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Content ArticleKnight et al. in a study published in the BMJ describe a national cohort of pregnant women admitted to hospital with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, identify factors associated with infection, and describe outcomes, including transmission of infection, for mothers and infants. Most pregnant women admitted to hospital with SARS-CoV-2 infection were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes, and transmission of SARS-CoV-2 to infants was uncommon. The high proportion of women from black or minority ethnic groups admitted with infection needs urgent investigation and explanation.
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Content Article
COVID-19 has exposed the weak safety culture in medicine
Patient Safety Learning posted an article in Blogs
"Many things will change as a result of the COVID-19 pandemic. One of them has to be the safety culture in medicine. Those in positions of authority must stop paying lip service to it and instead treat frontline workers as equal partners in the drive to improve safety, not as expendable infantry who can be bullied over the top with impunity or scapegoated ‘pour encourager les autres'", says Dr David Berger, a remote hospital doctor in Northern Australia. In this blog, David discusses how a robust, modern safety culture involves the closest possible partnership between management and frontline workers, where concerns can be shared freely, cooperation is total and where all interested parties must agree that the best possible system is in place. -
Content ArticleThe International Pharmaceutical Federation (FIP) has set up a FIP COVID-19 information hub with guidance to support pharmacists and the pharmacy workforce in responding to the pandemic. The updated guidance document takes into account newly available evidence and recommendations.
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Content ArticleThe government has unveiled a COVID-19 test and trace strategy for England, but it wasted valuable time in recognising what needed to be done after the lockdown was imposed and has been playing catch up ever since writes Chris Ham in a BMJ Opinion article. Chris says responding effectively to COVID-19 requires a blend of national and local leadership. Tragically, the government has been slow to recognise this, no more so than in plans to resume community testing and contact tracing as the lockdown is relaxed. These plans are essential to identify further outbreaks when they occur and to contain their impact. The challenge now is to ensure that every area of England has effective arrangements in place ahead of further relaxations of the lockdown in June. These arrangements must involve people being able to access tests in convenient locations, including their own homes, and for tests to be analysed rapidly. Agreement is needed on sharing test results with GPs and contact tracing staff to enable effective follow up.
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Content ArticlePharmacy Times® interviewed Allison Hanson, PharmD, BCPS, 2019-2020 Institute for Safe Medication Practices (ISMP) International Medication Safety Management Fellow, to discuss medication safety during the coronavirus disease 2019 (COVID-19) pandemic, including key medication safety takeaways from the pandemic and current advancement efforts in the promotion of knowledge around medication safety.
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Content ArticleTo deliver a new normal that serves patients we must grab this opportunity to bake patient involvement into new structures, processes and cultures within the NHS, writes Rachel Power, Chief Executive at the Patients Association, in this HSJ article. In responding at scale and pace to coronavirus – discharging patients, cancelling operations, changing how patients access services – the NHS avoided becoming overwhelmed. However, changes were delivered without allowing the patients affected a say. Given the emergency, that was probably necessary and people were largely supportive. But as the NHS looks ahead to what the “new normal” might be, if its recent experience has given it a taste for bold, clinically led change, then the NHS needs to think again.
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Content Article
BMA. COVID-19: PPE for doctors (last updated June 2022))
Patient Safety Learning posted an article in Guidance
The BMA has provided clarification on PPE use in primary and secondary care, including procurement, use, safe working and CPR. -
Content ArticleAs the number of COVID-19 hospital admissions gradually declines, policy attention is turning to how the NHS can restart some more routine activities. But doing this while living alongside COVID-19 will involve major practical challenges that will need to be overcome. This new discussion paper by Nigel Edwards looks at the realities the health and care systems will now begin to face.
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Content ArticleAn update on how Care Quality Commission is monitoring the Mental Capacity Act and people who are subject to the Deprivation of Liberty Safeguards (DoLS) during the coronavirus pandemic.
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Content ArticleAlongside the frustrations, difficulties and challenges of the pandemic, many great things are also happening in the healthcare system. Prof Becky Malby and Tony Hufflett from the Health Systems Innovation Lab at London South Bank University undertook a survey to help the NHS bring this all together so that we don’t end up going back to old, less effective habits. They asked a broad mix of frontline, senior, board and middle leadership across different NHS sectors to reflect on their experiences. They received over 70 responses from a mix of frontline, senior, board and middle leadership and other roles. They reflected and spotted patterns in the core changes people are most passionate about and have summarised 10 common themes that have emerged so far.
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Content ArticleThe UK NHS has risen to the challenge posed by COVID-19 through Herculean efforts to expand capacity. This has included doubling or trebling intensive care (ICU) capacity within hospitals, augmenting this with Nightingale Hospitals, cancelling all non-emergency surgery and redeploying staff and equipment to focus on a single disease. At the same time, government and population efforts have – through social distancing then lockdown – successfully flattened the epidemic curve and so reduced demand. Together, these actions have enabled treatment of all those needing hospital care for COVID-19 and avoided the unfettered increase in mortality that would have accompanied an overwhelmed healthcare service. However, this has been achieved ‘by the skin of our teeth’ and until very recently, the threat of insufficient ICU beds ventilators, and the need for triage were all anticipated: a few hospitals were overcome by the surge of critically ill patents. Now, political and social thoughts and actions are turning to loosening lockdown and determining what ‘post-pandemic normality’ will look like. In this Editorial, William Harrop‑Griffiths and Tim Cook discuss the prospects and challenges of ‘planned surgery’ – both time-critical and wholly elective procedures.
