Search the hub
Showing results for tags 'Research'.
Found 500 results
-
Content ArticleIn January 2025, the Republican majority in the House of Representatives’ Budget Committee offered a list of possible spending reductions to offset revenue losses from proposed tax cuts. In May, the Committee advanced a bill incorporating several reductions on the list. The Committee estimated that the 6 largest potential Medicaid cuts (for example, work requirements for some Medicaid enrollees) would each reduce the federal government’s Medicaid outlays by at least $100 billion over 10 years. On the basis of the Committee’s estimates of savings; Congressional Budget Office analyses; and peer-reviewed studies of the coverage, financial, and health impacts of past Medicaid expansions and contractions, the authors project the likely effects of each option and of the House bill advanced by the Budget Committee in May. Each option individually would reduce federal Medicaid outlays by between $100 billion and $900 billion over a decade, increase the ranks of the uninsured by between 600 000 and 3 900 000 and the annual number of persons forgoing needed medical care by 129 060 to 838 890, and result in 651 to 12 626 medically preventable deaths annually. Enactment of the House bill advanced in May would increase the number of uninsured persons by 7.6 million and the number of deaths by 16 642 annually, according to a mid-range estimate. These figures exclude harms from lowering provider payments and shrinking benefits, as well as possible repercussions from states increasing taxes or shifting expenditures from other needs to make up for shortfalls in federal Medicaid funding. Policy makers should weigh the likely health and financial harms to patients and providers of reducing Medicaid expenditures against the desirability of tax reductions, which would accrue mostly to wealthy Americans.
-
News ArticleOn 9 June 2025, federal employees at the National Institutes of Health (NIH) stood up for the health and safety of the American people and faithful stewardship of public resources by authoring and signing the Bethesda Declaration. Read the open letter in support of the Bethesda Declaration.
-
News Article
NIH grant cuts have pulled $2B from medical schools, academic hospitals
Patient Safety Learning posted a news article in News
National Institutes of Health (NIH) grant terminations have pulled almost $2 billion in funding away from U.S. medical schools and hospitals, including $314.5 million in funding intended to train biomedical and health researchers, according to an analysis from the Association of American Medical Colleges (AAMC). The halted funding undercuts medical schools and academic hospitals’ financial sustainability, immediately ended at least 160 active clinical trials for patients being treated for conditions like HIV/AIDS or cancer and threatens “the ability of academic medicine to attract and retain the best and brightest scientists,” the association warned in a Wednesday data brief. An accompanying release from the AAMC framed the grant terminations alongside a slew of proposed executive and legislative actions it said threaten academic medicine and millions of patients, such as Medicaid provider tax limits and eliminating federal student aid programmes. “For generations, bipartisan leaders have recognized that America’s strength and future rely on the groundbreaking research performed at our nation’s biomedical research facilities, the complex and highly sophisticated care provided at academic health systems that is the envy of the world, and the ability of our medical schools and teaching hospitals to train the next generation of physicians," AAMC President and CEO David Skorton, M.D., said in a position piece published Wednesday. “For the sake of medical advancement, economic prosperity, and the health of every citizen, we need policymakers to work with us, not against us. The stakes could not be higher—lives truly hang in the balance.” Read full story Source: Fierce Healthcare, 11 June 2025 -
Content ArticleIn high-income countries, critical illness in children is rare, and often difficult for physicians to distinguish from common minor illness until late in the disease. Parents or caregivers are well positioned to detect early and subtle signs of deterioration, but the relationship between their concerns and patient outcomes is unknown. This study examined the relationship between documented caregiver concern about clinical deterioration and critical illness in children presenting to hospital. It found that caregiver concern for clinical deterioration is associated with critical illness in paediatric patients and, after adjusting for variables including abnormal vital signs, had a strong association with ICU admission and mechanical ventilation. Rapid response systems should incorporate proactive assessment of parent or caregiver concerns for deterioration.
