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Content Article
When we think of improving patient safety, we often think of strategies that can be implemented at the healthcare organisation or healthcare professional level. However, improving patient safety is a multifaceted issue, and health plans play an important role in monitoring and improving patient safety. In the United States, insurance status can determine a patient’s access to safe, high-quality health care. The Patient Protection and Affordable Care Act (ACA), established in 2010, sought to improve access to care by expanding coverage through Medicaid and reforming the private insurance market. The ACA specifically sought to improve patient safety by establishing quality reporting programs and pay-for-performance initiatives that tied reimbursement payments to quality measures and patient safety indicators. It also mandated funding for patient safety initiatives and research and highlighted the role of health plans as critical players in patient safety. Health plans have a unique position in addressing patient safety, as their covered services can impact patient access to care. Although there is extensive published literature on the health plan’s role in monitoring and improving healthcare quality, a limited body of work specifically examines the health plan’s role in monitoring and improving patient safety. However, health care quality and patient safety are closely intertwined, and patient safety events often overlap with quality issues. This essay published on PS Net explores ways that health plans are currently monitoring patient safety and discusses opportunities and initiatives at the health plan level to improve patient safety. -
Content Article
A set of eLearning modules designed to educate and update clinicians on the importance of involving families wherever possible during mental health crises to improve patient care, avoid harm and reduce deaths. They were developed as a partnership between Oxford Health NHS Foundation Trust and Making Families Count, with funding from NHS England South East Region (HEE legacy funds). The resources have been co-produced by people with lived experience as patients, family carers and clinicians, supported by an Advisory Group drawn from a wide range of expertise, tested in eleven NHS Trusts and independently evaluated. The resources can be downloaded by NHS Trust Learning and Development teams to support a Trust-wide approach to essential learning and training. Through short film and audio scenarios and case studies, Life Beyond the Cubicle shows why it is so important to involve family and friends, helps clinicians reflect on why they don’t do so routinely, and how they can overcome these barriers. The resources are engaging and interactive. The modules are: Introduction (includes guidance on how to use this resource) Module 1: Why do families and friends matter? Module 2: Assumptions and expertise Module 3: Feelings and fears Module 4: Confidentiality and Information Sharing Module 5: Safety planning Resources for family and friends They are free to the health and social care workforce. Further reading on the hub: Safer outcomes for people with psychosis Patient Safety Spotlight interview with Rosi Reed, Development and Training Coordinator at Making Families Count The future has been around for too long—when will the NHS learn from their mistakes?- Posted
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- Patient / family involvement
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Content Article
This policy paper from the Department of Health and Social Care sets out the Government’s response to the recommendations of the investigation into the death of Elizabeth Dixon in respect of the failures of care she received from the NHS. Elizabeth Dixon was a child with special health needs. She had been born prematurely at Frimley Park Hospital on 14 December 2000. Following treatment and care at Great Ormond Street Hospital and a children’s hospice she was nursed at home under a care package. As a result of a failure to clear a tracheostomy tube she asphyxiated and was pronounced dead at Frimley Park hospital on 4 December 2001. The investigation chaired by Dr Bill Kirkup looked at the events surrounding the care of Elizabeth and makes a series of recommendations in respect of the failures in the care she received from the NHS. The report which set out the findings and recommendations of this investigation, The life and death of Elizabeth Dixon: a catalyst for change, was published on the 26 November 2020. This policy paper details the UK Government’s response each of the report’s recommendations. It also highlights a number of areas where action is being taken by government departments, arm’s length bodies and other organisations in response to the investigations recommendations.- Posted
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News Article
Warning over use in UK of unregulated AI chatbots to create social care plans
Patient Safety Learning posted a news article in News