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Content ArticleWe all can experience mental health problems, whatever our background or walk of life. But the risk of experiencing mental ill-health is not equally distributed across our society. Those who face the greatest disadvantages in life also face the greatest risk to their mental health. The distribution of infections and deaths during the COVID-19 pandemic, the lockdown and associated measures, and the longer-term socioeconomic impact are likely to reproduce and intensify the financial inequalities that contribute towards the increased prevalence and unequal distribution of mental ill-health.
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Content ArticleThe Royal College of Nursing has undertaken two surveys of health and care staff to identify their experiences and ongoing issues with the supply of and access to personal protective equipment (PPE) during the COVID-19 pandemic. This report details the findings of the second survey (May 2020).
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Content ArticleThis interview is part of the hub's 'Frontline insights during the pandemic' series where Martin Hogan interviews healthcare professionals from various specialties to capture their experience and insight during the coronavirus pandemic. Here Martin interviews an oral surgeon who has been in the post for a year in a trust that covers two sites in the West Country.
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Content ArticleThis interview is part of the hub's 'Frontline insights during the pandemic' series where Martin Hogan interviews healthcare professionals from various specialties to capture their experience and insight during the coronavirus pandemic. Here Martin interviews a chief nurse of clinical productivity leading dynamic change within culture and governance. 15 years in the post, the chief nurse is responsible for leading improvement in standards of nursing and service.
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Content Article
Understanding the needs of youth during the COVID-19 crisis
Claire Cox posted an article in Blogs
While COVID-19 coverage has been saturated with news of clinical cases, deaths, hospital shortages, and financial losses, it seems as though a key population has been excluded from the concern. The youth and young adult population, of all ethnicities and backgrounds, have not had the proper attention to their needs as other groups impacted by COVID-19 have. Particularly, these populations are at risk of severe mental health distress due to COVID-19 related financial, academic, and housing instability. -
Content Article
COVID deaths – how accurate are the statistics?
Patient Safety Learning posted an article in Blogs
Malcolm Kendrick, an NHS doctor, has seen people die and be listed as a victim of coronavirus without ever being tested for it. In his blog, Malcolm says if we do not diagnose deaths accurately we will never know how many died of COVID-19, or ‘because of’ the lockdown. Accurate statistics are vital for planning for the future. We have to accurately know what happened this time, in order to plan for the next pandemic, which seems almost inevitable as the world grows more crowded. What are the benefits of lockdown, what are the harms? What should we do next time a deadly virus strikes? -
Content ArticleThis interview is part of the hub's 'Frontline insights during the pandemic' series where Martin Hogan interviews healthcare professionals from various specialties to capture their experience and insights during the coronavirus pandemic. Here Martin interviews an advanced specialist paramedic working in central London with four years' experience of working on the frontline.
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Content ArticlePublic Health England (PHE) has published data on the disparities in the risk and outcomes from COVID-19. This review presents findings based on surveillance data available to PHE at the time of its publication, including through linkage to broader health data sets. It confirms that the impact of COVID-19 has replicated existing health inequalities and, in some cases, has increased them. These results improve our understanding of the pandemic and will help in formulating the future public health response to it.
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Content Article
Choices for the “New Normal” (4 May 2020)
Patient Safety Learning posted an article in Blogs
No one can say with certainty what the consequences of this pandemic will be in 6 months, let alone 6 years or 60. Some “new normal” may emerge, in which novel systems and assumptions will replace many others long taken for granted. But at this early stage, it is more honest to frame the new, post–COVID-19 normal not as predictions, but as a series of choices. In this article in JAMA, Donald Berwick proposes six properties of care for durable change: tempo, standards, working conditions, proximity, preparedness, and equity. -
Content ArticleMost Americans are eager to see the country re-open. In this article Nicole Saphier and Marty Makary discuss why we need to be smart about how we do it and why we need accurate statistics.
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Content ArticleThe rapid transmission of COVID-19 has resulted in an international pandemic with the cumulative death rate expected to further escalate in the months to come. The majority of deaths to date (May 2020) have been highly concentrated in certain geographic areas, placing tremendous stress on local healthcare systems and associated workforces. Healthcare is a fundamentally human endeavor; its reliability and the capacity to provide it are tested under stressful conditions and the COVID-19 pandemic is proving to be an especially difficult test for healthcare systems. Consideration of the humanness of care in the broader context of patient safety can raise awareness of how human weaknesses impact individual clinicians and care teams in ways that could degrade patient safety and quality of care and increase risk for both patients with COVID-19 and the staffs that care for them. These weaknesses are exacerbated by fatigue and burnout, absence of team trust, lack of time, medical illness, and poor psychological safety, each of which can result in reduced performance and contribute to failures such as misdiagnoses and adverse events. This article published on AHRQ's PSNet explores these weaknesses.
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Content ArticleThis perspective published in the The New England Journal of Medicine examines the problem of racial disparities and the COVID-19 pandemic. The Chowkwanyun and Reed highlight the importance of viewing the data emerging from the crisis in the appropriate socioeconomic and deprivation contexts to protect against ineffective compartmentalisation of the populations being affected.
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Content ArticleThis data snapshot from Santoli et al. highlights the results of an examination of two data sets (Jan to April 2019 and Jan to April 2020) to assess the impact of the pandemic on pediatric vaccination in the United States. The authors found significant vaccination declines and highlight the importance of childhood vaccination to prevent future disease outbreaks.
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Content ArticleThis essay in The New Yorker summarises known weaknesses in US healthcare visible long before COVID-19—and discusses others more specific to the pandemic. The author suggests that efforts to change the system be informed by the COVID-19 experience. The work should not seek to return to the pre-pandemic state but instead aim to making changes based on what was revealed to improve health care delivery overall.
