals in 10 countries, shines a needed light on the misunderstood realities, unseen burden and care challenges of sickle cell disease. The Sickle Cell Health Awareness, Perspectives and Experiences (SHAPE) survey, one of the largest global burden of disease surveys conducted in sickle cell disease, identified long-term health complications of sickle cell disease as a key concern among 1,300 patients and healthcare professionals surveyed from 10 countries The survey also revealed that sickle cell disease patients' caregivers face profound physical, psychosocial, and economic burdens resulting from taking care of people living with the disease. The findings of the survey were presented during a poster presentation at the European Hematology Association (EHA) 2022 Hybrid Congress. “Sickle cell disease is a lifelong condition that causes damage in the body and has a profound impact on the quality of life of those who suffer from it and their caregivers. The SHAPE survey is important because it illustrates how vital it is that we understand our patients’ needs, and it suggests what we within the medical community can do to help change perspectives, increase education and awareness, and improve care,” said Dr. Baba Inusa, professor and consultant of paediatric haematology, Guy’s and St Thomas’ NHS Foundation Trust, London and chair of the National Haemoglobinopathy Panel in England. “These results are a wake-up call, and I believe that the actions that follow can enable us to help drive a better dialogue and improved conversations around the management and care of this long-neglected and devastating disease.”
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Content ArticleThe SingHealth Duke-NUS Institute for Patient Safety & Quality (IPSQ) based in Singapore has developed several training courses to improve the skills of healthcare workers in patient safety. The courses are part of the Academic Medicine – Enhancing Performance, Improving Care (AM-EPIC) Framework and cover six areas of competency: Patient safety Improvement sciences Innovation and system design Patient centeredness and advocacy Clinical governance and risk Staff resilience and care support To find out more and book IPSQ to deliver any of these courses to your organisation, email ipsqworkshop@singhealth.com.sg
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Content ArticleSarah Louise Dunn was admitted to the Blackpool Victoria Hospital on 10 April 2020. She was suffering from a Group A Streptococus infection following an early medical abortion on 23 March 2020 which by the time of her admission at hospital had produced sepsis and had progressed to toxic shock. Signs of sepsis were apparent before and on her admission given Sarah’s history and symptoms but Sarah was treated upon admission to hospital as a Covid-19 patient. Prior to admission, Sarah had not been seen by a doctor on either 9 or 10 April despite contacting both her GP surgery and the Out of Hours Service. The surgery pharmacist had not read Sarah’s notes properly and was not aware on 9 April that she had recently had undergone an early medical abortion. Her GP on 1 April had not recorded his face to face consultation with her nor noted the possibility of infection. Sepsis was not recognised or treated by the GP surgery, emergency department or Acute Medical Unit and upon Sarah’s arrival at hospital, the sepsis pathway was not followed. Antibiotics were not given to Sarah until 7.5 hours after her arrival at hospital. Sarah suffered a seizure at 6.30pm on the Acute Medical Unit and was transferred to the Intensive Care Unit. These matters in aggregate impacted on her care and Sarah would not have died had she been admitted to hospital sooner. Sarah died on 11 April 2020 on the Intensive Care Unit at Blackpool Victoria Hospital at 2.15am.
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Content ArticleThe Regulation and Quality Improvement Authority (RQIA) has published its independent 'Review of the implementation of recommendations to prevent choking incidents in Northern Ireland'. The Review examined the measures and governance arrangements in place to prevent choking, in line with current guidance, focusing on the work undertaken in high-risk areas across health and social care, including stroke care, care of the elderly and services for those with physical and/or mental health and learning disabilities. The Review found that there was a clear and urgent need to improve the quality and safety of care provided to people at risk of choking. The key recommendations in the Review include: training for staff including clinicians, catering and domestic teams; shorter waiting times for assessment by Speech and Language Therapy; better systems for communication between staff, and safer systems for ordering and storing food.