Britain’s hard-pressed carers need all the help they can get. But that should not include using unregulated AI bots, according to researchers who say the AI revolution in social care needs a hard ethical edge. A pilot study by academics at the University of Oxford found some care providers had been using generative AI chatbots such as ChatGPT and Bard to create care plans for people receiving care. That presents a potential risk to patient confidentiality, according to Dr Caroline Green, an early career research fellow at the Institute for Ethics in AI at Oxford, who surveyed care organisations for the study. “If you put any type of personal data into [a generative AI chatbot], that data is used to train the language model,” Green said. “That personal data could be generated and revealed to somebody else.” She said carers might act on faulty or biased information and inadvertently cause harm, and an AI-generated care plan might be substandard. But there were also potential benefits to AI, Green added. “It could help with this administrative heavy work and allow people to revisit care plans more often. At the moment, I wouldn’t encourage anyone to do that, but there are organisations working on creating apps and websites to do exactly that.” Read full story Source: The Guardian, 10 March 2024 -
Event
This conference will provide a practical guide to delivering an effective prehabilitation programme, ensuring patients are fit for cancer surgery or treatment. This is even more important in light of the COVID-19 pandemic and lockdowns which have had a negative effect on many individual’s health and fitness levels. The conference will look at optimisation of patients fitness and wellbeing through exercise, nutrition and psychological support. Register- Posted
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Community Post
What training have you had to have that crucial end of life conversation with a patient and their relatives? What has helped you have those conversations?- Posted
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News Article
One of the mysteries of COVID-19 is why oxygen levels in the blood can drop to dangerously low levels without the patient noticing. It is known as "silent hypoxia" and as a result, patients have been arriving in hospital in far worse health than they realised and, in some cases, too late to treat effectively. But a potentially life-saving solution, in the form of a pulse oximeter, allows patients to monitor their oxygen levels at home, and costs about £20. They are being rolled out for high-risk Covid patients in the UK, and the doctor leading the scheme thinks everyone should consider buying one. A normal oxygen level in the blood is between 95% and 100%. "With Covid, we were admitting patients with oxygen levels in the 70s or low-or-middle 80s," said Dr Matt Inada-Kim, a consultant in acute medicine at Hampshire Hospitals. He told BBC Radio 4's Inside Health: "It was a really curious and scary presentation and really made us rethink what we were doing." Read full story Source: BBC News, 21 January 2021 See hub resource on the 'Covid Oximetry @home' project -
News Article
Global health insurance card to replace EHIC under new rules
Patient Safety Learning posted a news article in News
UK residents can apply for a Global Health Insurance Card (GHIC) to access emergency medical care in the EU when their current EHIC card runs out. Under a new agreement with the EU, both cards will offer equivalent healthcare protection when people are on holiday, studying or travelling for business. This includes emergency treatment as well as treatment needed for a pre-existing condition. The new GHIC card is free and can be obtained via the official GHIC website. Current European Health Insurance Cards (EHIC) are valid as long as they are in date, and can continue to be used when travelling to the EU. You don't need to apply for a GHIC until your current EHIC expires. People should apply at least two weeks before they plan to travel to ensure their card arrives on time. Read full story Source: BBC News, 11 January 2021 -
News Article
Demand for public inquiry into NHS mental health deaths to be debated by MPs
Patient Safety Learning posted a news article in News
A mother fighting for a public inquiry into the death of her son and more than 20 other patients at an NHS mental health hospital in Essex has won a debate in parliament after more than 100,000 people backed her campaign. On Monday, MPs in the House of Commons will debate Melanie Leahy’s petition calling for a public inquiry into the death of her son Matthew in 2012, as well as 24 other patients who died at The Linden Centre, a secure mental health unit in Chelmsford, Essex, since 2000. The centre is run by Essex Partnership University NHS Trust which has been heavily criticised by regulators over the case. A review by the health service ombudsman found 19 serious failings in his care and the NHS response to his mother’s concerns. This included staff changing records after his death to suggest he had a full care plan in place when he didn’t. Matthew was detained under the Mental Health Act but was found hanged in his room seven days later. He had made allegations of being raped at the centre, but this was not taken seriously by staff nor properly investigated by the NHS. The trust has admitted Matthew’s care fell below acceptable standards. In November, it pleaded guilty to health and safety failings linked to 11 deaths of patients in 11 years. Read full story Source: The Independent, 29 November 2020- Posted
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News Article
NHS England has said disabled and vulnerable patients must not be denied personalised care during the coronavirus pandemic and repeated its warning that blanket do not resuscitate orders should not be happening. In a joint statement with disabled rights campaigner and member of the House of Lords, Baroness Jane Campbell, NHS England said the COVID-19 virus and its impact on the NHS did not change the position for vulnerable patients that decisions must be made on an individualised basis. It said: “This means people making active and informed judgements about their own care and treatment, at all stages of their life, and recognises people’s autonomy, as well as their preferences, aspirations, needs and abilities. This also means ensuring reasonable adjustments are supported where necessary and reinforces that the blanket application of do not attempt resuscitation orders is totally unacceptable and must not happen.” Read full story Source: The Independent, 26 May 2020 -
