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Found 322 results
  1. Content Article
    In this blog, Peter Provonost MD, Chief Quality and Transformation Officer at University Hospitals Cleveland Medical Center, offers advice about what patients and their families can do to prevent health risks associated with hospital stays. He looks ways to mitigate against medication errors, surgical errors, infections, blood clots and other medical complications.
  2. News Article
    A woman who feared she was having a heart attack said she spent nine days in a hospital staff room because of a shortage of beds. Zoe Carlin, 23, was admitted to Altnagelvin Hospital in Londonderry in March after experiencing severe chest pain. She said she spent more than a week in a “locker room” where she had to use a hand bell to call staff during what she described as a “dehumanising” ordeal. The Western Health and Social Care Trust (WHSCT) said it faced "extreme pressures" in its hospital emergency departments but could not comment on individual cases due to confidentiality. “For the full nine days I was in this alcove,” she told BBC Radio Foyle’s North West Today programme. “It’s basically the nurses' locker room. You can see the nurses’ lockers with their names on them. They [staff] just said there’s not enough beds,” she added. A privacy screen did not fully cover the room’s doorway and she had no access to a private bathroom. She said she was forgotten about at meal times on three occasions. A spokesperson for WHSCT said, "We are acutely aware of the continuing challenges and extreme pressures not just in our emergency departments but across both of our acute hospital sites with full escalation of beds on all wards and departments. In the Western Trust, when we learn of examples where care falls below the standard we expect, we review the circumstances and explore ways to improve care in the future." Read full story Source: BBC News, 11 April 2024
  3. News Article
    More than 150,000 patients had to wait a day in A&E before getting a hospital bed last year, according to new data. Freedom of information data compiled by the Liberal Democrats from 73 hospital trusts – about half the total – found that the number of patients forced to wait more than 24 hours in A&E before a bed could be found for them has increased by tenfold since 2019. The majority of those forced to wait were elderly or frail, with two-thirds of the patients over the age of 65. Read full story Source: Guardian 8 April 2024
  4. Content Article
    Following consultation, the Care Quality Commission have now published final guidance to help providers understand and meet the new fundamental standard on visiting and accompanying in care homes, hospitals, and hospices. The guidance (on Regulation 9A: visiting in care homes, hospitals, and hospices) also sets out what people using health and social care services and their families, friends or advocates can expect.
  5. Content Article
    Making hospitals more conducive to high quality sleep might benefit patient experience and wellbeing, and could perhaps even lead to reduced length of stay. Sleep is known to be closely connected to physical and mental health, and yet hospital environments are far from conducive to high quality rest. Noise, light, disturbances for treatment or tests, other patients, staff noise and temperature can all reduce the odds of a good night’s sleep. Overnight observations can also be extremely disruptive. At some trusts, efforts are being made to address this situation. The ultimate aim? Not only to improve the patient experience, but to potentially the speed with which they heal–so reducing the likes of length of stay. Others, meanwhile, are exploring whether supporting better sleep could even reduce the need for hospital admission in the first place.
  6. Content Article
    The National Safety Standards for Invasive Procedures (NatSSIPs) 2 are intended to help share learning and best practice to support multidisciplinary teams and organisations to deliver safer care. This two-page summary document, published by the Centre for Perioperative Care, provides a concise overview of NatSSIPs for anyone who does interventional procedures and the teams who support them.
  7. News Article
    Distressed elderly patients are being “treated like animals” and left begging for care as NHS staff struggle to cope with overwhelmed wards and an ever-increasing ageing population, an investigation by The Independent has revealed. Scores of families have come forward to share harrowing allegations of neglect as one top doctor warns that elderly people are receiving care “well below the standards they should expect” – including long waits in waiting rooms and “degrading” corridor care. In one shocking case, a 96-year-old patient admitted to the hospital with a urinary tract infection (UTI) was allegedly left semi-naked and delirious in his hospital bed – before choking on vomit after being sedated without his family’s permission, his daughter told The Independent. Another patient, 99, was traumatised after being left in a bed next to the body of a dead woman. The investigation was sparked by the horrific story of 73 year old Martin Wild who was left so desperate for pain medication he was forced to call 999 from his hospital bed. It comes as analysis by the Independent shows the government was warned three times last year by coroners over the increasing risk to elderly patients’ lives amid fears they are not being “effectively safeguarded”. Read full story Source: The Independent, 11 March 2024
  8. Content Article
    This article looks at US study showing that the simple act of a doctor sitting in a chair during hospital bedside discussions improves the experience for both doctors and patients. The research team examined whether educating internal medicine residents on the value of sitting and adding a wall-mounted folding chair in plain sight to hospital rooms would motivate doctors to use chairs. The study also measured the impact of whether this physician behaviour impacted patient perceptions. The results showed that: Education alone improved sitting frequency to 15%, but adding dedicated chairs for the clinicians in addition to any patient or visitor chairs improved sitting to 45%. In units where residents were given only education on the value of sitting, patients reported 49% of the time residents always spent enough time by the bedside with them, compared to 73% when a chair was available. In units with education only, 67% of the time residents always checked to ensure the patient understood everything, compared to 87% when a chair was present.