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Content Article‘Digital clinical safety’ refers to avoiding harm to patients and staff that could be caused by technologies manufactured, implemented and used in the health service. In this blog, Dr Kelsey Flott, Deputy Director of Patient Safety at the NHS Transformation Directorate, looks at the importance of digital clinical safety in driving quality improvement. She talks about how the Digital Clinical Strategy is being implemented and the drive to collect better evidence about the effectiveness of improvement technologies.
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Content ArticleSean Mansell had a medical history of alcohol dependence syndrome. On the 5 July 2021, the West Midlands Ambulance Service received a 999 call at 19.23 hours from a neighbour of who reported that Shaun couldn't walk. The call was allocated a category 3 disposition which had a target response time frame of 120 minutes. An ambulance arrived on scene at 03.38 on the 6 July which was 8 hours and 15 minutes later and not within the response time frame. This was due to the fact that demand outstripped available resources. A welfare call was undertaken at 21.28 hours by a paramedic who had been asked to go into the control room to assist with welfare calls due to the high volume of 999 calls outstanding. The paramedic had not received prior training on how to complete these calls. The welfare call was conducted with the neighbour. No contact was made directly with Shaun during the 8 hour delay which led to a missed opportunity to identify a change in his condition. When the ambulance arrived, Shaun had passed away on the sofa in his front room. There was evidence of blood loss on the floor next to him and around his mouth. The police did not find any suspicious circumstances. A post mortem examination found the cause of death to be acute gastrointestinal haemorrhage and liver disease due to chronic alcoholism. The medical evidence was not able to determine if the delay in the arrival of the ambulance contributed to the death because there was no certainty of timeline about the bleeding.
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Content ArticleThe International Confederation of Midwives (ICM) aims to strengthen Midwives Associations and advance the profession of midwifery globally. These resources from the ICM provide guidance for midwives on: Policy and practice Advocacy Education Regulation Association Covid-19 Respectful maternity care Mentoring
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Content ArticleThese resources by Health Education for Scotland support their e-learning modules on hand hygiene. You will need an account to access the e-learning modules, but the supporting resources are available to download. Resources include: Hand hygiene: print version, PDF version of the SIPCEP foundation layer e-learning module 'Hand hygiene' for use in offline settings Advantages and disadvantages of alcohol based hand rub (ABHR), This document lists the advantages and disadvantages of using ABHRs and handwashing Preparing your hands before starting work: job aid, A short job aid for Hand hygiene Hand hygiene using alcohol based hand rub (ABHR): tip sheet, A short tip sheet for using ABHRs Washing hands with liquid soap and warm running water: tip sheet, A short tip sheet about washing hands with liquid soap Work based activity – Hand hygiene Video: What's stopping you? Video: Alcohol-based hand rub Video: Liquid soap and warm water
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Content ArticleThe Ockenden review into the failings in maternity care at Shrewsbury and Telford Hospital NHS Trust in the UK makes for sobering reading. The review focuses predominantly on the period from 2000 to 2019 and estimates that there were significant or major concerns in the care of nine women and more than 200 babies who died while receiving care at the Trust. Many more women and babies suffered serious injuries. It was clear that the Shrewsbury and Telford Hospital NHS Trust did not investigate, learn, change, or listen to families when adverse events occurred. The conclusions of the Ockenden review make it clear that safe staffing levels, a well trained workforce, an ability to learn from incidents, and a willingness and ability to listen to families are all crucial for safe maternity care.
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Sarah and Jaydee are working on an innovative project at NHS Dorset Integrated Care Board (ICB) to ensure general practice is a central part of improving patient safety across services. They talk about the value and challenges of collaborative working, how they are tailoring their offer to fit the needs of local GP practices, and making patient safety a core part of training for all healthcare professionals. -
Content ArticleTeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety) is an evidence-based set of teamwork tools created by the US Agency for Healthcare Research and Quality (AHRQ). It aims to optimise patient outcomes by improving communication and teamwork skills among healthcare professionals. An organisational readiness assessment, other guidance and all curriculum materials are available on this website.
