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Found 27 results
  1. Event
    PPPs 2024 Cancer Care programme kicks off with this report launch webinar on AI in Imaging Diagnostics. While discussions concerning artificial intelligence (AI) have come to dominate public discourse since the launch of ChatGPT last year, in healthcare, AI has been the subject of intense debate for some time. Many of the key talking points that define the debate in healthcare echo that of its wider implications, namely the unintended consequences of unleashing unregulated algorithms across the sector and the potentially profound implications AI could have upon workforces globally. However, it is perhaps in healthcare where AI stands to make its greatest and most positive impact. Healthcare is a data-rich industry, with the treatment of patients leading to the production of vast amounts of medical records, images, lab results, and numerous other data outputs. This multimodal data can be used to train a wide range of AI systems, leading to the development of new, more targeted drug treatments and diagnostic tools, more personalised care, and a more efficient healthcare system. Join an expert panel as they help to launch PPPs newest report exploring what it takes to begin implementing AI at scale in imaging diagnostics in the NHS. Register for the webinar
  2. News Article
    A Norfolk hospital trust has been fined £60,000 after pleading guilty to criminal charges of exposing a 28-year-old patient who died to significant risk of avoidable harm. Queen Elizabeth Hospital King’s Lynn Foundation Trust was sentenced on Thursday 8 December at Chelmsford Magistrates’ Court, as a result of a prosecution brought by the Care Quality Commission. The dilapidated hospital’s “outdated” computer system, which is long overdue a major upgrade, was cited as a factor in the young patient’s death, which followed a mix-up over scans. Lucas Allard, who was awaiting heart surgery, had attended the hospital’s emergency department on 12 March 2019 with chest pain. He was sent home after staff determined his computerised tomography scan results meant he was fit for discharge. But two days later, a consultant discovered staff had been looking at the wrong scan, and the correct report showed significant abnormality. Mr Allard was urgently called back to the hospital but suffered a cardiac arrest shortly after arriving, and died despite attempted resuscitation. Read full story (paywalled) Source: HSJ, 9 December 2022
  3. Content Article
    In July 2022, HSIB launched a national investigation into the safety risk of clinical investigation booking systems failures. Specifically, the investigation explores the use of paper or hybrid booking systems and the production of appointment letters. This interim bulletin highlights a safety risk identified by the investigation and presents a safety observation for the attention of NHS care providers. Some vital NHS services still use paper-based or hybrid systems, which may have been developed over time and could leave unintended gaps where patients can be lost in the system. The reference case for this investigation is the experience of a patient whose magnetic resonance imaging (MRI) scan was not rescheduled following a cancellation, leading to a delay in the diagnosis of cancer. Hybrid systems were in use, which did not assist staff to keep track of patients. Additionally, the hybrid systems in use did not allow appointment letters in non-English languages to be produced.
  4. Content Article
    This letter from Dr Robert Farley, President of the Institute of Physics and Engineering in Medicine (IPEM) to Karen Reid, the Chief Executive Officer of NHS Education for Scotland (NES) highlights that lack of funding for Clinical Scientist training places is putting patient safety in Scotland at risk. Dr Farley says, "We understand NHS Education for Scotland are proposing funding that equates to less than a single training post in medical physics and clinical engineering in 2023. ‘This is despite the Scottish Government's Chief Healthcare Science Officer’s public acknowledgement of the importance of training. "Scotland currently has a 10 per cent Clinical Scientist vacancy rate across the medical physics specialisms. This equates to seven vacancies in radiotherapy, three in nuclear medicine, four in diagnostic radiology and radiation protection. These posts are critical to supporting diagnostics and cancer treatments."
  5. Content Article
    This article looks at how Sheba Medical Center in Tel Aviv, one of the largest health systems in the region, has used artificial intelligence to turn around statistics on patient safety. In 2016, the Accelerate Redesign Collaborate Innovation Center at Sheba launched a an AI solution called Aidoc to read CT scans. It is being used to more accurately predict stroke and pulmonary embolism, allowing healthcare professionals to offer preventative treatment more quickly that when CT scans are read purely manually.
