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Found 332 results
  1. Content Article
    A common administrative framework of healthcare involves focus upon costs, quality and patient satisfaction—this is known as The Triple Aim.  However, this framework does not allow the experience and human factors of providing care to be integrated into high-level decision making. This report describes the process of transition from The Triple Aim to The Quadruple Aim administrative framework of healthcare delivery at the University of Rochester Medical Center, which resulted in an integrative model of patient safety and clinician wellbeing. Developing the fourth aim of improving the experience of providing care was widely accepted and aligned with other health system goals of optimisation of safety, quality and performance by applying a human factors/ergonomic (HFE) framework that considers human capabilities and human limitations.
  2. Content Article
    It is well known that the NHS is suffering from staff shortages, with 121,000 full-time equivalent (FTE) vacancies and only 26% of the workforce stating there are enough staff at their organisation. The reasons why staff are leaving are well documented (burnout, lack of work–life balance, low pay etc), and the direct impact on patients is obvious – staff shortages are one of the main reasons why there is a backlog of care. But these headlines mask nuance. They hide the areas where staff shortages are even more acute than the average, and they obscure the indirect impact on patients. Where are these areas, what are the impacts, and will the NHS Long Term Workforce Plan help?
  3. Content Article
    Doctors in Distress is a UK-based independent charity that promotes and protects the mental health of all healthcare workers and prevents suicides in the medical profession. It was set up in 2018 by Amandip Sidhu following the suicide of his brother Jagdip, a consultant cardiologist, with the aim of providing support for healthcare staff facing burnout and mental health difficulties. The charity runs free online support groups and webinars for healthcare professionals and students. Previous webinars can be viewed on the Doctors in Distress YouTube channel.
  4. Content Article
    In 2023, the Royal College of Surgeons of England surveyed the UK surgical workforce to identify the key challenges facing surgical teams and to inform workforce planning. Respondents included consultants, surgeons in training, Specialist, Associate Specialist and Specialty (SAS) surgeons, Locally Employed Doctors in surgery (LEDs) and members of the extended surgical team (EST).   Advancing the Surgical Workforce reveals a number of interesting insights and paints a picture of a surgical workforce working long hours and in stressful environments. Too many staff are trying to navigate a system which frustrates the delivery of surgical services rather than enabling them. Surgical trainees in particular are increasingly being affected by these pressures. 
  5. Content Article
    The current challenges in the NHS are leading to staff burnout and staff leaving their jobs. In a new blog, hub topic lead Sally Howard asks us to take a few minutes out of our day to day work to reflect and re-calibrate.
  6. Content Article
    This project aimed at understanding and tackling the barriers to sufficient hydration, breaks and refreshment facilities for NHS staff. Sherwood Forest Hospitals NHS Foundation Trust was keen to introduce the Royal College of Nursing's (RCN) rest, rehydrate and refuel initiative, and did so through a project led by one of the chief nurse clinical fellows. First, staff were surveyed to understand the current situation and any barriers they may face. This was followed by a trial on two pilot wards, before roll our of a trust-wide campaign.