Content Article
This guide will support healthcare professionals to integrate prehabilitation services into the cancer pathway. Macmillan have developed our principles and guidance for prehabilitation with the Royal College of Anaesthetists, the National Institute for Health Research Cancer, and Nutrition Collaboration. The principles and guidance will help you to: advance cancer care provision include prehabilitation in the cancer pathway inform service provision and development inform and support a change policy.- Posted
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Content Article
Although midwifery-led continuity of care is associated with superior outcomes for mothers and babies, it is not available to all women. Issues with implementation and sustainability might be addressed by improving how it is led and managed – yet little is known about what constitutes the optimal leadership and management of midwifery-led continuity models. Hewitt et al. carried out a scoping review on leadership and management in midwifery-led continuity of care models. -
Content Article
CQC review of ‘do not attempt cardiopulmonary resuscitation’ decisions during the coronavirus (COVID-19) pandemic. From the beginning of the COVID-19 pandemic, there were concerns that ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions were being made without involving people, or their families and/or carers if so wished, and were being applied to groups of people, rather than taking into account each person’s individual circumstances. In October 2020, the Department for Health and Social Care commissioned the CQC to conduct a special review into these concerns. The review, which took place between November 2020 and January 2021, looked at how DNACPR decisions were made in the context of advance care planning, across all types of health and care sectors, including care homes, primary care and hospitals. During our review, we heard about the experiences of over 750 people and about the distress that people face when they do not feel involved in decisions about their care. When done well, DNACPR decisions are an important aspect of advance care planning, and people should be fully involved in discussions about their care. -
Content Article
NHSX's Innovation Team has released its latest digital playbook which focuses on eye care and directs clinicians and organisations to digital tools that can support patient pathways. The resource, which is extensive and features numerous case studies, can be used by eye care specialists looking to digitally enhance their ophthalmology pathways, remote monitoring and sharing of diagnostics. Areas and scenarios covered in the eyecare playbook include examples of digital tools and solutions to help with communication, improving referrals, setting up virtual clinics, remote consultations and self-monitoring, as well as sharing clinical data and images. A step-by-step, recommended eye care pathway is also featured covering stages from primary care, referrals and diagnostics, through to outpatients and day surgery, and finally, community care and supported self-care. Some of the innovative case studies featured include examples from: NHS Grampian’s Eye Health Network Moorfields Eye Hospital NHS FT County Durham and Darlington NHS FT The Royal College of Ophthalmologists Bolton NHS Trust FT East Kent Hospitals University NHS FT Gloucestershire Hospitals NHS FT The University of Strathclyde and NHS Forth Valley Digital tools and solutions highlighted stretch from home visual acuity testing and remote vision monitoring for macular disease, through to secure video messaging service examples, smartphone-based lenses for image capturing and referrals, virtual glaucoma clinics, and integration platforms.- Posted
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Content Article
'Covid Oximetry @home' describes an enhanced package of care for individuals with confirmed (or suspected) COVID-19 who are at risk for future deterioration. NHS England and Improvement wrote to all CCGs and trusts to encourage the development of local CO@H projects. The 'CO@h' package of care involves the remote monitoring of the patient's condition through providing regular contact with a local health care team who will reassess the individuals symptoms (including oxygen saturation levels). This close monitoring enables the individual to remain at their usual place of residence whilst allowing early signs of deterioration to be identified and escalated quickly and appropriately. This material has been designed primarily for use across the South East AHSN network by colleagues within the Wessex AHSN, Kent Surrey Sussex AHSN and Oxford AHSN regions. Colleagues from regions beyond the South East are also very welcome to make use of this toolkit in setting up their own local approaches to remote monitoring. -
Content Article
Ward rounds are the focal point for a hospital’s multidisciplinary teams to undertake assessments and care planning with their patients. Coordination of assessments, plans and communication is essential for effective and efficient care. However, the delivery of ward rounds is consistently constrained by the competing priorities of clinical staff. A number of factors contribute to this, including workforce gaps, inadequate planning, unwarranted variation in practice and an absence of training in the skills required to deliver complex multidisciplinary team care. This leads to frustration for staff and patients, and can lead to errors in care, longer stays in hospital and readmissions. A new report from UK healthcare professional leaders including the Royal College of Physicians, and developed along with patients, sets out best practice for modern ward rounds.- Posted
