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Found 58 results
  1. News Article
    A bid for more control over the NHS by ministers risks undermining patient safety and sowing confusion over who is ultimately responsible for services, MPs have been warned. The Commons Health Select Committee was told the proposals, set out in a new white paper published last month, lacked detail on the involvement of patients in local services and needed urgent clarification of the new powers the health secretary will have. The plans will give ministers new powers over the independent Healthcare Safety Investigation Branch (HSIB), including being able to tell it what to investigate
  2. Content Article
    Key points Learning from Excellence (LfE) is a system for capturing examples of good practice in healthcare as a complementary approach to traditional incident reporting. The LfE philosophy proposes that learning from what works well in a system enables improvements in the quality and safety of the work, and the morale of staff performing it. LfE systems comprise simple reporting forms for peer-to-peer positive feedback with sharing of examples to enable wider learning. LfE reporting identifies excellence and learning opportunities in both process and outcome.
  3. Content Article
    Healthcare is inherently a messy business. It is complex and filled with hazards. If I asked you to list the things that could potentially go wrong, I suspect you would be there for a while... So, how do you even begin to bring some consistency and safety into a system such as healthcare? How do you ‘head off’ incidents at ‘the pass’ before they occur? My experience of healthcare in the last 30 years, and of investigating complaints, incidents and errors in the last 10 years, is that we often immediately check if the appropriate policy has been followed. The ‘horror of horrors’
  4. Content Article
    Implementation challenges The investigation highlighted the main implementation challenges. This includes: National consistency in drug libraries – smart infusion pumps have an inbuilt dose error reduction system (DERS) which requires the use of a drug library. The investigation found that drug libraries were developed ‘locally’ and that there is no agreed national drug library for use in NHS. They also found that there is no national guidelines or standards on how to implement the libraries. Significant changes in processes – introducing the technology requires significant cha
  5. News Article
    A Tory peer has attacked the Department of Health and Social Care’s ‘woeful’ response to the patient safety review she authored and has revealed she intends to create a cross-party group to force action. Baroness Julia Cumberlege - who led the “First Do No Harm” report on device and medicine safety– has said she has “not had a whisper” from the department over the report’s key recommendations since it was published in July. She told HSJ’s Patient Safety Congress she is setting up a cross-party parliamentary group to “pressure” the department to adopt the report’s recommendations.
  6. News Article
    An NHS hospital where a woman bled to death in childbirth has been given an "urgent" deadline to keep patients at its maternity unit safe. A letter seen by the BBC reveals the Care Quality Commission (CQC) found unsafe staffing levels at the unit at Basildon Hospital throughout August. The CQC said the trust that runs it had until next Monday to implement appropriate measures. The trust said it had a "robust improvement plan in place". The seven-page document, sent by the CQC on 7 October, puts the Mid and South Essex NHS Foundation Trust on notice that it has to "implement an e
  7. Content Article
    Developing the FRAS In January 2017, I read a tragic story in Outpatient Surgery involving an elderly patient in the US who suffered multiple burns following the use of chlorohexidine bottled alcoholic prep. I'd also read that in the US there are over 600 surgical fires every year. As the Practice Development Lead for my theatre department at the time, I decided to design a Fire Risk Assessment Score (FRAS). I discussed the FRAS with my manager and my suggestion to add the FRAS to the 'Time Out' of our WHO Surgical Safety Checklist. To further develop my ideas, I attended one of th
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