  7. News Article
    Half of surgeons in England have considered leaving the NHS amid frustration over a lack of access to operating rooms, a new survey shows. More than 3,000 surgeons contemplated quitting the health service in the last year, with two-thirds reporting burn out and work-related stress to be their main challenge, a new survey by the Royal College of Surgeons England has revealed. As the NHS tries to reduce the 7.61 million waiting list backlog, the survey, covering one quarter of all UK surgeons, found that 56% believe that access to operating theatres is a major challenge. RCS England president, Mr Tim Mitchell, said: “At a time when record waiting lists persist across the UK, it is deeply concerning that NHS productivity has decreased. “The reasons for this are multifactorial, but access to operating theatres and staff wellbeing certainly play a major part. If surgical teams cannot get into operating theatres, patients will continue to endure unacceptably long waits for surgery. “There is an urgent need to increase theatre capacity and ensure existing theatre spaces are used to maximum capacity. There is also a lot of work to be done to retain staff at all levels by reducing burnout and improving morale.” Read full story Source: The Independent, 18 January 2024
  8. Event
    This Hospital at Night Summit focuses on out of hours care in hospitals delivering high quality safe care at night and supporting the wellbeing of those working at night. Through national updates, networking opportunities and case studies this conference provides a practical guide to delivering a high-quality hospital at night service and transforming out of hours services and roles to improve patient safety. The 2024 conference will focus on developing an effective Hospital at Night service and focus on the practicalities of supporting staff at night, improving wellbeing, and fighting fatigue. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/virtual-online-courses/hospital-at-night-summit or email aman@hc-uk.org.uk hub members receive a 20% discount code. Email info@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #HospitalAtNight
  9. Content Article
    In the USA, Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions (WHRs) are intended to improve patient safety by reducing resident doctor fatigue. However, compliance with ACGME WHRs is not universal. This study aimed to identify factors that influence resident doctors' decisions to take a post-call day (PCD) off in line with ACGME WHRs. The authors concluded that as most important influencer of residents’ decisions to take a PCD off was related to feedback from their supervisors, compliance with WHRs can be improved by focusing on the residency program’s safety culture.
  10. 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
  11. Content Article
    In this article, Natalie Tikhonovsky, Analyst at Lane, Clarke and Peacock, looks at results from the 2022 NHS Staff Survey in order to identify the reasons staff are increasingly dissatisfied. The article contains graphics that visualise this data to demonstrate a mixed picture of staff satisfaction across England.
  12. 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.
  13. Content Article
    This rapid evidence review and economic analysis makes the business case for investing in the wellbeing of NHS staff. It was written by a team from the University of East Anglia, RAND Europe and the International Public Policy Observatory (IPPO) and includes a narrative review of data on the current state of the mental health and wellbeing of NHS staff. Data shows that nearly half of staff reported feeling unwell as a result of work-related stress in the most recent survey, that sickness absence has increased and that there are high vacancy and turnover rates in some trusts. Research also shows that patient care can be affected by poor healthcare staff wellbeing. 
  14. News Article
    An overworked nurse who failed to give medication to a patient told a colleague “I don’t care anymore”, a hearing was told. Niall O’loingsigh was lead nurse in the Avon unit within the Charterhouse Care Home in Keynsham, Somerset, which looks after elderly residents and those with dementia. In 2020 a complaint was made by a colleague about him breaching safe medication management protocols and being dishonest in relation to medication administration. A misconduct hearing at the Nursing and Midwifery Council was told later, in May 2021, he was seen behaving in an “unsupportive manner” and told a colleague: “I don’t care anymore”. The panel also heard how on 18 May 2021, Mr O’loingsigh failed to record he had administered medication to three residents, BristolLive reported. A colleague wanted to report Mr O’loingsigh’s conduct, in which Mr O’loingsigh patted her on the back and said “well done mate, you did the right thing but I may lose my PIN though”. Mr O’loingsigh told his colleague of feelings of distress and anxiety about being reported and its impact on his career, but he wanted to reassure her. The colleague however felt “uncomfortable”. The panel found that he underwent “a course of conduct which put patients at risk of suffering harm at the time of the incidents” and noted “there were repeated failures over a period of time”. Read full story Source The Mirror, 10 December 2023
  15. News Article