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News Article
Coronavirus: Doctors urge conversations about dying
Patient Safety Learning posted a news article in News
Palliative care doctors are urging people to have a conversation about what they would want if they, or their loved ones, became seriously unwell with coronavirus. We should discuss all possible scenarios - even those we are not "comfortable to talk about", they said. Medics said the virus underlined the importance of these conversations. New guidelines are being produced for palliative care for Covid-19 patients, the BBC understands. Read full story Source: BBC News, 21 March 2020- Posted
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Content Article
Alzheimer's Society: 'This is me' leaflet
Patient-Safety-Learning posted an article in Dementia
'This is me' is a simple leaflet for anyone receiving professional care who is living with dementia or experiencing delirium or other communication difficulties. 'This is me' can be used to record details about a person who can't easily share information about themselves. For example, it can be used to record: a person’s cultural and family background important events, people and places from their life their preferences and routines. -
Content Article
The power of a health care advocate
Patient-Safety-Learning posted an article in Patient safety in health and care
This article from the John Hopkins explains the importance of a good healthcare advocate, particularly for older adults who may have more health issues to discuss. When choosing the right healthcare advocate, they should be calm, supportive and assertive and can be a family member, spouse, relative or friend. This article suggests several ways in which to select the right person and lists resources to explore on how best to choose an advocate. -
Content Article
In this Episode of the 'This Is Nursing' podcast series, Gavin Portier speaks to with Alison Schofield, Tissue Viability Clinical Nurse Specialist from North Lincolnshire & Goole NHS Trust. Alison has worked in Tissue Viability since 2012 and during this time she has studied extensively in leading change in tissue viability, tissue viability management and leg ulcers. Alison discusses her role of a Tissue Viability Clinical Nurse Specialist and the challenges facing the role in this current world of nursing, the impact of COVID-19 has had on the delivery of community tissue viability services and on people in receipt of the services in care homes and in their own homes.- Posted
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Content Article
Patient Safety Authority: Pressure injuries
Patient Safety Learning posted an article in Patient management
Pressure injuries are a recognized patient safety concern and meet the definition of a reportable event under the Pennsylvania Medical Care Availability and Reduction of Error (MCARE) Act. The Patient Safety Authority has collated guidelines, tools and resources on pressure injuries. -
Content Article
A report on the investigation into the death of Elizabeth Dixon and a series of recommendations in respect of the failures in the care she received from the NHS. Elizabeth Dixon was a child with special health needs. She had been born prematurely at Frimley Park Hospital on 14 December 2000. Following treatment and care at Great Ormond Street Hospital and a children’s hospice she was nursed at home under a care package. As a result of a failure to clear a tracheostomy tube she asphyxiated and was pronounced dead at Frimley Park hospital on 4 December 2001. The investigation chaired by Dr Bill Kirkup looked at the events surrounding the care of Elizabeth and makes a series of recommendations in respect of the failures in the care she received from the NHS. Recommendations Hypertension (high blood pressure) in infants is a problem that is under-recognised and inconsistently managed, leading to significant complications. Its profile should be raised with clinicians; there should be a single standard set of charts showing the acceptable range at different ages and gestations; and a single protocol to reduce blood pressure safely. Blood pressure should be incorporated into a single early warning score to alert clinicians to deterioration in children in hospital. Community care for patients with complex conditions or conditions requiring complex care must be properly planned, taking into account and specifying safety, effectiveness and patient experience. The presence of mental or physical disability must not be used to justify or excuse different standards of care. Commissioning of NHS services from private providers should not take for granted the existence of the same systems of clinical governance as are mandated for NHS providers. These must be specified explicitly. Communication between clinicians, particularly when care is handed over from one team or unit to another, must be clear, include all relevant facts and use unambiguous terms. Terms such as palliative care and terminal care may be misleading and should be avoided or clarified. Training in clinical error, reactions to error and responding with honesty, investigation and learning should become part of the core curriculum for clinicians. Although it is true that curricula are already crowded with essential technical and scientific knowledge, it cannot