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Found 309 results
  1. Content Article
    Incorporating parental values in complex medical decisions for young children is important but challenging. This review in The Lancet Child & Adolescent Health explores what it means to incorporate parental values in complex paediatric and perinatal decisions. It provides a narrative overview of the paediatric, ethics and medical decision-making literature, focusing on value-based and ethically complex decisions for children who are too young to express their own preferences. 
  2. Content Article
    Decisions to admit older, frail patients to critical care must pay particular attention to quality of life and the potential burden of care on patients. This burden may extend beyond surviving a critical illness. These decisions are not easy and require careful thought, clinical judgment, and communication write Daniele Bryden and colleagues in this BMJ opinion piece. 
  3. Content Article
    Nontechnical skills (NTS) are the behaviours and thought processes used by surgeons to make decisions, maintain awareness of the operating environment, communicate with and lead team members with the view to producing reliably safe outcomes. This qualitative research explored how surgeons deploy NTS to facilitate safe and effective outcomes from surgical interventions. The authors conclude that successfully understanding and engaging NTS is potentially more proactively useful to surgeons than feedback from more invasive techniques used by some approaches to safe operator assurance.
  4. Content Article
    Emergency general surgery (EGS) involves care and treatment of a patient's often previously unknown disease in an unplanned interaction with the healthcare system. This leads to challenges in collecting and interpreting patient reported outcome measures (PROMs). This study in the American Journal of Surgery aimed to capture the peri-operative experiences of 30 patients at 6 to 12 months after their treatment. The authors found that: two-thirds reported feeling no choice but to pursue emergency surgery with many reporting exclusion from decision-making. Females reported these themes more commonly. patients with minor complications less frequently reported trust in their team and discussed communication issues and delays in care. patients with major complications more frequently reported confidence in their team and gratefulness, but also communication limitations. patients not admitted to the ICU more frequently discussed good communication and expeditious treatment.
  5. Content Article
    This study examines the prevalence of advanced care planning (ACP) for patients undergoing endoscopic, fluoroscopic, laparoscopic or open surgical gastrostomy tube procedures at an academic hospital in the USA. The authors found that only 10.6% of included patients had accessible ACP documents available within their electronic medical record (EMR) and that Black patients had lower rates of ACP documentation. They also highlight an association between ACP documentation and decreased hospital length of stay, with no difference in mortality. The authors recommend the expansion of ACP in perioperative settings.
  6. Content Article
    Join Alan Lindemann, an obstetrics-gynecology physician, who shares his insights and real-life experiences, shedding light on the issues surrounding patient care, medical decision-making, and the role of institutions and personal connections in shaping health care outcomes. Discover how the pursuit of quality care can sometimes be obstructed by self-interest and the need to protect reputations. Alan also proposes innovative ideas to enhance transparency and public involvement in health care quality assurance.
  7. Content Article
    In this infographic, the Patient Safety Commissioner for England, Dr Henrietta Hughes, sets out her strategy for supporting the development of a new culture for the health system centred on listening to patients.
  8. Content Article
    This paper addresses the fundamental discipline theoretic question of whether situation awareness is a phenomenon best described by psychology, engineering or systems ergonomics. Each of these disciplines places a different emphasis on the notion of what situation awareness is and how it manifests itself. Each of the perspectives is presented and compared with reference to studies in aviation and other domains.
  9. Content Article
    The Academy for Healthcare Science is the single overarching body for the entire UK Healthcare Science (HCS) workforce, working alongside the healthcare science professional bodies, and also professionals from the life science industry and clinical research practitioners, helping to strengthen the visibility of the contribution of those workforces. Could you play an important role by becoming a Lay Assessor for the Academy for Healthcare Science? Are you able to demonstrate professionalism and strong interpersonal skills? Do you have a sound understanding of assessment principles and a keen sense of objectivity and consistency? Then this may be the perfect opportunity for you. Follow link for full role description and how to apply. Deadline: 31 January 2024
  10. Content Article
    This leaflet aims to help people with type 1 diabetes decide between the different technologies available to manage diabetes. It contains summaries of devices available and infographics outlining eligibility criteria for continuous glucose monitors (CGM), insulin pumps and hybrid-closed loop systems. Diabetes care is one of the five clinical areas of focus for integrated care boards and partnerships to achieve system change and improve care as part of Core20Plus5 for children and young people with the aim to increase access to real-time continuous glucose monitors and insulin pumps across the most deprived quintiles and from ethnic minority backgrounds.
