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Content ArticleIn this anonymous opinion piece for the British Medical Journal, a researcher from within the US federal system describes how they are being instructed to delete critical data and advised that grants could be pulled if specific words are mentioned (advocacy, biased, gender, LGBT, lesbian, gay, bisexual, transgender, diversity, inclusion, marginalised, and underserved). "This is digital genocide: populations of vulnerable people are being deleted. Data on transgender men and women are being deleted. We are also losing data on maternal mortality. These populations will suffer now and for decades to come. The US will be unable to understand mortality and morbidity rates to tackle health inequalities because the data are forbidden." In summary he says that through the anger, shock, and sadness, they must not despair. They must figure out how they can work within this greatly changed system to keep America healthy. How they can care for all Americans in the face of digital genocide.
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News ArticleThe Danish government wants to abolish healthcare professionals' obligation to report unintentional incidents with patients, a system that has existed for 20 years and is still considered a success. In its recent budget proposal for 2025, the Danish coalition government repeals the 20-year-old obligation for healthcare workers to report “unintentional incidents” to municipalities and regions, which then anonymise these reports and register them in the Danish Patient Safety Database. The decision has sent shockwaves through the Danish health community since the system is considered effective. “Yes, it is a success. The obligation to report errors has created a culture of patient safety that has led to more errors and cases being reported and learned from during the years,” Annette Wandel, Deputy Director at the Danish Patients Association, told Euractiv. She is afraid that the budget proposal would undermine this. The move, which will also close the national database, is a part of the government’s de-bureaucratisation ambition to cut the number of civil servants in Denmark. The Danish Nurses’ Association considers the implementation would send Denmark back 20 years. “It is unique in Denmark that we have created a system where employees can safely report errors to prevent the same errors from happening again,” Harun Demirtas, deputy chairman of the Danish Nurses' Council, told TV 2. Camilla Rathcke, chairwoman of the Danish Medical Association, called it a bombshell: “Improving patient safety through learning is an ongoing process - it's not something the health system will stop. If you want patient safety and a learning healthcare system." She added: "It makes no sense to close the database. On the contrary, more effort should be put into learning from its data,” she told the union newspaper Ugeskrift for Laeger. Read full story Source: EURACTIV, 18 September 2024
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Content ArticleA broken hip or ‘hip fracture’ is a serious injury, which each year in the UK leads to around 75,000 people needing hospital admission, surgery and anaesthesia, followed by weeks of rehabilitation in hospital and the community. The National Hip Fracture Database (NHFD) is an online platform that uses real-time data to drive Quality Improvement (QI) across all 163 hospitals that look after patients with hip fractures in England and Wales. This report highlights key research carried out using data from the NHFD in 2021, and makes a number of recommendations to improve treatment and outcomes for patients with hip fractures. Recommendations Hip fracture teams should use quarterly governance meetings to review the quality and outcome of the care they provide. Where performance is significantly below average, units should formally discuss possible reasons for this within their regular MDT meeting, and plan a QI project to address it. Quarterly governance meetings should be taken as an opportunity for team members and trainees from all disciplines to make use of the NHFD website as a driver for QI; the new Quarterly Governance Tool is designed to help them do this. The NHFD recommends that governance meetings of surgical, orthogeriatric, anaesthetic, nursing, therapy and management leads should take place on at least a monthly basis. Monthly governance meetings should be used to plan appropriate QI interventions, and to monitor the impact of these using the real-time data reported in the NHFD run charts. Hip fracture teams should use their KPI caterpillar plots to identify better-performing neighbouring units, so they can share best practice and network with them in designing QI work. Hip fracture teams should use KPI 0 as a marker of initial care and a driver to improve the provision of local anaesthetic nerve blocks and fast-tracking of patients to an appropriate ward. Performance should be considered alongside the figures for their unit in the Anaesthesia run chart and Assessment benchmarking table. To help patients avoid further fragility fractures, hip fracture team governance meetings should review KPI 7 alongside their Bone Medication Table and arrangements for 120-day follow-up. Hip fracture teams should signpost patients, their families and carers to the NHFD website resources designed to help them understand their care and recovery following a hip fracture. Hip fracture teams should use monthly governance meetings to review their policies and protocols, and to compare these with those in other units as described in the Facilities Survey. Hip fracture teams should minimise inequalities in health care; specifically by reviewing whether support and information are provided in formats and languages appropriate to their patients.
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Content ArticleShould new draft legislation around the use of mesh in women regarding incontinence or prolapse and a new guidance on a national registry meaning every woman choosing mesh in the future must be logged on a database be extended? Haydn Wheeler argues that a broader database is in need.