be the case that no room can be found for training in the third leading cause of death in western health systems. Clinical error, openly disclosed, investigated and learned from, must not be subject to blame. Conversely, there should be zero tolerance of cover up, deception and fabrication in any health care setting, not least in the aftermath of error. There should be a clear mechanism to hold individuals to account for giving false information or concealing information relating to public services, and for failing to assist investigations. The Public Authority (Accountability) Bill drawn up in the aftermath of the Hillsborough Independent Panel and Inquests sets out a commendable framework to put this in legislation. It should be re-examined. The existing haphazard system of generating clinical expert witnesses is not fit for purpose. It should be reviewed, taking onto account the clear need for transparent, formalised systems and clinical governance. Professional regulatory and criminal justice systems should contain an inbuilt ‘stop’ mechanism to be activated when an investigation reveals evidence of systematic or organisational failures and which will trigger an appropriate investigation into those wider systemic failures. Scrutiny of deaths should be robust enough to pick up instances of untoward death being passed off as expected. Despite changes to systems for child and adult deaths, concern remains that without independent review such cases may continue to occur. The introduction of medical examiners should be reviewed with a view to making them properly independent. Local health service complaints systems are currently subject to change as part of wider reform of public sector complaints. Implementation of a better system of responding to complaints must be done in such a way as to ensure the integration of complaints into NHS clinical governance as a valuable source of information on safety, effectiveness and patient experience. The approaches available to patients and families who have not been treated with openness and transparency are multiple and complex, and it is easy to embark inadvertently on a path that is ill-suited to deliver the answers that are being sought. There should be clear signposting to help families and the many organisations concerned. Ministerial Statement Patient Safety Learning's statement on the Dixon Inquiry report- Posted
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Content Article
Wirral University Teaching Hospital's SSKIN bundle
Patient Safety Learning posted an article in Pressure ulcers
SSKIN is a five step approach to preventing and treating pressure ulcers. Wirral University Teaching Hospital is sharing their version of the SSKIN bundle as part of Stop The Pressure Day. They have worked with their Allied Health Professional colleagues on refreshing the bundle for local use. -
News Article
Coeliac patient died after being fed Weetabix in hospital, inquiry hears
Patient Safety Learning posted a news article in News
An 80-year-old woman with coeliac disease died within days of being fed Weetabix in hospital, an inquest has heard. Hazel Pearson, from Connah’s Quay in Flintshire, was being treated at Wrexham Maelor hospital and died four days later on 30 November from aspiration pneumonia. Although her condition was recorded on her admission documents, there was no sign beside her bed to alert healthcare assistants to her dietary requirements. Coeliac disease is a condition where the immune system attacks the body’s own tissues after consuming gluten, a type of protein found in wheat, rye and barley, causing damage to the small intestine. The hospital’s action plan to avoid similar fatal incidents lacked detail and had “narrow vision”, the coroner said. The hospital’s matron, Jackie Evans, told the inquest that changes, including placing signs above the beds of patients with special dietary requirements, had been implemented since Pearson’s death. But Sutherland raised concerns that the hospital had yet to carry out a formal investigation into what went wrong. She said: “The action plan lacks detail. What has happened locally is commendable, but it lacks detail and it has narrow vision.” She added that the plan that had been put in place was “amateurish with no strategic vision”. The assistant coroner said she would be unable to make a decision on a prevention of future deaths report until the Betsi Cadwaladr University Health Board (BCUHB) provided a witness to answer further questions about changes. Read full story Source: The Guardian, 17 June 2022- Posted
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Content Article
Healthcare Improvement Scotland is currently working with the Scottish Government to develop COVID-19 specific Anticipatory Care Planning (ACP) templates and guidance. ACP is a person-centred approach to help people to plan for their future. The essence of ACP is to encourage individuals to think ahead to help ensure that in the event of a change in their health or care needs, including loss of capacity, the right thing is done at the right time by the right person with the right outcome. ACP can benefit many individuals, from those with early onset of long-term conditions to people with chronic and complex illnesses, to plan ahead for care needs. ACP can be beneficial to individuals towards the end of their life, however the process can be more effective if started earlier in their journey. The link below takes you to an online resource that is designed to be used in conjunction with practitioner judgement, and is not for sole use by individuals and their families without guidance.- Posted
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