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Found 799 results
  1. Content Article
    Preventable harm, from the systems of care intended to improve health, continues to occur at an unacceptable rate in the United States. Healthcare systems have an opportunity to learn and improve from each episode of preventable harm. Accordingly, every preventable patient death or injury must energise our efforts to prevent future patient harm. The Anesthesia Patient Safety Foundation (APSF) believes that criminal prosecution of healthcare providers will make the work of preventing harm more difficult since it continues to shift the focus away from system improvements. They have released a position and policy statement outlining the rationale for opposing criminal prosecution and, equally important, recommends that all healthcare systems and organisations aggressively act, now, to improve their culture, processes, and training to reduce errors of all kinds and, specifically in light of recent events, medication errors. Some specific actions are recommended as examples of what can be done. Individual healthcare professionals should be mindful of their role in preventing errors and reporting errors that occur as well as taking action to encourage and enable their organization to improve the flaws in the systems in which they work that lead to harm to patients.
  2. Content Article
    This programme from the Advancing Quality Alliance (Aqua) provides participants with the tools, skills and knowledge to oversee the successful implementation of a safety culture survey in organisations. Participants of this programme will develop a working knowledge of safety culture theory and the Agency for Healthcare Research and Quality (AHRQ) safety culture survey alongside the support that Aqua provides to enable deployment and analysis of the survey. This programme links directly to Aqua’ safety offers, including Psychological Safety, Human Factors and Improvement Practitioner programmes.
  3. Content Article
    On 23 April 2020 Jaqueline Lake commenced an investigation into the death of Eliot Harris aged 48. Eliot had schizophrenia and diabetes. Eliot had not been taking medication for several days and his condition deteriorated. He was admitted to Northgate under the Mental Health Act after assessment on 5 April. He was initially in seclusion then on the ward from 6 April, he spent a lot of time in his room and only ate cheese sandwiches. He only accepted medication in intramuscular form and on 9 April by depot injection. His physical observations were recorded as being normal, and a blood test on 7 April showed he did not have diabetes. His intake of food and fluid remained minimal but he was not put on a chart to monitor this. Staff last entered his room at 17:46 on 9 April. He was last seen conscious at 18:10 on 9 April. He was found unresponsive at 01:33 and declared dead at 02:00.  The investigation concluded at the end of the inquest on 8 August 2022. Medical cause of death: 1a) Unascertained Conclusion: Open – the evidence does not reveal the means by which Eliot Harris came by his death.
  4. Content Article
    On 24 October 2019 coroner Lydia Brown commenced an investigation into the death of Asher William Robert Sinclair, age 3. The investigation concluded at the end of the inquest on 24 January 2022. The conclusion of the inquest was: His medical cause of death was: 1a Hypoxic ischaemic brain injury 1b out of hospital cardiac arrest 1c displaced tracheal tube (trachael tube dependant) II Neonatal enterviral myocarditis and encephalitis (trachael ventilator dependant and cardiac pacemaker). Asher died on 8th October 2019 in Great Ormond Street hospital when his life support mechanisms were withdrawn.
  5. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to different people about their role and what motivates them to make health and social care safer. Judy talks to us about the power of After Action Reviews (AARs) to promote learning and bring about lasting improvements in healthcare. She also discusses the opportunity that the new Patient Safety Incident Response Framework (PSIRF) offers to take a more people-focused approach to learning from patient safety incidents.
  6. Content Article
    Healthcare simulation is an established technique for improving patient safety, through training individual skills, teamwork behaviours, and by testing healthcare systems for latent safety threats. However, healthcare simulation may present risks to safety, especially when delivered ‘in situ’—in real clinical environments—when lines between simulated and real practice may be blurred. Brazil et al. developed a simulation safety policy (SSP) after reading reports of adverse events in the healthcare simulation literature, editorials highlighting these safety risks, and reflecting on our own experience as a busy translational simulation service in a large healthcare institution. The process for development of a comprehensive SSP for translational simulation programs is unclear. Personal correspondence with leaders of simulation programs like our own revealed a piecemeal approach in most institutions. In this article, the authors describe the process we used to develop the simulation safety policy at our health service, and crystalize principles that may provide guidance to simulation programs with similar challenges.
