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Content ArticleIn this blog, Steven Shorrock discusses Learning Teams, small group conversations and action, and makes a case for learning in the following ways: talk about everyday work start with what’s strong, not what’s wrong find ways to cross departmental boundaries and get multiple perspectives understand first what can be done by teams.
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News Article
NHS hospitals to employ safety experts to tackle thousands of avoidable mistakes
Patient Safety Learning posted a news article in News
Hospitals will be required to employ patient safety specialists from next April as part of efforts by the health service to reduce thousands of avoidable errors every year. NHS trusts will be told to identify staff who will be designated as the safety specialist for each organisation. These workers, who will get specific training and work as part of a network across the country, will help to tackle a fragmentation in the way safety issues are dealt with in the NHS and ensure nationwide action on key safety risks is coordinated. The proposals are part of a national patient safety strategy which is aiming to save 928 lives and £98.5m across the NHS, as well as reducing negligence claims by £750m by 2025. The specialists will be identified from existing staff, with part of the role focused on embedding a so-called “just culture” approach to safety. This means reducing blame, supporting staff who make honest errors and tackling systemic causes of mistakes. Read full story Source: The Independent, 26 December 2019 What do you think? Join the conversation on the hub. -
Content ArticleThis study by Charles Vincent and colleagues, published in the Archives of Disease in Childhood, looked at the nature and causes of reported patient safety incidents relating to care in the community for children dependent on long-term ventilation with the further aim of improving safety. Common problems in the delivery of care included issues with faulty equipment and the availability of equipment, and concerns around staff competency. There was a clearly stated harm to the child in 89 incidents (40%). Contributory factors included staff shortages, out of hours care, and issues with packaging and instructions for equipment. This study has identified a range of problems relating to long-term ventilation in the community, some of which raise serious safety concerns. The provision of services to support children on long-term ventilation and their families needs to improve. Priorities include training of staff, maintenance and availability of equipment, support for families and coordination of care.
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Content ArticleThe South Thames Paediatric Network's aim is to enable children within the South Thames region (South London, Kent, Surrey and Sussex) to have access to high-quality specialist paediatric care in the place most suitable to their needs, at the appropriate time with a focus on surgery in children, critical care, long term ventilation and gastroenterology.
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News Article
The NHS staffing crisis is about the expanding knowledge gap – not just numbers
Patient Safety Learning posted a news article in News
A lot has been written about the workforce crisis in health and social care. 43,000 registered nurse vacancies, a 48% drop in district nurses in eight years and not enough GPs to meet demand. When we talk about workforce, the focus is always on numbers. There are campaigns for safe staffing ratios and government ministers like to tell us how many more nurses we have. But safety is not just about numbers. Recent workforce policy decisions have promoted a more-hands-for-less-money approach to staffing in healthcare. More lower-paid workers mean something in the equation has to give. In this case, it’s skill and expertise. In this article in The Independent, Patient Safety Learning's Trustee Alison Leary discusses how healthcare has failed to keep frontline expertise in clinical areas due to archaic attitudes to the value of the experienced workforce. Read full story Source: The Independent, 15 December 2019 -
Content Article
RCOG: Video briefing on human factors and situational awareness
Claire Cox posted an article in Maternity
Each baby counts is the Royal College of Obstetricians and Gynaecologist's national quality improvement programme to reduce the number of babies who die or are left severely disabled as a result of incidents occurring during term labour. Watch the Each baby counts human factors video for information on how to address issues within your unit. -
Content ArticleImperial College Hospital NHS Trust have launched their new falls safety improvement video to highlight the importance of safe mobility in hospital. Watch the video and join the conversation on Twitter.
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Content Article
Put an end to cannula site infections!
Claire Cox posted an article in Other hospital-based clinical areas
This presentation written by Dr Gordon Caldwell, a Consultant Physician at Lorn and Islands Hospital, Oban, Argyll, Scotland, highlights the importance of surveillance and actions to be taken around prevention of infection of cannlula sites. -
Content ArticleChances are, you’ve heard of an electronic health record, or EHR. Over the past 10 years, the vast majority of healthcare providers in the United States have implemented this technology to use in caring for their patients. EHRs have benefited us in many ways and hold tremendous promise. Given their widespread use, this technology now plays a significant role in the routine delivery of health care. Less understood outside the healthcare profession, however, is that EHRs have introduced new kinds of risks to the safety and quality of care, due to serious challenges with EHR usability, or the effectiveness and efficiency of using the technology. These well documented issues can lead to clinician burnout and errors that directly impact patient safety. In response, the MedStar Health National Center for Human Factors in Healthcare teamed up with the American Medical Association to show what they mean by sharing rare videos of real and simulated EHR usability challenges. They believe improving EHR design, development, and implementation to eliminate known patient safety risks and make them easier to use is the responsibility of healthcare providers, EHR vendors, policymakers, and patients, all working together.