    NHS staff are carrying out the equivalent of one 'never-event' every day, figures show. This is despite the Government ordering a crackdown on the mistakes, which cost hospitals an estimated £800million in compensation each year. Experts today demanded further action on 'unacceptable' levels of never-events, blaming inadequate staffing levels and a lack of investment in the NHS. A MailOnline audit of a decade's worth of NHS data found a colossal 4,328 never-events have occurred in England since 2013. This equates to roughly eight a week. Shocking incidents uncovered include women getting parts of their reproductive anatomy cut out instead of an appendix, men getting unwanted circumcisions and laser procedures to the wrong eye. The Royal College of Surgeons said the level of never-events was 'unacceptable' and blamed NHS staffing levels for increasing the risk to patients. "Surgeons will be working hard to do their best for patients, but they do so in difficult circumstances," a spokesperson said. "The NHS is overstretched, with staff shortages, a workforce suffering from burn-out and pressure to get record waiting times down. "This increases the risk of mistakes happening." Read full story Source: MailOnline, 10 October 2023
  16. News Article
    A growing number of doctors plan to leave the profession due to burnout and dissatisfaction, the General Medical Council has said, highlighting fears that the government’s long-term strategy for the NHS may have come too late. The GMC’s annual report on the medical workforce said the benefits of measures announced by the government in the NHS long-term workforce plan in June, such as the ambition to create more medical school places, “will only start to be seen a decade from now”. The report found that the number of licensed doctors increased in 2022, with 23,838 joining and 11,319 leaving. However, it said there were “still high vacancy rates and workforce pressure”, and that the rate of doctors leaving the profession was returning to pre-pandemic levels, at 4% last year. The GMC warned there were “worrying signs” that a growing number “plan to leave the profession as a result of high levels of dissatisfaction and high risk of burnout”. It added that there may be “a limited window of opportunity to address current issues” before more medics leave. Read full story Source: The Guardian, 12 November 2023
  17. 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.
  18. 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.
  19. News Article
    A locum responsible pharmacist has been issued a warning after a patient died when he dispensed the wrong strength of oxycodone during a staffing crunch, the regulator has revealed. Paresh Gordhanbhai Patel supplied 120mg rather than the prescribed 20mg of oxycodone hydrochloride to an “elderly” patient while working two locum shifts as responsible pharmacist at Crompton Pharmacy at Whitley House Surgery in Chelmsford. After taking one tablet, the patient died from an “accidental” oxycodone “overdose”, the General Pharmaceutical Council’s (GPhC) fitness-to-practise (FtP) committee heard at a hearing held on 11-13 September. Mr Patel admitted that he was “stressed and overtired” when he failed to notice a “discrepancy” between the prescribed strength of oxycodone and what he ordered and dispensed, The regulator heard that Mr Patel was “over-conscientious” and felt compelled “at a human level” to help out at the under-staffed pharmacy, despite the fact that it was “not safe to do so”, it added. Mr Patel admitted that his errors “amounted to misconduct” and conceded to the committee that his fitness to practise was “impaired” because he “breached one of the fundamental principles of the pharmacy profession.” The regulator heard that Mr Patel had “immediately” admitted his mistake to the pharmacy and did so again at the coroner’s inquest, where he also publicly apologised to the patient’s family. Read full story Source: Chemist and Druggist, 12 October 2023
  20. Event
    until
    This session is aimed at understanding what causes burnout, the impact and how to prevent/overcome it. Listening to stories from 2 Doctors and understanding the emotions, impact and consequence of burnout can help others look out for the signs and try to prevent it. Through talking and opening up, we hope to raise the awareness of burnout. It is real, can cause trauma and is linked to our wellbeing needs in the workplace. Guest speakers are: Dr Jess Morgan, Paediatrician Dr Chris Healey, Gastroenterologist Please join this session to learn from each other, listen and talk about wellbeing needs in the workplace. This is an open session to everyone, it will be healthcare based but is transferable. It is a free space and a social movement that has one agenda: To help staff flourish in the workplace. Sign up for the session. Joining instructions for this virtual event will be emailed directly to you closer to the date The basic needs at work campaign is based on research and simple QI methodology to address basic needs. It doesn't need to be complicated, but it does need to stick! The Basic Needs at Work resources can be found here
  21. Content Article
    This paywalled article, published in Advanced Critical Care, notes that ten years after the publication of a landmark article in AACN Advanced Critical Care, alarm fatigue continues to be an issue that researchers, clinicians, and organisations aim to remediate. 