  7. Content Article
    In healthcare, there is a well-recognised gap between what we know should be done, and what is actually done. This article considers new models that look at the implementation of evidence-based practice in healthcare systems, particularly looking at the application of a conceptual model called 'sticky knowledge'.
  8. Content Article
    Nine specialist mesh centres have been set up by NHS England to offer removal surgery and other treatment to women suffering from complications and pain as a result of vaginal mesh surgery, but women are reporting that they are not operating effectively. In this opinion piece, Kath Sansom highlights ten problems with these specialist mesh centres, evidenced by the real experiences of women who are part of the Sling the Mesh campaign Facebook group.
  9. Event
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    The Patient Information Forum's sell-out writing training course has been redeveloped for online delivery, maintaining the element of classroom style teaching with direct interaction with tutors and group work with practical exercises. The course features practical exercises, group work and feedback from tutors. The course is ideal for anyone starting out in health information and for those wishing to improve and refresh their skills. It is also ideal for staff planning to return from furlough who may have lost confidence while away from work. The course will be delivered via Zoom and will be held over three consecutive mornings with a maximum of 30 delegates. Register
  10. Event
    OSHAfrica (an Occupational health and safety site that spans the whole of Africa, based in Lagos) has now created OSHversity. This will provide training for people in workplace safety, regardless of their location and type of workplace. Joinn session using this link: https://us02web.zoom.us/meeting/register/tZUkcu-upzojHdA2-ZT9MFJe1UDY9lzqJYr7 Register for the session by emailing info@oshversity.com You can find out more about the courses offered by going to www.oshversity.com
  11. Event
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    This conference focuses on the delivery of ambitions in the newly published NHS People Plan, and wider priorities for the health workforce. It also takes place with: intensification of the recruitment drive for health and social care staff unprecedented personal and professional challenges for those working across the NHS in the face of the COVID-19 pandemic. Assessing what will be needed for ambitions in the newly published NHS People Plan to be achieved, including: improving health and wellbeing support for all staff tackling discrimination and fostering a sense of belonging adopting innovation in care and ways of working making the most of staff skills and experience recruitment, retention and encouraging previous staff to re-join the NHS plans for an additional people plan focussed on pay, based on workforce numbers and funding. Registration
  12. Event
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    As we face the challenge of responding to the COVID-19 pandemic we need to apply what we have learnt so far, and what we continue to learn. It is a fast-moving evolving situation and as with any new strain of virus, the guidance for healthcare workers and health and social care services is being developed and updated frequently. In is a fast-moving evolving situation, we need ensure that our approaches and support for staff enables patient safety. The aims of this webinar from GovConnect is to: To explore how staff roles, training and decision-making impacts on patient safety. To explore the opportunities and barriers that staff face in delivering safe care. To engage in debate with a specialist expert leaders with experience in care delivery, academic research, clinical education, medical device manufacture, human factors and ergonomics, innovation and technology. To engage with participants to gain insights from front line clinicians, educators and patient safety experts. To identify action for change and improvement. Presenters: Helen Hughes, Chief Executive Officer, Patient Safety Learning Professor Matthew Cripps, Director of Covid-19 Behaviour Change Unit, NHS England & Improvement Cheryl Crocker, Patient Safety Director, AHSN Network Clare Wade, Head of Patient Safety, Royal College of Physicians Paul Hinchley, Clinical Services Manager, Philips Healthcare Register
  13. Event