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Content ArticleSTOMP stands for: stopping over medication of people with a learning disability, autism or both with psychotropic medicines. It is a national project involving many different organisations which are helping to stop the over use of these medicines. STOMP is about helping people to stay well and have a good quality of life. Psychotropic medicines can cause problems if people take them for too long. Or take too high a dose. Or take them for the wrong reason. This can cause side effects like: putting on weight feeling tired or ‘drugged up’ serious problems with physical health.
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Content ArticleSTOMP stands for stopping over medication of people with a learning disability, autism or both with psychotropic medicines. It is a national project involving many different organisations which are helping to stop the over use of these medicines. STOMP is about helping people to stay well and have a good quality of life. Psychotropic medicines affect how the brain works and include medicines for psychosis, depression, anxiety, sleep problems and epilepsy. Sometimes they are also given to people because their behaviour is seen as challenging. People with a learning disability, autism or both are more likely to be given these medicines than other people. These medicines are right for some people. They can help people stay safe and well. Sometimes there are other ways of helping people so they need less medicine or none at all.
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Content ArticleSTOMP stands for stopping over medication of people with a learning disability, autism or both with psychotropic medicines. It is a national project involving many different organisations which are helping to stop the over use of these medicines. STOMP is about helping people to stay well and have a good quality of life.
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News Article
Half of unexpected deaths in Belgian hospitals are due to shortage of staff
Patient Safety Learning posted a news article in News
Half of the unexpected deaths in Belgian hospitals are due to a shortage of nurses, according to a study by the University of Antwerp. Researchers from the University of Antwerp show the link between the number of nurses in hospitals and the death of the patients they care for, based on data from 34,567 patients’ medical records in four Flemish, one Walloon and two Brussels hospitals. The records showed that, on average, three out of every thousand patients in the hospital died ‘unexpectedly’. A death is considered as unexpected when a patient suddenly dies during active treatment, with no care plan for the end of their life having been started. “We know from previous research that part of these unexpected deaths can be avoided, which is always heartbreaking for the family as well as the staff,” said Filip Haegdorens, a researcher at the university. “As a sector, we must do everything we can to prevent this,” he added. The average nurse in Belgium is responsible for 9.7 patients at a time. For 89% of all departments, the number of nurses per hospital department was too low to be able to ensure good quality care. “Compared to, for example, Australian hospitals, where legal minimums exist, our Belgian figures could be improved,” said Haegdorens. The study also shows a link between the training level of nurses and the number of unexpected deaths in the hospital. “In some hospital services, we found that more nurses with a high level of education would reduce the risk of unexpected deaths,” Haegdorens added. Read research paper Read full story Source: The Brussels Times, 4 December 2019 -
Content ArticlePublic Health England have estimated that on an average day in England, between 30,000 and 35,000 adults with a learning disability, autism or both are taking a prescribed antipsychotic, an antidepressant or both without appropriate clinical indications (psychosis or affective/anxiety disorder). A substantial proportion of people with a learning disability, autism or both who are prescribed psychotropic drugs for behavioural purposes can safely have their drugs reduced or withdrawn. This research showed that among adults known to their GP to have a learning disability, (excluding only those in hospital as inpatients) on any average day: 17.0% were taking prescribed antipsychotic drugs, 16.9% antidepressants, 7.1% drugs used in mania and hypomania, 4.2% anxiolytics and 2.7% hypnotics. STOMP stands for stopping over medication of people with a learning disability, autism or both with psychotropic medicines. It is a national project involving many different organisations which are helping to stop the over use of these medicines. STOMP is about helping people to stay well and have a good quality of life.
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Content ArticleThe number of doctors entering GP training is higher than ever, yet the overall number of full-time equivalent GPs keeps decreasing. This is one of the reasons that patients report increasing dissatisfaction with their ability to access general practice, although they are satisfied with their care once they are seen. In this blog for the King's Fund, Abigail Heller, a current GP trainee discusses the results of a recent survey of 840 trainees about their career intentions. Abigail and many of the respondents hope to pursue other clinical or non-clinical interests alongside general practice, with interests ranging from expedition medicine to medico-legal work to give them the opportunity to broaden their skills However, despite this desire for a more flexible career, the trainees have concerns about an unmanageable workload. The intensity of the working day remains the leading factor in not wishing to undertake full-time GP work.