  9. News Article
    Left in agonising pain, with staff ignoring his cries for help, Martin Wild called 999 from his hospital bed, desperate for someone to get him the medication he needed. This was just the beginning of the 73-year-old’s “nightmare” experience at the hands of Salford Royal Hospital. Over nearly five months, the former car salesman says he was subjected to prolonged periods of neglect, including being left to lie in urine-soaked sheets, pleading for medication. He lost so much weight that, according to his wife, he became skin and bone. One staff member involved in his care said they’d never seen a hospital patient neglected to such a serious degree. Mr Wild told The Independent that his time at Salford Royal Hospital has shattered his belief in the NHS and that he believes it is not fit for purpose. “It was a nightmare in that ward. I didn’t feel like there was much caring going on,” he said. “I used to lie there at night; I could hear people shouting and screaming for help. It was like being in the third world.” Read full story Source: The Independent, 24 February 2024
  10. Content Article
    Corridor nursing is increasingly being used in the NHS as demand for emergency care grows and A&E departments struggle with patient numbers. In this anonymous account, a nurse shares their experience of corridor nursing, highlighting that corridor settings lack essential infrastructure and pose many safety risks for patients. They also outline the practical difficulties providing corridor care causes for staff, as well as the potential for moral injury.  Using the System Engineering Initiative for Patient Safety (SEIPS) framework, they describe the work system, the processes and how that influences the outcomes.
  11. Content Article
    In my 15 years focusing on developing drink thickening solutions for dysphagia patients, the intersection of dysphagia management and patient safety has become increasingly apparent. Dysphagia, or difficulty swallowing, presents not only as a significant health challenge but also as a critical patient safety issue. The condition's underdiagnosis, particularly in vulnerable populations, heightens the risk of severe complications, including choking, aspiration pneumonia, dehydration and the profound fear of choking that can lead to malnutrition.
  12. Content Article
    Prolonged stays in hospital can be bad for patients. Individuals who have longer hospital stays are at greater risk of falling and catching infections. Their physical and mental capabilities, including mobility, physical strength and awareness levels, may also be negatively impacted.  Increases in length of stay can also affect patients waiting for elective and emergency care. The NHS has limited ability to increase hospital capacity. Therefore, longer stays mean fewer patients can be admitted. This analysis from The Health Foundation, suggests that, despite accounting for just 9% of hospital admissions, COVID-19 is likely a key driver of the increase in length of stay. This suggests that whilst the impact of COVID-19 on hospital capacity was less severe in 2022 than during the peak of the pandemic throughout 2020 and 2021, it was still significant. As the government and the NHS in England look to recover waiting times, reduce the backlog and improve productivity, it is important to recognise the ongoing challenges posed by the virus.
  13. Content Article
    This study from Jalilian et al., published in the BMJ, evaluated the length of stay difference and its economic implications between hospital patients and virtual ward patients. It found that the use of a 40-bed virtual ward was clinically effective in terms of survival for patients not needing readmission and allowed for the freeing of three hospital beds per day. However, the cost for each day freed from hospital stay was three-quarters larger than the one for a single-day hospital bed. This raises concerns about the deployment of large-scale virtual wards without the existence of policies and plans for their cost-effective management.
  14. News Article
    Researchers have found the costs of treating patients in a 40-bed virtual ward were double that of traditional inpatient care. The study’s authors said the findings should raise concerns over a flagship NHS England policy, which has driven the establishment of 10,000 virtual ward beds. Virtual wards, sometimes described as “hospital at home”, are cited as a safe way to reduce pressure on hospitals, by reducing length of stay and enabling quicker recovery. The study at Wrightington Wigan and Leigh Teaching Hospitals, in Greater Manchester, found a clear reduction in length of stay but also found higher rates of readmission. The authors said this led to additional costs, with the cost of a bed day in the virtual ward estimated at £1,077, compared to £536 in a general inpatient hospital bed. “This raises concerns [over] the deployment of large-scale virtual wards without the existence of policies and plans for their cost-effective management. This evidence should be taken into consideration by [the] NHS in planning the next large deployment of virtual wards within the UK… “Virtual wards must be cost effective if they are to replace traditional inpatient care, the costs must be comparable or lower than the costs of hospital stay to be economically sustainable in the medium to long terms.” To break even, the paper said the virtual ward would need to double its throughput, but warned this would risk lowering the standard of care. Read full story (paywalled) Source: HSJ, 25 January 2024
  15. Content Article
    In this film the team at Leeds Teaching Hospitals NHS Trust provide an overview of Parkinson's and why it is important that medication is administered properly and on time. They also talk about improvements they have made in their own practice, and offer tips around medication management for Parkinson's.
  16. Content Article
    This staffing calculator has been developed by the US Association for Professionals in Infection Control and Epidemiology (APIC). The tool is in beta version and uses input from individual healthcare facilities to provide recommendations to assist with infection prevention staffing decisions. There are three separate calculators: Acute care hospital calculator Long-term care calculator Ambulatory clinic calculator As the tool is currently in development, the data collected from participating organisations will be used to update the calculators and provide the most accurate staffing recommendations.