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    This unique 1-day distance-learning course from Medled is delivered via Zoom by our expert trainers in a format designed to maximise learning retention and application of knowledge. You'll learn to: Understand the concept of systems thinking and models of safety – looking beyond the individual and the flawed concept of ‘Human Error’. Gain an introduction to human capabilities & limitations & how those influence quality and safety of care – how humans can be heroes and hazards. Be able to unpick the nature of human fallibility and why practice does not always make perfect. Have the knowledge to proactively contribute to the safety culture in your organisation. Be able to recognise error-provoking conditions and influence your systems of work. Understand the relationship between stress and performance/risk of error. Take away a tangible model for understanding the relationship between our physiological needs and performance – do we set ourselves up to fail? Understand strategies to optimise high-performance teamworking with ad hoc teams. Evidence-based, utilising cutting edge safety & performance science this course is suitable for all Healthcare Professionals, both clinical and non-clinical; it is applicable to all departments and multi-disciplinary teams. Accredited by Chartered Institute of Ergonomics & Human Factors, you'll take part in interactive actitvities and leave with practical tools to take away. Registration
  14. Event
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    This is a global online event from the Royal College of Surgeons of Edinburgh, relevant to all who work in healthcare, with a focus on the role of the surgical team in delivering care. Everyone is invited to register for this free online event. The participants will be encouraged to use a smartphone or another second screen to actively participate and answer questions. This event will be delivered on Zoom – questions can be submitted, and the use of the chat room is encouraged. Registered participants will get a copy of the webinar recording, slides, questions and answers, chat room, Menti results and a Spotify playlist. The conference panel is formed of a diverse group of experts with a range of skills in healthcare, surgery, education, business, leadership, coaching, training, human factors, and situational awareness. They have experience working with high performance teams, global industries, firefighters, aircrews, and fighter pilots in theatres of operation, cockpits, and on oil rigs. All have worked in high performance teams and understand the critical importance of listening and communication. The conference is headlined by the global leader, Bob Chapman, CEO of Barry-Wehmiller and co-author of the bestselling book; ‘Everybody Matters – the extraordinary power of caring for your people like family’. Further information and registration
  15. Event
    The Patient Safety Movement Foundation is proud to partner with MedStar Health to offer free Continuing Education (CE) credit for this patient safety webinar. With Dr. Arthur Kanowitz, Dr. Sarah Kandil, Dr. Edwin Loftin, Dr. Anne Lyren, Dr. Kevin McQueen and Dr. Lauren Berkow. Free CE offered for physicians and nurses. This activity has been approved for AMA PRA Category 1 Credits™ and ANCC contact hours. Registration
  16. Event
    The Patient Safety Movement Foundation is proud to partner with MedStar Health to offer free Continuing Education (CE) credit for this patient safety webinar. With Patricia Merryweather-Arges, Dr. Ronald Wyatt, Dr. Daria Terrell, and Dr. Marcus Robinson. M Free CE offered for physicians, nurses, and pharmacists. This activity has been approved for AMA PRA Category 1 Credits™ and ANCC contact hours. Register
  17. Event
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    East London NHS Foundation Trust (ELFT) Quality Improvement (QI) Department is hosting a one-day Pocket QI training. This is an interactive easy to follow introduction to some of the concepts and methods of QI. Join a team of Improvement Advisors who will take you through the fundamentals of QI and how you can make apply the methodology to your personal and professional life. Training will be delivered by ‘Zoom’ video conferencing. Registration
  18. Event