  6. News Article
    Ultrasound scans for around 1,800 patients have had to be reviewed over concerns about the “quality and safety” of work carried out by two sonographers employed by an independent provider. The two sonographers were employed by Bestcare Diagnostics. The company held an “any qualified provider” contract for non-obstetric ultrasound scans with Coastal West Sussex Clinical Commissioning Group (CCG) from April 2017. This contract was suspended in September 2018 over what the CCG said were “quality issues”. However, new information came to light in spring 2019 and the CCG decided to review all 1,800 patients seen by the pair, who worked for the company between April and August 2018. The CCG said scans for these patients were reviewed and, wherever possible, the patients were contacted. A second stage of the review will look at whether any harm was caused to the patients. Read full story (paywalled) Source: HSJ, 20 February 2020
  7. News Article
    Herefordshire clinicians injected a patient in the wrong eye after a technical blunder, board papers have revealed. The Wye Valley Trust patient was injected with an antivascular endothelial growth factor to treat age-related macular degeneration. They did not come to harm as a result of the incident. The mistake occurred after the ophthalmology department deleted a poor quality image of one of the patient’s eyes. This shifted up the other images, which were stored sequentially using software called IMAGEnet6, which led to the mistake. Although initially reported as a “never event,” the incident was downgraded to a “serious incident” after a review by the Herefordshire Clinical Commissioning Group (CCG). The trust, which is still using the software, is updating its standard operating procedure and has installed new technology that can take higher quality images. A spokesman said: “Patient safety is the trust’s priority. While no harm was caused to this patient, the trust has taken this incident seriously.” Read full story (paywalled) Source: HSJ, 21 January 2020
  8. Content Article
    This investigation by the Healthcare Safety Investigation Branch (HSIB) explores the timely recognition and treatment of suspected pulmonary embolism in emergency departments. Pulmonary embolisms can form when clots from the deep veins of the body, usually originating in the legs, travel through the venous system and become lodged in the lungs. A person suffering from a pulmonary embolism requires urgent treatment to reduce the chance of significant harm or death.
  9. Content Article
    Diagnostic errors have a negative impact on patient treatment and cost healthcare systems a large amount in wasted resources. This paper published by the Deeble Institute for Health Policy Research looks at diagnostic errors related to medical imaging in Australian public healthcare. It also looks at health policies that have been used internationally to improve the use of diagnostic imaging and reduce the consequences of diagnostic errors. The authors recommend: implementing a national strategy in Australia to identify and prevent diagnostic errors analysing medical indemnity claims to help measure the incidence and consequences of diagnostic errors.
  10. Content Article
    This report shares findings from complaints made to Parliamentary and Health Service Ombudsman (PHSO) about failings in imaging in the NHS. The majority of these complaints involve people who had cancer at the time they used imaging services. Through highlighting these complaints, the PHSO’s objective is to support NHS services to improve. It suggests that failings in imaging services can only be addressed and learned from through collaboration across clinical specialties, looking at the whole imaging journey and its intersections as part of the patient’s care pathway.
  11. Content Article
    This blog by patient Lelainia Lloyd in the Journal of Medical Imaging and Radiation Sciences is a personal account of two starkly different MRI appointment experiences. In the first scan, the technologist said very little to Lelainia and the experience left her with significant anxiety about future MRIs. But her second experience was completely different, with the technologist communicating clearly, asking questions and making sure she felt comfortable throughout the process. Lelainia highlights the importance of communicating clearly and compassionately with patients to make them feel safe and able to ask for help. She outlines some practical steps for healthcare workers to help them engage with patients and ensure they are clearly consenting to all aspects of care and treatment.