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Content ArticleIn England and Wales, coroners are required to write Prevention of Future Deaths reports when a death is deemed preventable so that action is taken to avert similar deaths. Since July 2013, Prevention of Future Deaths reports have been openly available via the Courts and Tribunals Judiciary website (https://www.judiciary.uk/prevention-of-future-death-reports/). However, their presentation to date have been insufficient to identify trends and learn lessons. The authors of this paper designed a web scraper to create the Preventable Deaths Tracker. On 22 June 2022, 4001 PFDs were scraped, analysed, and compared to the Office of National Statistics’ preventable mortality statistics. This commentary, published in Medico-Legal Journal, summarises the key findings and offers recommendations to improve the Prevention of Future Deaths system so lessons can be learnt to avert preventable deaths.
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Content ArticleThe Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest repository of patient safety data in the United States and one of the largest in the world, with over 4.7 million acute care event reports dating back to 2004. This article in the journal Patient Safety analyses the patient safety event reports submitted to PA-PSRS in 2023. Key findings In 2023, 287,997 reports were submitted to PA-PSRS, which is a considerable increase from 2022, but very close to the 2021 total. Reports of serious and high harm events increased by 20.6% and 25.0%, respectively, representing the largest annual increases historically. Of the 287,997 reports, 96.0% were from hospitals, 3.8% were from ambulatory surgical facilities, and 0.2% were from birthing centres and abortion facilities. The vast majority (95.9%) of the 2023 reports were incidents, with the remaining 4.1% classified as serious events. The reporting rate based on event occurrence date for hospitals in the first half of 2023 was 30.0 reports per 1,000 patient days; for ASFs, the rate was 9.9 reports per 1,000 surgical encounters. For each of the past five years, the most frequently reported event type was Error Related to Procedure/Treatment/Test, which accounted for 33.1% of acute care event reports submitted in 2023. From a distribution perspective, the greatest increase in percent of total reports in 2023 occurred with event type Medication Error, and the greatest increase for serious events was with event type Complication of Procedure/Treatment/Test (P/T/T). Almost half of the increase in Complication of P/T/T was with subtype Complication following surgery or invasive procedure (48.2%; 968 of 2,009), and 54.6% (529 of 968) of reports in this subtype were due to unplanned returns to the operating room.
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Content ArticleIncident reports of medication errors are valuable learning resources for improving patient safety. However, key information is often contained within unstructured free text, which prevents automated analysis and limits the usefulness of these data. Natural language processing can be used to structure this free text automatically and retrieve relevant past incidents and learning materials, but this requires a large, fully annotated and validated set of incident reports. This study in Nature used a set of 58,658 machine-annotated incident reports of medication errors to test a natural language processing model. The authors provide access to the validation datasets and machine annotator for labelling future incident reports of medication errors.
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Content ArticleMedical device industry payments to healthcare organisations (HCOs) can create conflicts of interest which can undermine patient care. One way of addressing this concern is by enhancing transparency of industry financial support to HCOs. MedTech Europe, a medical device trade body, operate a system of disclosure of education payments to European HCOs. This study aimed to characterise payments reported in this database and to evaluate the disclosure system. Highlights Between 2017 and 2019, 116 medical device companies disclosed over €425 million in payments. A small number of medical device companies accounted for the vast majority of these payments and most payments were to healthcare organisations in a small number of countries. The database itself was rated as having a range of significant shortcomings such as the limited breadth of recipients, donors, and payment areas covered. A European wide system of mandatory disclosure for the medical device and pharmaceutical industries addressing these areas should be introduced to address the shortcomings of this database.