-
Content ArticleOver the past two decades, suicide prevention efforts have expanded significantly, yet deeply held assumptions continue to shape policy in ways that may limit effectiveness. This paper critically examines key assumptions in suicide prevention, including the predictability of suicide, the role of suicidal ideation, and the conflation of self-harm and suicide. It challenges the view that mental illness is the primary cause of suicide and questions whether psychiatric hospital admission ensures safety. The paper also argues that overemphasis on prediction fosters fear-driven responses and explores how shifting the focus beyond risk reduction could foster more nuanced, compassionate and sustainable approaches to care. Further reading on the hub: Understanding the true impact of suicide in inpatient mental health settings: reflections from a psychiatrist
-
Content ArticleIn the US, women die at a greater rate in pregnancy and during the postpartum period than in any other high-income country, and this rate has been increasing. Even if some of the apparent increase is attributable to changes in reporting, the fact remains that in the US, mortality rates are rising rather than falling, while disparities are widening.1Yet despite recent efforts to prioritise women’s health research, pregnancy research remains woefully underfunded. Much of the existing funding for pregnancy research focuses not on the health of pregnant individuals themselves; rather, they are considered hosts whose social, intrinsic biological, and environmental determinants affect fetal and child development: an important perspective, but not the only one. A recent report by the National Academies of Sciences, Engineering, and Medicine noted that National Institutes of Health (NIH) spending on women’s health research in the past decade has averaged only 8.8% of its total budget, of which only a fraction went to study pregnancy. Despite progress in the form of new initiatives—such as the NIH Implementing a Maternal Health and Pregnancy Outcomes Vision for Everyone (IMPROVE) Initiative—funding for research regarding preconception, pregnant, and postpartum individuals remains a small proportion of the NIH portfolio.
-
Content ArticleIn the UK, around 20,000 children are admitted to intensive care each year. Most will receive oxygen through a ventilator. Many hospitals aim to give almost as much oxygen as people’s blood can carry (more than 94% saturation). However, some studies suggest that this could be harmful for some children. Providing less oxygen (88 to 92% of the blood’s capacity) may be better. A groundbreaking nurse-led NIHR trial explored the oxygen levels of critically ill children in intensive care. The study found that with reduced oxygen targets children spent less time on life-saving machines and required fewer drugs. The researchers say that with reduced oxygen targets: 50 more children would survive in the UK each year the NHS could save £20 million per year. The findings suggest that, if oxygen targets for children in intensive care were reduced across the NHS, 50 more children would survive every year. In total, children would spend 6,000 fewer days in intensive care. Lower oxygen targets could be particularly beneficial in countries where resources are scarce, the researchers say, or at times of crisis (such as during a pandemic).
-
News Article
Blood test for Alzheimer's disease is highly accurate, researchers say
Patient Safety Learning posted a news article in News
Researchers say a new blood test for Alzheimer's disease has been shown to be highly accurate in detecting people with early symptoms. Scientists looked for two proteins - amyloid beta 42/40 and p-tau217 - and found the test was 95% accurate in identifying patients with existing cognitive impairment linked to the condition. The US study involved 509 patients in an outpatient memory clinic in Florida and was published in the medical journal Alzheimer's and Dementia. The test, which has already been approved by the US regulator, was also 82% accurate for specificity, which means it could rule out people without dementia. Dr Gregg Day, who led the study, said the test was as good as existing, but more invasive, tests. He said the next step was to extend the test to a wider range of patients, including those with early Alzheimer's who do not have any cognitive symptoms. Read full story Source: Sky News, 7 June 2025 -
News Article
Vaginal mesh particles ‘could trigger autoimmune response even after removal’
Patient Safety Learning posted a news article in News
Microscopic particles left behind by vaginal mesh could continue to trigger the immune system to attack healthy tissue even after the material has been removed, according to researchers. Experts suggest allergy testing patients before they are fitted with mesh may help to better understand why complications happen in some cases. Campaign group Sling the Mesh said the majority of its members have developed a reaction they believe is down to the material, including autoimmune diseases, unexplained rashes and chronic fatigue. Transvaginal mesh (TVM) implants are made from synthetic materials such as polypropylene, a type of thermoplastic, and have been used to treat pelvic organ prolapse and incontinence after childbirth. However, they can cause serious harm to some women, with side effects including infection, pelvic pain, and incontinence. The NHS restricted its use of TVM implants in 2018 and they are now used only as a last resort through a high-vigilance programme of restricted practice. A new article led by Dr Nicholas Farr, published in the journal Nature Reviews Urology, analysed studies which suggest polypropylene is a material which causes autoimmune/inflammatory syndrome induced by adjuvants (Asia). Asia arises following exposure to substances that enhance the immune response in the likes of vaccines, silicone implants, or other foreign materials. Symptoms can vary widely, but include chronic fatigue and chronic pain. Read full story Source: The Independent, 6 June 2025 Related reading on the hub: Read a blog Dr Nicholas Farr wrote for the hub on medical device safety -