  11. Content Article
    People with diabetes often encounter stigma in the form of negative social judgments, stereotypes and prejudice, which can adversely affect emotional, mental and physical health, self-care, access to healthcare and social and professional opportunities. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination due to diabetes in healthcare, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. To help achieve this, an international multidisciplinary expert panel conducted rapid reviews and participated in a three-round Delphi survey process. The group achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility and fear or disgust.
  12. Content Article
    Hospitals are complex adaptive systems. They are industrial environments where it isn't always possible to expect predictable responses to inputs. Patient safety management practices need to adapt to align with the environment in which events occur. It is time to reimagine safety event reporting and management solutions that guide, not prescribe, investigations and improvement actions.
  13. Event
    Aimed at Clinicians and Managers, this national virtual conference will provide a practical guide to human factors in healthcare, and how a human factors approach can improve patient care, quality, process, and safety. The conference delves into integrating human factors into healthcare systems and processes, clinical decision making, healthcare system design, quality of patient experience, medication safety, and workload, fatigue, and stress management. Throughout the day, there will be interactive sessions, small breakout groups, and collaborative exercises, fostering a dynamic learning experience. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/virtual-online-courses/a-practical-guide-to-human-factors-in-healthcare or email kate@hc-uk.org.uk hub members receive a 20% discount. Email info@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #HumanFactors
  14. Content Article
    The relationship between management and the workforce, in very simplistic terms, can be considered one of reward in return for effort. The contracted effort is communicated through a roster. In organisations that have a continuous operation, blocks of effort are distributed to maintain the flow of output. The organisation of effort, then, is a legitimate function of management.  Norman's previous blog looked at performance variability under normal conditions. In this blog, Norman looks at the impact of physiological states and how management’s organisation of effort degrades decision-making.
  15. Content Article
    This toolkit from the Institute from Healthcare Improvement (IHI) equips patient safety and finance leaders with tools and a collaborative approach to make a compelling business case for organizational investments to advance patient and workforce safety initiatives.
  16. News Article
    The nursing watchdog will miss its target to tackle a 5,500-case backlog of complaints as referrals hit a record high. The Nursing and Midwifery Council NMC has admitted it won’t hit its pledge to cut the number of unresolved complaints against nurses and midwives to 4,000 by March 2024. The news comes as it faces questions over the way it handles complaints after The Independent revealed a number of serious allegations, including poor investigations that have led to fears of rouge nursing going unchecked. The newspaper exposes have prompted two independent reviews. Details of the first two reviews have been revealed for the first time and will look at: The NMC’s response to whistleblower concerns, including whether they were treated fairly and whether it acted fairly and reasonably. Any evidence of cultural issues which may have impacted the NMC’s response to whistleblowing. Whether concerns raised are substantiated and indicate a decision-making process by the NMC which is insufficient in protecting the public. Evidence of shortcomings in guidance and training. The senior whistleblower whose evidence prompted the review said: “The NMC has refused to change its approach to the investigations into my whistleblowing concerns to allow me to share and explain my evidence without fear of reprisal. I don’t think it is possible to draw safe conclusions about either how I have been treated or the impact of our culture on case work from reviewing only 13 of our current 5,500 open cases, and 6 closed cases and a selection of my emails.” Read full story Source: The Independent, 16 November 2023
  17. Content Article
    A pulmonary embolism happens when a blood clot breaks off and travels to the lungs where it blocks the flow of blood. Although life-threatening, when diagnosed promptly survival rates are good. This report from the Parliamentary and Health Service Ombudsman (PHSO) looks at the case of a man who died of a pulmonary embolism after doctors failed to test for deep vein thrombosis.
  18. Content Article
    The depleting effect of repeated decision making is often referred to as decision fatigue. Understanding how decision fatigue affects medical decision making is important for achieving both efficiency and fairness in health care. In this study, Persson et al. investigate the potential role of decision fatigue in orthopaedic surgeons' decisions to operate, exploiting a natural experiment whereby patient allocation to time slots is plausibly randomised at the level of the patient. The results show that patients who met a surgeon toward the end of his or her work shift were 33 percentage points less likely to be scheduled for an operation compared with those who were seen first. In a logistic regression with doctor-fixed effects and standard errors clustered at the level of the doctor, the odds of operation were estimated to decrease by 10.5% for each additional patient appointment in the doctors' work shift. This pattern in surgeons' decision making is consistent with decision fatigue. Because long shifts are common in medicine, the effect of decision fatigue could be substantial and may have important implications for patient outcomes.
