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Found 37 results
  1. Content Article
    It's been a busy few months to say the least. Preparing for the pandemic, sourcing correct personal protective equipment (PPE), redeploying staff, acquiring new staff, making ventilators, redesigning how we work around the constraints, writing new policies, new guidance, surge plans, and then the complex part… caring for patients. If I am honest, when this all started it felt exciting. Adrenaline was high, motivation was high, we felt somewhat ready. There was a sense of real comradeship. It felt like we were all working for one purpose; to safely care for any patient that presented to us in hospital. We were a little behind London by about 2–3 weeks, so we could watch from afar on how they were coping, what they were seeing and adapting our plans as they changed theirs. Communication through the ITU networks was crucial. Clinical work has been difficult at times. The initial confusion on what the right PPE to wear for each area added to the stress of hearing that our colleagues in other places were dying through lack of PPE. The early days for me were emotionally draining. However, this new way of dressing and level of precaution is now a way of life for us. I have come to terms that I am working in a high-risk area and I may become unwell, but following guidance and being fastidious with donning and doffing helps with ‘controlling’ my anxieties in catching the virus. Some parts of the hospital remained quiet. Staff had been redeployed, elective surgery cancelled and the flow of patients in the emergency department (ED) almost stopped. I remember walking through ED and thinking: where are the people who have had strokes? Have people stopped having heart attacks? Are perforated bowels not happening anymore? The corridor in ED is usually full. Ambulances queuing up outside, but for a good few weeks the ambulance bays were deserted. The news says over and over again "we must not overwhelm the NHS". I always have a chuckle to myself as the NHS has been overwhelmed for years, and each year it gets more overwhelmed but little is done to prevent winter surges, although it's not just winter. The surge is like a huge tidal wave that we almost meet the crest of, but never get there, and emerge out the other side. I sit in the early morning ITU meeting. We discuss any problems overnight, clinical issues, staffing and beds. We have seen a steady decline in the number of ITU patients with COVID over the last week or so. The number of beds free for COVID patients were plentiful. We have enough ventilators and staff for them. This is encouraging news. I take a sigh, thinking we may have overcome the peak. In the next breath, the consultant states that we don’t have any non COVID ITU beds. We have already spread over four different areas and are utilising over 50 staff to man these beds (usually we have 25 staff). So that’s where the perforated bowels, heart attacks and strokes are. The patients we are caring for had stayed at home too long. So long, that they now have poorer outcomes and complications from their initial complaint. These patients are sick. Some of the nurses who are looking after them are redeployed from other areas; these nurses have ITU experience, but have moved to other roles within the hospital. This wasn’t what they had signed up for. They were signed up for the surge of COVID positive patients. I’m not sure how they feel about this. As the hospital is ‘quiet’ and surgical beds are left empty, there is a mention of starting some elective surgery. This would be great. It would improve patient outcomes, patients wouldn’t have to wait too long, so long that they might die as a consequence. However, we don’t have the capacity. We have no high dependency/ITU beds or nurses to recover them. We would also have to give back the nurses and the doctors we have borrowed from the surgical wards and outpatients to staff ‘work as normal’, depleting our staff numbers further. Add to the fact that lockdown has been lifted ever so slightly, the public are confused, I’m confused. With confusion will come complacency, with complacency will come transmission of the virus and we will end up with a second peak. If we end up with a second peak on top of an already stretched ITU and reduced staffing due to the secondary impact on non COVID care, the NHS will be overwhelmed. This time we will topple off that tidal wave. It’s a viscious cycle that I’m not sure how we can reverse. My plea, however, is to ensure we transition out of this weird world we have found ourselves in together. We usually look for guidance from NHS England/Improvement, but no one knows how best to do this. The people who will figure this out is you. If your Trust is doing something that is working to get out of this difficult situation, please tell others. We are all riding the same storm but in different boats. I would say that I am looking forward to ‘business as usual’ – but I can’t bare that expression. Now would be a great time to redesign our services to meet demand, to involve patients and families in the redesign – to suit their needs. We have closer relationships now with community care, social care and primary care, we have an engaged public all wanting to play their part. Surely now is the time we can plan for what the future could look like together? The Government has announced that Ministers are to set up a ‘dedicated team’ to aid NHS recovery. We need to ensure that patient and staff safety is a core purpose of that team’s remit and the redesign of health and social care. Would you be interested in being on our panel for our next Patient Safety Learning webinar on transitioning into the new normal? If so, please leave a comment below.
  2. Content Article
    The Committee identified the following health-related objectives of the lockdown withdrawal strategy: 1. Reduce spread of the COVID-19 virus. 2. Minimise loss of healthcare professionals and maximise their safety and availability to continue the work. 3. Increase case management capacity in existing hospitals and new hospitals. 4. Increase testing to eliminate community spread. 5. Ensure access to normal healthcare requirements of the population. 6. Maintain normal healthcare capacity during the coronavirus period. 7. Maintain public health initiatives (vaccinations, food/nutrition of children and pregnant/feeding mothers.
  3. Content Article
    Key points Incubation period = maximum 14 days. Symptomatic individuals stay in self isolation for 7 days from becoming ill (having symptoms). Day 1 is first day of symptoms. Household members who remain well stay in self isolation for 14 days due to maximum incubation period, calculated from day 1 of first symptomatic person. Household members do not need to restart the clock if other members become symptomatic during the 14 days self-isolation.