  17. Content Article
    The Parkinson’s Excellence Network has launched three new practical guides to support UK health professionals to deliver time critical Parkinson’s medication on time in hospital.
  18. Content Article
    Improving Healthcare Safety by Enhancing Healthcare Facility Design is the third in a series of AHRQ publications that summarise the Agency for Healthcare Quality and Research's (AHRQ's) investments in patient safety research as a pathway toward safer care. This research has shown that optimising the physical, functional, and aesthetic details of healthcare facilities (e.g., units, rooms, equipment, logistics and technologies) can improve patient outcomes, reduce injuries and hospital-associated infections, and increase provider satisfaction.
  19. Content Article
    Hospitalised adults whose condition deteriorates while they are on hospital wards have considerable morbidity and mortality. Early identification of patients at risk of clinical deterioration has traditionally relied on manually calculated scores, and outcomes after an automated detection of clinical deterioration have not been widely reported. The authors of this article published in The New England Journal of Medicine developed an intervention program involving remote monitoring by nurses who reviewed records of patients who had been identified as being at high risk. Results of this monitoring were then communicated to rapid-response teams at hospitals. They compared outcomes among hospitalised patients whose condition reached the alert threshold at hospitals where the system was operational, with outcomes among patients at hospitals where the system had not yet been implemented. The authors found that using an automated predictive model to identify high-risk patients, for whom interventions could then be implemented by rapid-response teams, was associated with decreased mortality. 
  20. Event
    This conference focuses on developing systems and processes for locally driven ward and unit accreditation for quality. These approaches can be used as a tool to encouraging ownership of continuous quality improvement at ward, unit or service level, reduce variation and increase staff pride and team working within their practise. Through practical case studies of organisations that have successfully introduced locally driven ward and unit accreditation systems the conference will provide practical guide to implementing systems, and improving staff engagement in driving forwards improvement for the benefit of patients, service users and communities. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/virtual-online-courses/ward-accreditation-for-quality-conference or email kerry@hc-uk.org.uk. hub members receive a 20% discount. Email info@pslhub.org for discount code. Follow this conference on Twitter @HCUK_Clare #wardaccreditation
  21. Content Article
    This study in the Journal of Applied Research in Intellectual Disabilities aimed to  share rich detail of the emotional and physical impact on children and young people with intellectual disabilities of attending hospital, from their own and their parent's perspective. The authors found that the multiple and compounding layers of complexity surrounding hospital care of children and young people with intellectual disabilities resulted in challenges associated with loss of familiarity and routine, undergoing procedures, managing sensory overload, managing pain and having a lack of safety awareness. They concluded that an individualised approach to care is needed to overcome these issues.
  22. Content Article
    This report by the Royal College of Emergency Medicine presents insights about Emergency Department (ED) crowding in England. It highlights that overcrowding is a major threat to public health and outlines the reasons for overcrowding - primarily increasing patient demand coupled with high hospital bed occupancy, which has resulted in exit block.
  23. News Article
    Two young people facing mental health crises were left on paediatric wards for months while different agencies across a health system struggled to find appropriate placements. The patients – who were both autistic and had learning disabilities, with special educational needs – were admitted to Maidstone and Tunbridge Wells Trust (MTW) last year after attending emergency departments more than 10 times within a two-month period. They were left on a paediatric ward – one of the patients for four months – as this was the “only available place of safety as opposed to the optimum setting to meet their needs,” according to Kent and Medway Integrated Care Board’s “learning review” of children and young people with complex needs, which the two cases prompted. The review, which HSJ obtained under a Freedom of Information request, revealed several problems with joint working, despite a multidisciplinary team meeting regularly to discuss the young patients’ needs. Since the review, a new escalation process has been introduced, urgent mental health risk assessments in the community have been enhanced and a three-month pilot of a self-harm service has been implemented at Tunbridge Wells Hospital, part of MTW. Read full story (paywalled) Source: HSJ, 17 November 2023
  24. News Article
    Hospitals are being prevented from adopting models which spread risk away from emergency departments because other teams refuse to take on the extra work, according to a top accident and emergency doctor. In a recent interview with HSJ, North Bristol Trust chief executive officer Maria Kane praised her trust’s risk-sharing approach to emergency care, which involves moving patients each hour from accident and emergency to the most appropriate ward for their needs and where a discharge is expected, even if it is full. Commenting on the article, Royal College of Emergency Medicine president Adrian Boyle said: “The NBT trust leadership deserve significant credit for maintaining this. All too often there is an acceptance of unacceptable delays (and risk) in ambulance handovers and long ED stays. “Where this fails, it is usually because inpatient teams (both nursing and medical) have objected to the extra workload, without appreciating the real harm elsewhere. The more interesting question is why isn’t this being done more widely?” Read full story (paywalled) Source: HSJ, 15 November 2023
  25. Content Article
    This blog calls for action on the careful review of established pain medication when a patient is admitted to hospital. Richard describes the experience of two elderly patients who suffered pain due to their long term medication being stopped when they were admitted to hospital. Pain control needs must not be ignored or undermined, there needs to be carer and patient involvement and their consent, and alternative pain control must be considered.
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