Content ArticleEvidence of polypropylene mesh degradation has revealed particle accumulation in surrounding tissues, raising concerns about potential local and systemic immune responses. Associations between polypropylene degradation and autoimmune/autoinflammatory syndrome induced by adjuvants-like symptoms have been made, and vigilant clinical assessment is important, especially in patients with a predisposition for allergy or autoimmune diseases. Related reading on the hub: Read a blog author Dr Nicholas Farr wrote for the hub on medical device safety
-
Content ArticleDefensiveness is often implicated in systemic organisational failures to explain why early warning signs were ignored and organisational resilience was compromised. But how does an organisation become defensive? The authors of this study propose that defensiveness can arise as a response to contradictory work demands. The research focuses on UK hospital staff tasked with responding to criticism online (herein complaint handlers). It examines these responses to criticism using a mixed methods explanatory sequential design. Six defensive tactics were reliably identified: redirecting patients to other channels, evading issues, psychologising concerns, invalidating concerns as incomplete, closing the feedback episode, and individualising concerns with bespoke workarounds. These defensive tactics were generally associated with less organisational learning and were sometimes viewed as unhelpful. To explain these results, the authors introduce the complaint handler’s bind: staff are tasked with responding to complaints without a viable pathway for organisational learning and an implicit injunction against voicing this dilemma. This demand-control double bind unwittingly gives staff little alternative but to be defensive. Future research, the authors conclude, needs to conceptualise defensiveness as sometimes a symptom rather than a cause of problems in organisational learning.
-
Content ArticleMedication dosing errors occur frequently and contribute to preventable patient harm and negative outcomes (including numerous patient deaths each year in the US). Dosing errors are particularly common in neonatal and paediatric populations, where weight-based dosing is often required and drug formulations are commonly tailored towards adult populations. Hospitalised neonates require frequent dosing adjustments as their weights can change substantially over the course of their hospitalization and even day to day, increasing the potential for dosing errors. Technologies such as computerised order entry, clinical decision support systems, and electronic prescribing strategies have been used to improve dosing accuracy and prevent adverse drug events with mixed results. Additionally, paediatric functionalities are often not integrated into electronic health records (EHR) or tools tailored to the adult population are incorrectly applied to paediatric patients. In this issue of Pediatric Research, Levin and colleagues compared the accuracy of three Large Language Models (LLMs) to nurses of varying clinical backgrounds and experience levels in calculating paediatric medication dosing. Although this study focused on nurses, it applies to all healthcare providers. Medication dosing errors do not occur in a vacuum and it is the responsibility of all healthcare providers (including nurses, physicians, pharmacists, technicians, etc.) to ensure that medications are given at the correct dose, route, interval, and duration.
- Posted
- 1 comment
-
1
-
- (and 3 more)
-
News Article
RFK Jr threatens ban on federal scientists publishing in top journals
Mark Hughes posted a news article in News
The US health secretary Robert F Kennedy Jr has threatened to ban government scientists from publishing in the world’s leading medical journals, which he branded “corrupt”, and to instead create alternative publications run by the state. Kennedy outlined plans to launch government-run journals that would become “the preeminent journals” because National Institutes of Health (NIH) funding would anoint researchers “as a good, legitimate scientist”. The three publications Kennedy targeted are among the most influential medical journals globally, established in the 19th century and now central to disseminating peer-reviewed medical research worldwide. The Lancet and Jama each report more than 30m annual website visits, while the New England Journal of Medicine claims more than 1 million weekly readers. Read full article Source: The Guardian, 28 May 2025 -
Content ArticleThe purpose of this study was to identify which, and to what extent, demographic and operational factors are indicative of likelihood for a new call handler or paramedic to remain in role within the first two years of employment at an ambulance trust using data held in the trust’s bespoke data warehouse. Several factors showed a significant contribution to the likelihood of remaining in post within an ambulance NHS Trust. Among the findings, short-term sick leave in the first two years of employment was associated with increased retention for paramedics. In addition, female call handlers were found to have increased retention and paramedic retention increased with time outside of ‘job cycle time’ (JCT) activities (ie, activities other than responding to calls). This study presents a method for extracting new insights from routinely collected operational data, identifying common drivers and specific predictors for retention among the ambulance NHS workforce. It emphasises the importance of workforce-centred retention strategies, highlighting the need for non-JCT time, which in turn would allow paramedics to have time to reflect and recuperate to avoid burnout and attrition. The study also suggests that a lack of sick leave might indicate a lack of trust and self-care culture, potentially leading to paramedic staff attrition. Our approach to retention analytics provides a new mechanism for trusts to monitor and respond to their attrition risks in a timely, proactive fashion.