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News Article
Medical device companies pay millions to NHS while pushing products, says study
Patient Safety Learning posted a news article in News
Medical device companies are paying millions of pounds to hospitals in the UK to fund staff places, as well as training and awareness campaigns, while pushing sales of their products, including implants, heart valves and diagnostic equipment, a new report reveals. An analysis of disclosures by medical device companies found that between 2017 and 2019 they reported €425m (£367m at today’s rates) in payments to healthcare organisations in Europe, according to the study in the journal Health Policy and Technology. The businesses reported paying more than €37m to hospitals and other healthcare bodies in the UK over the three-year period. The disclosures include payments to some of the biggest hospital trusts in England. James Larkin, one of the authors of the study and a postdoctoral researcher at the Royal College of Surgeons in Ireland, said the filings did not include consultancy fees for medical staff and many companies did not register their payments. “This is just the tip of the iceberg,” he said. “There is a huge number of payments that are not being disclosed. The descriptions for payments which are disclosed are very vague and it is not completely clear what they are for.” Read full story Source: The Guardian, 20 April 2024 -
News Article
‘Computer error’ removed 1,800 patients from trust’s elective waiting list
Patient Safety Learning posted a news article in News
A trust has discovered 1,800 patients who were removed by mistake from its elective waiting list. Barking, Havering and Redbridge University Hospitals Trust chief executive Matthew Trainer wrote to colleagues in the east London health system today to “apologise for the stress this will have caused those experiencing a delay”. Of the 1,800 patients involved, 600 have been waiting more than a year and roughly 200 have been waiting for more than two years. Mr Trainer’s note explained: “The patients have been waiting to see our specialists in routine clinics in gynaecology, neurology, neurosurgery and ophthalmology.” It continued: “As we have been working through our waiting lists, we have discovered a problem with one of them that was used to deal with the backlog created by the pandemic. “It contained routine referrals that were submitted by GPs who wanted their patients to be seen by a specialist, but for whom there were no appointments available due to covid-19. Unfortunately, these patients were removed automatically from this list before they had been seen.” Read full story (paywalled) Source: HSJ, 26 April 2022 -
Content ArticleThis study in the journal Medical Devices: Evidence and Research aimed to assess health system experiences of implementing Unique Device Identifier (UDI) systems for medical devices. Although the US Food and Drug Administration (FDA formalised the Unique Device Identification System Rule in 2013, parallel regulatory requirement for US health systems to use UDIs is lacking. Through semi-structured interviews, the authors identified barriers to implementing UDI systems and strategies to overcome them. The authors identified a range of internal and external barriers to UDI implementation in health systems, including: lack of organizational support information technology gaps clinical resistance information technology vendor resistance limitations in manufacturer support gaps in reference data lack of an overall UDI system). They also identified strategies for overcoming these barriers, including: relationship building education engagement communication. They concluded that next steps to advance UDI adoption need to focus on education, research, support and policy.
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Content Article
Waiting Lists Tracker
Patient Safety Learning posted an article in Suggest a useful website
Get information on waiting times for treatment at NHS Trusts in England. This data is sourced from NHS England, and is published two months in arrears. Please note that some data may not be available. This could be because a) the Trust does not provide treatment for the selected condition, b) data has not been submitted, or c) some services (e.g. mental health) are not covered in the source data. -
Content Article
Preventable deaths tracker
Patient-Safety-Learning posted an article in Coroner reports
The Preventable Deaths Tracker was set up to explore concerns raised by coroners to prevent future deaths. The tracker aims to collate data, information and analysis arising from coroners reports and other investigations and make it accessible for all. It hopes to warn against repeat hazards and highlight important lessons, to improve public safety, reduce avoidable harms and prevent premature deaths. The tracker was originally developed with funding from the National Institute for Health Research (NIHR) School for Primary Care Research. -
Content Article
ABPI: What is legitimate interests? (9 December 2021)
Patient-Safety-Learning posted an article in Good practice
Disclosure UK is the Database on which all pharmaceutical companies abiding by the Association of the British Pharmaceutical Industry (ABPI) Code of Practice must disclose ‘transfers of value’ to healthcare professionals, other relevant decision makers and healthcare organisations in the UK. Where possible, companies do this by naming the individuals and organisations and according to GDPR law, companies must identify an appropriate lawful basis before they process an individual's information. This guidance document by the ABPI is aimed at pharmaceutical companies using Disclosure UK. It explains and promotes the choice of the basis of 'legitimate interests' for disclosure, with the aim of increasing transparency in the relationships between healthcare professionals, other relevant decision-makers and the industry. -
Content ArticleThis article, published by the Journal of Clinical Nursing, argues there can be no healthy patient safety culture where Datix or other electronic incident reporting systems (EIRS) are trivialised and weaponised. Nurses at every level can support and enable the blame free culture where nurses use Datix to genuinely promote patient safety. Follow the link below to download the full article. Other blogs you may also be interested in: “I’m going to Datix you” – a blog from Datix’s former chief executive and now chairman of Patient Safety Learning, Jonathan Hazan Silent witness: My experience when filing an incident report – newly qualified nurse describes what happened when she reported her first Datix for a serious incident. Marking your own homework – an anonymous blog
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Content ArticleThe Patient Safety Database (PSD), previously called Anesthesia Safety Network, is committed in the delivery of better perioperative care. Its primary goal is to make visible the lack of reliability of healthcare and the absolute necessity to build a new system for improving patient safety. They have begun by developing an open and anonymous incident reporting system focused on non-technical skills. Each quarter they summarise in their newsletter cases reported on the platform. Read the latest newsletter.
