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Found 794 results
  1. Content Article
    The Royal College of Emergency Medicine has developed The Safety Toolkit which aims to describe the structures, processes and skills required for a ‘safe’ department. There are resources identified within each section to stimulate, provoke and challenge, as well as guide personal development. There are overlapping references and differing perspectives but the vision is of a resource for change and development.
  2. Content Article
    Information for the Public pre-hospital emergency medicine (PHEM) feedback is a collaboration between the Princess Alexandra Hospital and the services who bring patients to them (ambulances and air ambulance teams) and provide pre-hospital care to those patients.
  3. Content Article
    Hamblin-Brown and Ingram, in the Journal of Patient Safety and Risk Management, discuss how Aspen Healthcare have reduced patient harm by engaging staff in ‘STEP-up’: a programme to improve the culture of patient safety. 
  4. Content Article
    This blog from Eli Quisenberry, Director of the Kaizen Promotion Office at the Virginia Mason Medical Centre, discusses what makes up 'standard work' and how this contributes to patient safety. Eli partners with leaders, staff and teams across the medical centre, applying the Virginia Mason Production System principles as they work to transform healthcare and achieve the organisation’s vision as the quality leader.
  5. Content Article
    Second part of a blog by Mark Hellaby on how simulation can be used to support some of the emerging patient safety concepts.
  6. Content Article
    NHS Education for Scotland's multi-disciplinary information and resources to help you understand more about patient safety and your contribution to making care safer.
  7. Content Article
    The Surgical Grand Rounds, hosted by the Nuffield Department of Surgical Sciences, are the key educational meetings for consultants, juniors and medical students. Presentations revolve around clinical cases and are followed by lively, educational discussion. These podcasts are brought to you by the Oxford University Medical Education Fellows.
  8. Content Article
    Patient Safety Learning speaks to Ben Tipney, Managing Director of MedLed and the hub topic lead in Human Factors, about how healthcare can achieve high performance and learn from other industries, including from the sports industry. 
  9. Content Article
    The clinical entrepreneur training programme is designed to offer opportunities for clinical, NHS staff and wider health professionals to develop their entrepreneurial aspirations during their clinical training period.
  10. Content Article
    We launched our green paper, 'A Patient-Safe Future’, in September 2018 for two reasons: first to help us develop our strategy and work programme to ensure we are focused on areas that will help make a real difference and, second, to develop a clear and consistent message about how the wider system needs to change to better support patient-safe care.
  11. Content Article
    NHS Improvement have published a number of case studies on appropriate use of clinical risk assessment tools, developing new evidence-based alerting systems and developing personalised risk management plans for people who use services, to manage risks positively.
  12. Content Article
    Despite 20 years of effort, every year avoidable unsafe care still leads tens of thousands of patients to suffer death or serious, life-changing harm. A Blueprint for Action, a report from Patient Safety Learning, furthers the analysis of the systemic causes of this harm and describes actions to make patient care safer. Last September, health and patient safety professionals and patients overwhelmingly welcomed the analysis of avoidable unsafe care offered in Patient Safety Learning’s Green Paper, A Patient-Safe Future. Matt Hancock, Secretary of State for Health and Social Care described it as “…the blueprint for action that we need.” Following widespread consultation on the Green Paper, A Blueprint for Action extends this analysis to identify actions to address the systemic causes of unsafe care.
  13. Content Article
    Mind the Gap 2021 explores what training looked like for the maternity services workforce during the COVID-19 pandemic, and how this relates to the factors that contribute to the avoidable harm and deaths of mothers, birthing people, and their babies. It is an ongoing piece of research by the charity Baby Lifeline. The report directly surveys recommendations from reports investigating avoidable harm and takes into account wider events affecting maternity care. Training is a central recommendation for improving safety in maternity services. Gaps which already existed in training due to chronic underfunding and staff shortages have become worse, and this report will give recommendations to improve training nationally and locally at a critical time for maternity.
  14. Content Article
    The following is an example of a case investigator’s report based on the Dr Purple case used in training, produced by the NHS National Clinical Assessment Service.
  15. Content Article
    The Parliamentary Healthcare Service Ombudsman published 'Ignoring the alarms: How NHS eating disorder services are failing patients' in December 2017. The families who brought forward their complaints helped uncover serious issues that required national attention. The failings catalogued in the report highlighted a systemic set of problems in relation to identifying, treating and monitoring eating disorders that require a systemic response. This encompasses raising awareness among clinicians, building greater specialist capability and ensuring adult eating disorder services achieve parity with child and adolescent services. This submission provides an overview of the report’s systemic findings and the responses seen to the systemic recommendations made to date.
  16. Content Article
    This pack is for acute, specialist, mental health and community trust boards and specifically trust non-executive directors (NEDs) and non-clinical executive directors. It explains what boards are expected to do in relation to the Learning from Deaths framework.
  17. Content Article
    In this series 'e-Patient Dave' deBronkart shares what we all need to know to get the best medical care without going broke or getting killed in the process. An 'e-patient' is someone who is empowered, engaged, equipped, and able, who never expected the system to do everything but thinks and acts like a responsible independent person.
  18. Content Article
    This guide, by NHS Improvement, contains key questions for chairs, chief executives and senior leaders about common barriers to clinicians taking part in senior organisational management. It addresses the NHS Long Term Plan priority around nurturing the next generation of leaders and supporting all those with the capability and ambition to reach the most senior levels of the service. It was developed in response to the 2018 recommendations to the Secretary of State for Health and Social Care to ensure more clinicians from all professional backgrounds take on strategic leadership roles.
  19. Content Article
    This National Patient Safety Agency (NPSA) guide provides a detailed illustration of how principles of safe design can be applied to widely used medical technologies. It focuses on the design of electronic infusion devices, such as infusion pumps and syringe drivers. There a wide variety of infusion device designs in use in healthcare. This document provides practical guidance and examples of best practice in the design of infusion devices, as well as a guide for those involved in the purchase and procurement of these devices.
  20. Content Article
    Inclusion is core to the NHS Constitution, yet it remains one of the biggest challenges that health systems face globally, nationally and systemically. In the face of a growing body of evidence, which demonstrates the critical role that inclusive leadership plays in ensuring that health and care systems operate most effectively for patients and public, it is incumbent upon us to ensure that leaders at all levels are equipped and capable of leading inclusively and effectively. 
  21. Content Article
    This video form Trent Hospital shows how using human factors can improve patient outcomes and how things go wrong in healthcare. Can you spot how systems and protocols could be changed here?
  22. Content Article
    Nikki Davey, Clinical Human Factors Group Trustee, talks about how we might measure if a human factors intervention has been implemented on an operational basis.
  23. Content Article
    Five tips to improve hand hygiene compliance within healthcare facilities.
  24. Content Article
    Interview on 'This Morning' with Dr Chris Steele discussing the signs and symptoms of sepsis.
  25. Content Article
    This study from Landefeld et al., published in the Indian Journal of Community Medicine, looks at the perceptions of healthcare providers about barriers to improved patient safety in the Indian state of Kerala. Five focus group discussions were held with 16 doctors and 20 nurses across three institutions (primary, secondary and tertiary care centers) in Kerala, India and transcripts were analysed by thematic analysis.
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