  12. News Article
    About a third of NHS trusts in England are using “technically obsolete” imaging equipment that could be putting patients’ health at risk, while existing shortages of doctors who are qualified to diagnose and treat disease and injuries using medical imaging techniques could triple by 2030. According to data obtained through freedom of information requests by Channel 4’s Dispatches programme, 27.1% of trusts in NHS England have at least one computerised tomography (CT) scanner that is 10 years old or more, while 34.5% have at least one magnetic resonance imaging (MRI) scanner in the same category. These are used to diagnose various conditions including cancer, stroke and heart disease, detect damage to bones and internal organs, or guide further treatment. An NHS England report published last year recommended that all imaging equipment aged 10 years or older be replaced. Software upgrades may not be possible on older equipment, limiting its use, while older CT scanners may require higher radiation doses to deliver the same image, it said. Dr Julian Elford, a consultant radiologist and medical director at the Royal College of Radiologists (RCR), said: “CT and MRI machines start to become technically obsolete at 10 years. Older kit breaks down frequently, is slower, and produces poorer quality images, so upgrading is critical." “We don’t just need upgraded scanners, though; we need significantly more scanners in the first place. The [NHS England report] called for doubling the number of scanners – we firmly support that call, and recommend a government-funded programme for equipment replacement on an appropriate cycle so that radiologists can diagnose and treat their patients safely." Read full story Source: The Guardian, 18 October 2021
  13. News Article
    Coroners have warned the NHS nearly a dozen times in recent years that a lack of imaging capacity could lead to more deaths, HSJ can reveal. Five of these warnings followed deaths at a single site, Tameside General Hospital in Greater Manchester. The most recent case concerned a patient that died after developing covid during a prolonged wait for an MRI scan. Sir Mike Richards last year warned in a major report for NHS England about the lack of imaging equipment, and the Royal College of Radiologists has highlighted national shortages of radiology staff on numerous occasions in recent years. HSJ combed through more than 100 prevention of future death reports and responses published between 2018 and 2021 in an effort to quantify harm linked to these shortages. Of dozens of reports mentioning imaging issues, including software problems, poor note-taking and incorrect interpretation of results, HSJ identified 11 cases where coroners specifically warned either the trust or system concerned, and/or NHS England or the Department for Health and Social Care, that capacity issues could lead to future deaths. In some of the cases, coroners concluded that shortages likely contributed to a patient’s death. Read full story (paywalled) Source: HSJ, 20 May 2021
  14. Content Article
    Some patients are unable to tolerate imaging procedures such as MRIs due to pain or anxiety. In these cases, a variety of medications are routinely used prior to imaging to allow the procedure to be carried out successfully. Varying levels of sedation before imaging can be appropriate given the need for patients to remain still during the imaging process, but the minimal amount of sedation should be used to mitigate unwanted side effects and reduce the risk of adverse events. This article examines two cases that highlight the risks of minimal-to-moderate sedation for imaging procedures, especially in high-risk patients, when multiple medication doses are required and when monitoring is limited or inadequate.
  15. Content Article
    Closed-loop communication—when every test result is sent, received, acknowledged and acted upon without failure—is essential to reduce diagnostic error. This requires multiple parties within the healthcare system working together to refer, carry out tests, interpret the results and communicate them in language the patient can understand. If abnormal test results are not communicated in a timely manner, it can lead to patient harm. This Quick Safety case study looks at the case of a 47-year-old school teacher who had a screening mammogram. The radiologist identified a suspicious area of calcifications, which required follow up. The patient’s GP was not on the same electronic medical record (EMR) as the imaging centre and, because of front office changes, missed the notification to follow up. The patient was told that the radiologist would contact her if the results were abnormal and therefore assumed she was okay. A year later when seeing her GP, the patient was told that she needed follow-up testing and that she had stage 3 cancer. Her lesion had grown significantly, and she now required surgery, chemotherapy and radiation for advanced breast cancer. The case study suggests safety actions that should be considered to prevent this error from happening again.
  16. Content Article
    This study in the journal Current Problems in Diagnostic Radiology aimed to explore the perspectives of radiology and internal medicine residents on the desire for personal contact between radiologists and referring doctors, and the effect of improved contact on clinical practice. A radiology round was implemented, in which radiology residents travel to the internal medicine teaching service teams to discuss their inpatients and review ordered imaging. Surveys were given to both groups following nine months of implementation. The vast majority of both diagnostic radiology residents and internal medicine residents reported benefits in patient management from direct contact with the other group, leading the authors to conclude that this generation of doctors is already aware of the value of radiologists who play an active, in-person role in making clinical decisions.