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    Book here Matt Hassan, National Retraining Scheme and National Skills Fund Programme Director, Department for Education Iain Murray, Senior Policy Officer, TUC Nic Trower, Senior Policy Advisor, CBI Juliet Stuttard, Director, PwC UK Patrick Craven, Director of Assessment Policy, Research and Compliance, City & Guilds Dr Fiona Aldridge, Director, Policy and Research, Learning and Work Institute and Kenny Barron, Unite the Union; Joe Billington, National Careers Service; Stephen Cole, CITB; Lesley Giles, Work Advance; Jack Orlik, Nesta; Dr Susan Pember, Holex; Patrick Spencer, Centre for Social Justice; Simon Tindall, The Open University and Paul Warner, Association of Employment and Learning Providers Chaired by: Baroness Garden of Frognal, Deputy Speaker, House of Lords Lord Watson of Invergowrie, Shadow Spokesperson for Education The agenda: What has been learnt from the National Retraining Scheme Creating an effective retraining offer - funding, scope, and engagement with industry and the workforce Case study: international approaches to lifelong learning The role of qualifications in the future lifelong learning landscape Adapting to a changing labour market following COVID-19 - careers advice and guidance, retraining, digital literacy and the impact on labour mobility Lessons from the National Retraining Scheme pilots and user research, and the next steps for the National Skills Fund The discussion will also look ahead to: the role of the NRS in dealing with medium term skills needs following the COVID-19 pandemic the establishment of the Government’s new £2.5bn National Skills Fund prior to an expected consultation on the fund which will look at long term skills needs wider issues around lifelong learning Funding With concerns being raised by some in the sector, and with projected costs for both the National Retraining Scheme and National Skills Fund yet to be outlined - delegates will discuss: cost expectations sources of funding, including the potential balance of contributions from government, employers, and users. Size and scope Discussing what has been learnt so far from the National Retraining Scheme, with: pilots initially focused towards adults in low-skilled work and occupations susceptible to automation the first phase of the Scheme ahead of full rollout available only to adults aged 24 and older, qualified below degree level, and within a certain wage threshold. Inclusivity What will be needed to develop programmes that: adapt to user needs ensures high take-up secures the involvement of hard-to-reach groups serves those who are otherwise unlikely to receive retraining - particularly those lacking the time, money, and the confidence or necessary skills to retrain. Strategic aims How to achieve the overarching objectives of both the NRS and National Skills Fund, for: creating a culture of retraining and lifelong learning overcoming the barriers that adults face to retraining - looking at the roles of: careers advice and guidance - and how it will need to develop qualifications and awarding bodies. The changing skills landscape following the pandemic With the Government increasingly focusing on digital skills across the spectrum, we expect discussion on: the contribution of the National Retraining Scheme to maintaining and updating the digital literacy of the workforce opportunities for retraining in data science and artificial intelligence skills, with plans for this to be supported by the Adult Learning Technology Innovation Fund the shape that the National Skills Fund should take to support long term skills needs following COVID-19 - including how: the Fund can complement existing support which is available support employers - particularly SMEs how the Government can ensure the best possible return on investment. Broader economic impacts With the National Retraining Scheme and National Skill Funds widely considered as a response to work automation, we also expect discussion on: how the programmes can be designed to combat macro-economic challenges, such as skill shortages, productivity issues, and labour mobility examples of how retraining is being approached outside the UK. Developments that are relevant to the discussion: The first phase of the NRS - in the Liverpool City Region, the West Midlands Combined Authority, the Leeds City Region LEP, Cambridgeshire and Peterborough combined authority area, the Heart of the South West LEP and the North East LEP. The forthcoming Government consultation on the establishment of the National Skills Fund with a report by City and Guilds recently calling for government to release and redirect £3bn in funding assigned for the National Skills Fund to support those that have lost their jobs as a result of the COVID-19 pandemic. The announcement by Government of reforms to Higher Technical qualifications to improve support adults seeking to retrain and upskill, including new qualifications from September 2022 with a Government quality mark. Launch of the new digital service ‘Get Help to Retrain’ last year and the recent issuing by Government of a tender as part of the NRS for groups of employers, providers and local authorities to deliver a new training model in the digital sector with the partnership providing 12 week courses.