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Content ArticleGrowing evidence indicates that improved nurse staffing in acute hospitals is associated with lower hospital mortality. Current research is limited to studies using hospital level data or without proper adjustment for confounders which makes the translation to practice difficult. In this observational study published in BMC Health Services Research, Haegdorens et al. analysed retrospectively the control group of a stepped wedge randomised controlled trial of 14 medical and 14 surgical wards in seven Belgian hospitals. All patients admitted to these wards during the control period were included in this study. Pregnant patients or children below 17 years of age were excluded. The records showed that, on average, three out of every thousand patients in the hospital died ‘unexpectedly’. A death is considered as unexpected when a patient suddenly dies during active treatment, with no care plan for the end of their life having been started. Their results are in accordance with previous research and confirm the association between higher nurse staffing levels and lower patient mortality. Furthermore, they also found that a higher proportion of bachelor’s degree nurses is related to a reduction in patient mortality. They proposed a new method to estimate optimal staffing levels using ward level data.
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Content ArticlePhysicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts. In a study published in NEJM, Hu et al. carried out a cross-sectional national survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination assessed mistreatment, burnout (evaluated with the use of the modified Maslach Burnout Inventory), and suicidal thoughts during the past year. They found mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.
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Content ArticleDesigned for faculty, medical education curricula developers, residents, medical school administration, Designated Institutional Officials (DIOs), clinical leaders at teaching hospitals, and others interested in undergraduate, graduate and continuing medical education. There have been many advancements in medical education over the past 20 years, including how outcomes such as competencies are defined and used to guide teaching and learning. To support this positive change, the Association of American Medical Colleges (AAMC) has launched the New and Emerging Areas in Medicine series. This first report in the series focuses on quality improvement and patient safety competencies across the continuum of medical education. It presents a roadmap for curricular and professional development, performance assessment, and improvement of health care services and outcomes. The competencies can help educators design and deliver curricula and help learners develop professionally.
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Content ArticleEast Kent Hospitals University NHS Foundation Trust is delighted to have been the recipients of the Patient Safety Learning Award 2019 for ‘Professionalising Patient Safety’ for our FallStop programme.
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News Article
Nursing shortages forcing NHS to rely on less qualified staff
Patient Safety Learning posted a news article in News
The NHS is relying on less qualified staff to plug workforce gaps because of a huge shortage of nurses, according to a new report. Support staff, such as healthcare assistants and nursing associates, have been used to shore up staffing numbers, said the Health Foundation charity. The NHS has relied upon overseas recruitment, but a lack of EU nurses because of Brexit means it is now taking more nurses from countries such as India and the Philippines. At present, there are almost 44,000 nursing vacancies across the NHS (12% of the nursing workforce), but this could hit 100,000 in a decade, the report said. The report said most changes to the skill mix – meaning the ratio of fully qualified to less qualified staff – are implemented well and led by evidence, but added: “It is important that quality and safety are at the forefront of any skill mix change.” Read full story Source: The Guardian, 28 November 2019 -
Content ArticleThis is the fourth annual NHS workforce trends report published by the Health Foundation. In it, they analyse the changes in the size and composition of the NHS workforce in England in the context of long-term trends, policy priorities and future projected need.
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Content ArticleA whole-system approach to nasogastric tubes led by nurses is improving patient safety at Lancashire Teaching Hospitals NHS Foundation Trust. This initiative won the patient safety improvement category in the 2018 Nursing Times Awards.
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Content ArticleHealthcare systems are operating in an environment that is increasingly moving toward value-based payments that reward good health outcomes and patient experience. An impediment to success in this environment, however, is that both health care delivery systems and health information are extremely complicated. The level of complexity stymies many people and hinders them from making informed preventive care and self-management decisions. Health systems are finding that they cannot achieve improved patient outcomes or experiences without improving how health care professionals communicate with and support patients. Health systems have begun to respond to the mismatch between patients’ capabilities and the health literacy-related demands of the healthcare system. A new term has emerged – the health literate organisation – that describes organisations that aspire to make it easier for people to navigate, understand, and use information and services to take care of their health. Health literate organisations, in turn, need healthcare professionals who have health literacy knowledge and skills, such as being able to communicate effectively, break down health goals into manageable steps, and connect people with the resources they need to be successful Harris et al. explores health literate care in this Commentary for the National Academy of Medicine.
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Content ArticleAntibiotic resistance is an increasingly serious threat to global health and human development. It is rising to dangerously high levels in all parts of the world, compromising our ability to treat infectious diseases and putting people everywhere at risk.
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Content Article
Antibiotic awareness: quizzes and crosswords (updated 2017)
Claire Cox posted an article in Medicine management
The Antibiotic Guardian has produced a range of quizzes and crosswords about antibiotic resistance for the public, healthcare prescribers and pharmacists.