  19. Content Article
    In this article, published by Psychology Today, Eva Krockow looks at research questioning the notion that we can run out of willpower. Key points:Decision fatigue describes a depletion of choice quality with repeated decision-making.Previous studies suggested people make poorer choices late in the day, possibly affecting healthcare outcomes.Recent findings question the existence of decision fatigue and suggest a self-fulfilling prophecy.Read the full article via the link below.
  20. News Article
    ‘Chronic short-termism’ by government is undermining the nation’s ability to respond to another pandemic, a previous NHS England chief executive has said. In his first written statement to the covid public inquiry, Lord Stevens said ministers had failed to upgrade NHS infrastructure and modernise social care, delayed public health improvements, and cut testing and research programmes. This is despite the 2023 national risk register identifying a further pandemic as the highest risk, with “5-25%pa Lord Stevens – NHSE CEO from 2014 to summer 2021 – said it was “encouraging the government has now permitted NHS England to publish a funded long-term workforce plan”, but added: “There is also a strong case for revisiting several other national decisions. “These include the dismantling of some community infection surveillance infrastructure; cancelling some scientific and clinical research programmes developed during the pandemic; postponing various preventative health measures; deferring reform of social care; and further delaying upgrades of health buildings, equipment and technology.” Read full story (paywalled) Source: HSJ, 3 November 2023
  21. Content Article
    This study from Allan et al. investigates whether nurses working for a national medical telephone helpline show evidence of “decision fatigue,” as measured by a shift from effortful to easier and more conservative decisions as the time since their last rest break increases. The study found that for every consecutive call taken since last rest break, the odds of nurses making a conservative management decision (i.e., arranging for callers to see another health professional the same day) increased by 5.5% from immediately after 1 break to immediately before the next. Decision-making was not significantly related to general or cumulative workload (calls or time elapsed since start of shift). The authors concluded that every consecutive decision that nurses make since their last break produces a predictable shift toward more conservative, and less resource-efficient, decisions. Theoretical models of cognitive fatigue can elucidate how and why this shift occurs, helping to identify potentially modifiable determinants of patient care.
  22. Content Article
    Artificial intelligence, as a nonhuman entity, is increasingly used to inform, direct, or supplant nursing care and clinical decision-making. The boundaries between human- and nonhuman-driven nursing care are blurred with the advent of sensors, wearables, camera devices, and humanoid robots at such an accelerated pace that the critical evaluation of its influence on patient safety has not been fully assessed. Since the pivotal release of To Err is Human, patient safety is being challenged by the dynamic healthcare environment like never before, with nursing at a critical juncture to steer the course of artificial intelligence integration in clinical decision-making. This paper presents an overview of artificial intelligence and its application in healthcare and highlights the implications which affect nursing as a profession, including perspectives on nursing education and training recommendations. The legal and policy challenges which emerge when artificial intelligence influences the risk of clinical errors and safety issues are discussed.
  23. Content Article
    Paula Goss had surgery to implant rectopexy and vaginal meshes which left her with severe pain and other serious complications. In this blog, Paula talks about why she set up Rectopexy Mesh Victims and Support to campaign for adequate treatment, redress and justice for people injured by surgical mesh. She outlines the need for greater awareness of mesh injuries amongst both healthcare professionals and the public and talks about what still needs to be done to enable people to access the treatment and support they need.
  24. Content Article
    Orchard Care Homes had noticed high numbers of antipsychotic medicines being prescribed to people living with dementia. There appeared to be little consideration of why these people were distressed and communicating this through behaviour. Orchard staff were convinced pain was a key factor in these distress responses—they were not necessarily because the person had a diagnosis of dementia. Orchard adopted PainChek, a digital pain assessment tool, in 2021 to support their dementia promise framework. They worked with the PainChek team and ran a pilot with the app. They were one of the first care providers to use this solution in the UK. It was originally launched it in one of their specialist dementia care communities, but is now in all 23 Orchard homes. Since the rollout of the app, there has been an increase in available pain relief and a decrease in conflict-related safeguarding referrals. There is increased time available for colleagues and a reduction in polypharmacy. There has been a 10% decrease in antipsychotic medicine use across all 23 homes, promoting a greater quality of life. People now have effective pain management plans. Orchard have also been able to ensure distress plans are in place which firstly considers if pain is the cause of distress. This case study was submitted to the Care Quality Commission's (CQC's) Capturing innovation to accelerate improvement project by Orchard Care Homes.
  25. Content Article
    In this episode of OVIDcast, Rachael Stewart, Deputy Head of Patient Partnerships at OVID Health continues the conversation with Rachel Power, Chief Executive of the Patients Association as they explore the role of patients in partnerships with both healthcare professionals and life science companies as well as how two award-winning projects focused on working directly with patients to improve shared decision-making.
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