  19. Event
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    This webinar will explore virtual care and the use of patient health data through remote patient monitoring. In the UK and US alike, COVID-19 has accelerated the dramatic shift towards utilising digital health services and tools to virtually connect with and care for patients. Remote patient monitoring (RPM) offers providers the opportunity to remotely collect and utilise patients’ personal health data, such as data from their home-use medical devices and wearables, within care delivery efforts. These personal health data are providing deeper insight into patients’ physiologic health metrics, lifestyle decisions and behavioural trends while replacing the clinical data previously collected in-person. As health care organisations need to quickly scale virtual care to thousands of patients, clear best practices and lessons learned have emerged. This episode will deep-dive into the successful operations of the largest, centralised RPM programme, supporting over 3000 clinicians and more than 50,000 enrolled patients. We’ll delve into the most basic and complex challenges around patient-generated health data, patient consent, enrollment workflows, device logistics, patient and provider engagement, and more. This webinar will explore: Core operations and technologies to a holistic virtual care strategy The clinical outcomes, patient and provider satisfaction, and efficiencies created with RPM Best practices in digital health operations, data integration, analytics, and engagement A model and framework for scaling virtual care and RPM to thousands of patients quickly A CPD certificate with 1 CPD credit will be issued to those joining the webinar live as well as those who watch the recording afterwards. Certificates will be issued 7 days after the webinar to those who watch it live and after 30 days for those that watch the recording. Join in the conversation online using #RSMDigiHealthBook hereFollow us on Twitter: @RoySocMed Book here
  20. Event
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    This Royal Society of Medicine meeting will focus on some of the key medico-legal issues that impact GPs, primary care and patient safety, with a specific emphasis on inquests, clinical negligence and incidents. This comprehensive programme will review and explore the latest legal and regulatory developments from national leaders in each of these fields. Delegates will gain an understanding of: The role of coroners and inquests, what to expect and what GPs and those working in primary care need to do to prepare and actively learn from deaths. The role of Medical Examiners and how they will impact on primary care. The support, including education and training, available to GPs in dealing with medico-legal issues and how to access practical support (e.g. via the Medical Defence Organisations) when necessary. The role of NHS Resolution and the Clinical Negligence Scheme for GPs (CNSGP) and their impact upon GPs and patient safety. Developments in learning from incidents in primary care, including feedback from the CQC regarding best practice and areas for improvement. Book here
  21. Event
    This intensive masterclass will provide in-house Root Cause Analysis training in line with The NHS Patient Safety Strategy (July 2019). The course will offer a practical guide to Root Cause Analysis with a focus on systems-based patient safety investigation as proposed by the forthcoming National Patient Safety Incident Response Framework which emphasises the requirement for investigations to be led by those with safety investigation training/expertise and with dedicated time and resource to complete the work. This course will include an opportunity for learners to gain a Level 3 qualification (A level equivalent) in RCA skills (2 credits / 20 hours) on successful completion of a short-written assignment. hub members can receive a 10% discount with code hcuk10psl. Further information and registration
  22. Event
    Patient Safety is an essential part of health and social care that aims to reduce avoidable errors and prevent unintended harm. Human Factors looks at the things that can affect the way people work safely and effectively, such as the optimisation of systems and processes, the design of equipment and devices used and the surrounding environment and culture, all of which are key to providing safer, high quality care. New for September 2020, this part-time, three year, distance learning course, from the Centre of Excellence Stafford, focuses specifically on Human Factors within the Health and Social Care sectors with the aim of helping health and social care professionals to improve performance in this area. The PgCert provides you with the skills to apply Human Factors to reduce the risk of incidents occurring, as well as to respond appropriately to health, safety or wellbeing incidents. Through the study of Human Factors, you will be able to demonstrate benefit to everyone involved, including patients, service users, staff, contractors, carers, families and friends. Further information
  23. Event
    This masterclass, facilitated by Barry Moult, a former Head of Information Governance for an NHS Trust, and his colleague Andrew Harvey, will focus on developing your role as a SIRO (Senior Information Risk Officer) in health and social care. Further information and to book your place or email kate@hc-uk.org.uk A discount is available to hub members by quoting reference hcuk20psl when booking (cannot be used in conjunction with any other offer; full T&Cs available upon request).
  24. Event
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    Bringing together healthcare and patient safety changemakers from across the globe, RLDatix Palooza creates a unique learning environment. With immersive education sessions, enlightening keynotes, healthcare thought leadership panels, interactive hands-on training opportunities and lively evening network activities – this is a conference like no other. You’ll leave with the inspiration (and skills) you need to take your patient safety initiatives to the next level. Registration
  25. Content Article
    Creating a foundation for safe and reliable care requires more than just a small team in an organisation. This short video captures what the Patient Safety Movement Foundation has to offer healthcare organisations hoping to make their care better and safer from the ground up.
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