  22. News Article
    The number of doctors seeking help for mental health issues has risen by more than three quarters within two years, according to figures from a specialist treatment service for NHS staff. For one GP, the relentless stress of the job led to him taking three months off work with burnout. David Triska is no stranger to high-pressure situations. As an army medic, he served two tours of Afghanistan. But mounting workloads at his village GP surgery left him feeling "hollowed out and spent". Simple tasks, like unlocking his car or making a meal, became a challenge - an experience he describes as leaving him feeling "like a husk of a human". "At that extreme point, I couldn't see why I needed to be here anymore," Dr Triska said. He is not alone. Since the year ending March 2021, there has been a 77% rise in the number of doctors seeking help for mental health issues, according to figures shared with the BBC by a confidential support service for NHS staff. More than 5,600 doctors used the NHS Practitioner Health programme in England in 2022/23, with about a third having thought about taking their own lives. Read full story Source: BBC News, 5 October 2023
  23. Content Article
    Shift work can introduce additional health, safety and wellbeing challenges. This article explore some of these challenges, including the increased risk of injury or illness, sleep and fatigue problems, psychological health, and suggest ways you can ensure safe and healthy shift work.
  24. News Article
    Steve Gulati, Associate Professor and Director of Healthcare Leadership at HSMC (University of Birmingham) discusses the concept of "time to care" within healthcare. A UK-wide poll of healthcare workers revealed that most NHS staff think they have too little time to help patients and the quality of care that services provide is falling. This reported reduction in the time to care is perhaps inevitable after almost a decade of health funding failing to keep up with increases in demand, and is a cause for concern for all of us – patients, carers or those working in the NHS. Where does this fit in to the wider picture – and can anything be done about it? It is not just NHS workers who are feeling the pinch – levels of public satisfaction with the NHS are at an all-time low. Interestingly, the two most cited reasons relate to access (difficulties or delays in getting appointments) and, tellingly, to staff shortages. Even against this gloomy backdrop, the collectivised funding model upon which the NHS is founded continues to find significant public support. All of this points towards a painful congruence – NHS staff feel that they do not have enough time to care, and the public is noticing. Is ‘time to care’ an outdated concept, harking back to an age of long patient stays, a paternalistic bedside manner and unrealistic expectations? Both staff and patient experience suggest not. Although technology plays an increasing role in healthcare diagnostics, treatment and recovery, delivering care remains a deeply human phenomenon and is essentially a relational and personal task. Recognising that frontline healthcare workers need time to care is not a new phenomenon. Influenced by service improvement methodologies, the ‘productive ward’ initiative in the mid-2000s placed an explicit emphasis on using efficiency techniques for the express purpose of releasing nursing staff to have “time to care”. It was acknowledged that productivity was more than metrics around bed occupancy and throughput, for example, and that the driving purpose of service improvement was to time to care. Whilst research indicated a nuanced impact, the principle is long recognised. If solutions to these problems were easy, they would have been implemented by now. There is no doubt that on one level, it really is a matter of resources – no system can carry a vacancy factor of around 10% for any length of time without there being an evident impact. However, even within an environment of constrained resources, choices are made every day by caregivers and leaders alike about what receives attention and what is allowed to move into the ‘important but not urgent’ category. That is in no way to blame the hard-pressed caregivers, but instead to indicate that even when it really does not feel like it, every individual has a level of agency. Feeling as though one does not have time to do one’s job is, put simply, unpleasant for all workers but should especially concern us in care environments. The impact on clinical safety and quality is an obvious starting point, but it is also important to recognise the impacts on care workers themselves with regard to emotional labour and the impact on the psychological contract that working in a caring profession, when people feel that they don’t have enough time to care, must have. As eloquently stated by the Vice-President of the Royal College of Physicians in Wales, it is “…very clear that good clinicians, be they nurses, doctors, therapists or pharmacists, need time to train, time to care and time to rest”. Even in challenging times, self-care and compassionate, values driven leadership can make a difference. Caring is everyone’s business. Link to original article: https://www.birmingham.ac.uk/news/2023/healthcare-workers-need-more-time-to-care
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