  4. News Article
    Change course or a quarter of a million people will die in a "catastrophic epidemic" of coronavirus – warnings do not come much starker than that. The message came from researchers modelling how the disease will spread, how the NHS would be overwhelmed and how many would die. The situation has shifted dramatically and as a result we are now facing the most profound changes to our daily lives in peacetime. This realisation has happened only in the past few days. However, it is long after other scientists and the World Health Organization had warned of the risks of not going all-out to stop the virus. Read full story Source: BBC News, 18 March 2020
  5. News Article
    The Prime Minister has said everyone in the UK should avoid "non-essential" travel and contact with others to curb coronavirus as the country's death toll hit 55. Boris Johnson said people should work from home where possible as part of a range of stringent new measures, which include: 1. Everyone of every age should avoid any non-essential social contact and travel. 2. Everyone to avoid pubs, clubs, cinemas, theatres and restaurants etc. 3. Everyone to avoid large gatherings - including sports events. 4. Everyone should work from home where possible. 5. If anyone in a house has CV19 symptoms, everyone in that house has to isolate for at least 14 days 6. Over 70s and those at risk (including pregnant women) to stay home for 12 weeks, which means no going out to shops or collect anything etc., unless there is no other option. Schools will not close for the moment. Read full story Source: BBC News, 16 March 2020
  6. Content Article
    It includes information on: symptoms advice on staying at home when and how to contact 111 advice on your immigration status how to stop the spread of the virus.
  7. Content Article
    This review was carried out in response to the very low numbers of investigations or reviews of deaths at Southern Health NHS Foundation Trust. Over a four-year period, fewer than 1% of deaths in Southern Health’s learning disability services and 0.3% of deaths in their mental health services for older people were investigated as a serious incident requiring investigation. Throughout this review, families and carers have told the CQC that they often have a poor experience of investigations and are not always treated with kindness, respect and honesty. This was particularly the case for families and carers of people with a mental health problem or learning disability. However, there is currently no single framework for NHS trusts that sets out what they need to do to maximise the learning from deaths that may be the result of problems in care. This means that there are a range of systems and processes in place, and that practice varies widely across providers. As a result, learning from deaths is not being given enough consideration in the NHS and opportunities to improve care for future patients are being missed. This reports sets out the next steps.
  8. News Article
    In a report published today, AvMA, the charity Action Against Medical Accidents, reveals serious delays in NHS trusts implementing patient safety alerts, which are one of the main ways in which the NHS seeks to prevent known patient safety risks harming or killing patients. The report, authored by Dr David Cousins, former head of safe medication practice at the National Patient Safety Agency, NHS England and NHS Improvement, identifies serious problems with the system of issuing patient safety alerts and monitoring compliance with them. Compliance with alerts issued under the now abolished National Patient Safety Agency and NHS England are no longer monitored – even though patient safety incidents continue to be reported to the NHS National Reporting and Learning System. David said: “The NHS is losing it memory concerning preventable harms to patients. Important known risks to patient safety are being ignored by the NHS. The National Reporting and Learning System, the NHS Strategy and new format patient safety alerts, all managed by NHS Improvement, now ignore the majority of ‘known/wicked harms’ which have been the subject of patient safety alerts in the past and have now been archived." “Implementation of guidance in new Patient Safety Alerts can be delayed, for years in some cases. The Care Quality Commission that inspects NHS provider organisations also no longer appear to check that safeguards to major risks, recommended in patient safety alerts, have been implemented, or continue to be implemented, as part of their NHS inspections. Read full story Source: AvMA, 28 January 2020
  9. Content Article
    Overview in numbers (2018/19) 12 national investigations launched. 440 maternity referrals received. 100 safety awareness notifications submitted for national investigations. 127 investigators trained. 174 members of staff recruited.
  10. News Article
    Paging systems used across B.C could be exposing sensitive health data of patients, and the privacy researcher who first discovered the data breach believes it’s likely happening across the country. “I wouldn’t be surprised to find this everywhere in Canada,” said privacy researcher Sarah Jamie Lewis, in an interview with CTVNews.ca in Vancouver. Lewis first discovered and reported the breach to Vancouver Coastal Health in November 2018. Now, internal emails released this month through a Freedom of Information request show that the vulnerability is not limited to Vancouver. Read full story Source: CTV News, 13 December 2019
  11. Content Article
    The Yorkshire Contributory Factors Framework (YCFF) is a tool which has an evidence base for optimising learning and addressing causes of patient safety incidents by helping clinicians, risk managers and patient safety officers identify contributory factors of PSIs. Incidents that occur in a hospital setting have been well studied and all contributory factors have been mapped. Based on this research, a team of practicing clinicians with human factors experts has adapted the evidence to a two page framework. The YCFF includes all sixteen domains of the evidence-based domains. The document suggests questions that you might want to ask of those involved in the incident. The underlying aim of this tool is not to ignore individual accountability for unsafe care, but to try to develop a more sophisticated understanding of the factors that cause incidents.
  12. Content Article
    This policy covers how Dorset Healthcare (DHC) University NHS Foundation Trust responds to patient deaths in care generally, not just those amounting to 'serious incidents', which will continue to be dealt with under the existing NHS Improvement’s 2015 'Serious Incident Framework'.
  13. Content Article
    High level findings There is an opportune ‘policy window’ for change in patient safety. The burden of unsafe care is clear and evidence-based both locally and globally. Momentum towards safer care is building at local, national and international levels. Culture is equal to policy and public momentum in order for safety innovations to land, take root and flourish. In order for safety opportunities to materialise, they require a concerted effort towards collaboration, innovation and education. Agreed actions Create national learning systems. Ensure meaningful collection and responses to patient feedback. Develop curricula for patient safety including curricula for investigations. Develop local and global portals for sharing ideas and best practice. Design systems to prevent harm with aligned priorities. Collect data about impact and evaluation. Harness existing digital innovations to improve patient safety. Wilton Park is an Executive Agency of the Foreign and Commonwealth Office.
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