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Content ArticleIn this blog, Ian Lavery, Senior Investigation Science Educator at the Healthcare Safety Investigation Branch (HSIB) summarises a presentation given to HSIB staff by healthcare improvement expert Professor Mary Dixon-Woods. The presentation highlighted that a recommendation alone could fall short of the intended impact on the healthcare system. It looked at creating recommendations to respond to real world working, the importance of involving people most affected by patient safety incidents and why it's vital to look at when things go right.
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Content ArticleIn order to become competent clinicians, doctors need to appropriately calibrate their clinical reasoning, but lack of follow-up after transitions of care can present a barrier to this. This study in the Journal of Hospital Medicine aimed to implement structured feedback about clinical reasoning for residents performing overnight admissions, measure the frequency of diagnostic changes, and determine how feedback impacts learners' self-efficacy. The authors concluded that structured feedback for overnight admissions is a promising approach to improve residents' diagnostic calibration, particularly given how often diagnostic changes occur.
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Content ArticleThis toolkit from the New South Wales Clinical Excellence Commission (CEC) provides information, resources and quality improvement (QI) tools for managers and clinicians to improve sepsis care. The resources can be adapted to suit local needs and cover: Getting started Making improvements Data for improvement Communicating changes Providing education Sustain and spread
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Content ArticleThis literature review in The Operating Theatre Journal examines why the decision was made not to class surgical fires as a 'Never Event', even though research has identified them as a preventable hazard. The author also examines steps that could be taken to further reduce the risk of surgical fires in the NHS and other health systems. You will need to create a free online account to view this article.
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Content ArticleThis article by The Decision Lab explains the Dunning-Kruger Effect, which occurs when a person’s lack of knowledge and skills in a certain area causes them to overestimate their own competence. By contrast, this effect also causes those who excel in a given area to think the task is simple for everyone, and underestimate their relative abilities as well. The article covers the following topics: Where this bias occurs Individual effects Systemic effects Why it happens Why it is important How to avoid it How it all started It also includes two real-world examples of the Dunning-Kruger Effect.
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Content ArticleThis report by the Academy of Medical Royal Colleges looks at the possibilities for establishing a system of staggered changeover start dates for trainee doctors. Evidence suggests that there is an increase in patient morbidity and mortality at the beginning of August each year, which corresponds with the time when trainee doctors rotate positions. The paper, produced by the Academy’s Staggered Trainee Changeover Working Group (STCWG), recommends that the most effective solution for safe trainee changeover is a roll forward model of staggering, where the more senior trainees rotate one month later. A survey of Foundation doctors demonstrated support for a system where all Specialty Training programmes start at the beginning of September, one month after the end of the Foundation Programme.
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Content ArticleOver the last four years, Health Education England (HEE) has led a collaborative effort, on behalf of patients, the profession and the NHS, to co-create reforms across medical education and training. HEE launched the Future Doctor Programme last year, linked to work on the NHS People Plan, to inform and galvanise change in medical education and training to achieve the vision for future healthcare as set out in the NHS Long Term Plan. The Future Doctor Programme provides a clear view of what the NHS, patients and the public require from future doctors within a transformed multi-professional team. This co-created vision for the future has also identified much of what is required to respond to the projected demands and needs of the workforce in the future.
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Content Article
We need to fix it (HindSite, 2021/22)
Sam posted an article in Digital health and care service provision
While ‘human error’ is often blamed when things go wrong, the ‘technical’ part of ‘sociotechnical systems’ often escapes the spotlight. In this article, Harold Thimbleby outlines how hidden risks with digitalisation have far-reaching consequences, and how we can start to fix them. -
Content ArticlePatients and providers often don't recognise skin cancer on darker skin. Medical school faculty and students are trying to change that.
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Content ArticleThis download is the first of three chapters of a book which complements the Chartered Institute of Ergonomics and Human Factors' Healthcare Learning Pathway and is intended as a practical resource for students
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Content ArticleIn this blog, Charlotte Clayton, midwife and clinical advisor at the Organisation for the Review of Care and Health Apps (ORCHA), explores how providing the right training and support for maternity staff is key to seeing the benefits tech can bring to quality of care and workload.