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Content Article
Uppsala Monitoring Centre: VigiBase
Patient Safety Learning posted an article in Adverse interactions
VigiBase is the Uppsala Monitoring Centre (UMC)’s starting-point for the journey from data to wisdom about safer use of medicines and wise therapeutic decisions in clinical practice. It is the driving-force at the heart of the work of UMC and the WHO Programme. The purpose is to ensure that early signs of previously unknown medicines-related safety problems are identified as rapidly as possible. VigiBase is the unique WHO global database of individual case safety reports (ICSRs). It is the largest database of its kind in the world, with over 20 million reports of suspected adverse effects of medicines, submitted, since 1968, by member countries of the WHO Programme for International Drug Monitoring. It is continuously updated with incoming reports. -
Content ArticlePennsylvania is the only state that requires acute healthcare facilities to report all events of harm or potential for harm. With over 3.6 million acute care event reports, the Pennsylvania Patient Safety Reporting System (PA-PSRS) is the largest repository of patient safety data in the United States and one of the largest in the world. This report analyses the serious events and incidents from the database.
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Content ArticleSince the Institute of Medicine’s 1999 report To Err is Human, it has been known that upwards of 100,000 deaths due to preventable medical errors occur each year. In the twenty years since then, little progress has been made in the way of reducing the number of these deaths and estimates now suggest between 200- 440,000 Americans are dying preventably each year. One major component many believe is lacking in the United States is a national agency that focuses on responsibility and accountability for patient safety. The Patient Safety Movement Foundation has published a white paper assessing the feasibility of creating a National Patient Safety Board to reduce preventable medical errors in facilities across the country.
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Content ArticleThis article describes the qualitative methodology developed for use in CIRAS (Confidential Incident Reporting and Analysis System), the confidential database set up for the UK railways by the University of Strathclyde. CIRAS is a project in which qualitative safety data are disidentified and then stored and analysed in a central database. Due to the confidential nature of the data provided, conventional (positivist) methods of checking their accuracy are not applicable; therefore a new methodology was developed – the Applied Hermeneutic Methodology (AHM). Based on Paul Ricoeur’s ‘hermeneutic arc’, this methodology uses appropriate computer software to provide a method of analysis that can be shown to be reliable (in the sense that consensus in interpretations between different interpreters can be demonstrated). Moreover, given that the classifiers of the textual elements can be represented in numeric form, AHM crosses the ‘qualitative–quantitative divide’. It is suggested that this methodology is more rigorous and philosophically coherent than existing methodologies and that it has implications for all areas of the health and social sciences where qualitative texts are analysed.
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Content ArticleAuthors of this article, published by Health Europa, argue that proactive patient safety and risk prevention are key to helping healthcare organisations surveil and mitigate global and local risks.
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Content Article
Acute Data Alignment Programme (ADAPt)
Claire Cox posted an article in Data and insight
The Acute Data Alignment Programme (ADAPt) is a joint programme between NHS Digital and the Private Healthcare Information Network (PHIN) which is looking to adopt common standards for data collections and performance measures across both the NHS and private healthcare. This will ensure that relevant information is consistently recorded and available so it can be more easily analysed and compared. The aims of ADAPt: To make it easier to monitor the quality and safety of services by including private healthcare data within healthcare reporting systems. To help staff keep accurate and complete records when a patient journey spans both private and public providers. To ensure transparency for patients by publishing comparable performance measures relating to quality of care and patient safety for both privately funded and NHS funded healthcare. To identify where the burden of data collection and reporting by NHS and private care providers can be reduced. Find out via the link below. -
Content Article
NHS Workforce Race Equality Standard (WRES)
PatientSafetyLearning Team posted an article in Health inequalities
The Workforce Race Equality Standard (WRES) is a set of metrics that would requires NHS organisations to demonstrate progress against a number of indicators of race equality, including a specific indicator to address the low representation of black and minority ethnic (BME) staff on Boards. NHS providers are expected to show progress against a number of indicators of workforce equality, including a specific indicator to address the low numbers of BME board members across the organisation. Follow the link below to find out more about WRES and to access the annual reports. -
Content Article
Monitoring joint replacement surgery (August 2019)
Claire Cox posted an article in Research, data and insight
Thousands of people have joint replacement surgery every year and the National Joint Registry gathers together data on the outcomes of these surgeries. This allows surgeons and hospitals to monitor the success of their operations and ensure that the devices used are safe and effective. Individuals can also use the Registry to inform themselves better about the surgery which they are having. This short video explains what data is used and, more importantly, how it is used to ensure best outcomes for patients. -
Content Article
Why do we need to talk about patient data?
Claire Cox posted an article in Actions in response to data
This short video, by Understanding Patient Data, shows people talking about why it's important to use patient data, and why we need to better explain the benefits and safeguards.