  17. Content Article
    In this opinion piece in The BMJ, consultant radiologist Giles Maskell examines changes to the ways in which medical imaging is used in the health service. He states that imaging used to be ordered, when necessary, at the end of a diagnostic process, whereas now many doctors are asking for scans before they will see a patient for the first time. The article highlights some of the implications of this shift in practice, including on screening service capacity and on the interpretation of test results.
  18. Content Article
    This article outlines the results of a recent investigation by the Parliamentary and Health Service Ombudsman (PHSO) which found that a 65-year-old man died after doctors failed to notice serious abnormalities on his X-ray. The patient, known as Mr B, was admitted to University Hospitals Birmingham NHS Foundation Trust in May 2019 after being unwell for several days with abdominal pain and vomiting. An X-ray of his abdomen was taken, which two doctors said did not show any apparent abnormalities. The following day Mr B's condition deteriorated and he suffered a heart attack and died. The PHSO investigation found that the Trust failed to notice a blockage in his intestine on the X-ray. Because of this failure, Mr B did not receive treatment that could have saved his life.
  19. Content Article
    Fracture liaison services (FLSs) check if people who have recently broken a bone after falling from a standing height or less (a fragility fracture) might also have osteoporosis – a disease that weakens bones. They then advise on treatments to reduce the risk of another fracture, helping to improve patient outcomes. The Royal College of Physicians (RCP) estimates that at least 90,000 patients in England and Wales who should have anti-osteoporosis therapy are not receiving it. This guide by the RCP's Fracture Liaison Service Database (FLS-DB) aims to help patients and their families and carers understand what to expect following a fragility fracture. It outlines three key findings and the actions that individuals can take to ensure they receive the care and treatment they need from health services.
  20. Content Article
    This article describes how a radiology group in Arizona allegedly missed dozens of breast malignancies, some of which were obviously cancer. Breast surgeon Dr Beth Dupree and a team of expert radiologists identified 25 missed cancer diagnoses that required either surgery, chemotherapy, radiation or a mastectomy at Northern Arizona Healthcare between 2016 and 2018. The team felt that there was a high chance of the number of women with missed cancers being higher than those uncovered by the review, but their request to expand the investigation did not go ahead.
  21. Content Article
    The Sentinel Stroke National Audit Programme (SSNAP), which assesses the care provided for patients during and after they receive inpatient care following a stroke, has published its ninth annual report. Based on data from April 2021 to March 2022, the report aims to identify which aspects of stroke care need to be improved with a particular focus on changes in stroke care over the last two years and the ‘roads’ that need to be followed in order to restore the quality of care. SSNAP measures the process of care against evidence-based quality standards referring to the interventions that any patient may be expected to receive. These standards are laid out in the latest clinical guidelines and include: whether patients receive clot busting drugs (thrombolysis). interventions for clot retrieval (thrombectomy). how quickly they receive a brain scan. how much therapy is delivered in hospital and at home.
  22. Content Article
    A 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.
  23. Content Article
    Half of COVID-19 patients who received a heart scan in hospital showed abnormalities in heart function, according to new research funded by the British Heart Foundation. In this study, Dweck et al. describe the cardiac abnormalities in patients with COVID-19 and identify the characteristics of patients who would benefit most from echocardiography.
  24. Content Article
    The Care Quality Commission (CQC)’s annual report on Ionising Radiation (Medical Exposure) Regulations in England has been published. The report gives a breakdown of the number and type of statutory notifications of errors received from healthcare providers in 2018/19 where patients were exposed to ionising radiation. These notifications are where there have been significant accidental or unintended exposures, for example where a patient received a higher dose than intended or where the wrong patient was exposed.
  25. Content Article
    This is a story of a patient in whom the emergency department missed the same diagnosis twice, four years apart. The first occasion (prior to his diagnosis of ankylosing spondylitis) was understandable. The second was not. As a result of this case, the hospital have changed their x-ray policy for non-traumatic back pain. They also want to share key learning points (the majority of which were due to lack of awareness about a relatively rare condition and its complications) as widely as possible, to help others avoid the same errors.  This reflective learning features guest educator, Mr Gareth Dwyer (the patient).
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