-
Content ArticleThe overarching vision of the NIHR Yorkshire and Humber Patient Safety Research Collaboration (PSRC) is to co-produce innovative solutions to make care safer for patients and their families. Key to this is ensuring that these solutions reflect and meet the needs of our diverse communities. This can be achieved by working with and for patients, families, and health and social care staff, grounding our research in their daily realities and the evolving system within which care is delivered. This PPIE strategy offers the mechanisms by which we can deliver on this, recognising that respectful and trusting relationships are the cornerstones to making effective change.
-
Content ArticleUnderstaffing by nursing staff in hospitals is linked to patients coming to harm and dying unnecessarily. There is a vicious cycle whereby poor work conditions, including understaffing, can lead to nursing vacancies, which in turn leads to further understaffing. Is hospital investment in nursing staff, to eliminate understaffing on wards, cost-effective? This longitudinal observational study analysed data on 185 adult acute units in four hospital Trusts in England over a 5-year period. The study found that exposure to registered nurse understaffing is associated with increased hazard of death, increased chance of readmission and increased length of stay, while exposure to nursing support understaffing is associated with smaller increases in hazard of death and length of stay but reduced readmissions. Rectifying understaffing on inpatient wards is crucial to reduce length of stay, readmissions and deaths. According to the National Institute for Health and Care Excellence £10 000 per QALY threshold, it is cost-effective to eliminate understaffing by nursing staff. This research points towards investing in registered nurses over nursing support staff and permanent over temporary workers. Targeting particular patient groups would benefit fewer patients and is less cost-effective.
-
News ArticleCuts to international aid ordered by Donald Trump have caused many African HIV researchers to fear for the future of long-term research programmes. In January, as one of his first acts after taking office, the US president froze all foreign aid and announced a 90-day review. That move and the firing of all but 15 employees at the US Agency for International Development (USAID) mean the agency has, in effect, been closed down. Also under threat are US National Institutes of Health (NIH) grants that support HIV research in Africa: cuts have affected funding for HIV-related research in specific populations, and a mechanism that awards grants to international collaborators has been suspended. US dollars have been key in mitigating the scourge of the virus, both through research and by providing lifesaving antiretroviral drugs. Salim Abdool Karim is co-founder and director of the Centre for the AIDS Programme of Research in South Africa (CAPRISA) at the University of KwaZulu-Natal in Durban. He says three USAID-funded collaborative grants for HIV research and one NIH grant related to tuberculosis have been terminated, totalling US$1.4 million. The public-health physician, who founded CAPRISA with his wife Quarraisha Abdool Karim, an infectious-disease epidemiologist, says that these funding cancellations will stymie the centre’s research, which prioritises slowing the number of new HIV infections in young women and reducing deaths from HIV–tuberculosis coinfections in Africa. “All our HIV-vaccine trials, and most of our HIV-treatment trials, will be stopped as these are funded by the NIH,” he says. Although he does not expect the suspended work to result in increased deaths, “it will, however, slow scientific progress on HIV vaccines and treatment”, he adds. He doesn’t think that USAID funding will be restored. “Although it has many great scientists, the United States government is now an unreliable funding partner. We have to mobilize our own resources.” Read full story Source: Nature, 20 May 2025
-
Content ArticleManaging insulin during care transfers requires improvement. Understanding factors that impact insulin management during this process improves the likely effectiveness of interventions. This study aimed to map the processes involved in managing insulin during transfers of care and the factors that affect them to identify potential areas for safety improvement interventions.
-
Content ArticleResilience Engineering principles are becoming increasingly popular in healthcare to improve patient safety. FRAM is the best-known Resilience Engineering method with several examples of its application in healthcare available. However, the guidance on how to apply FRAM leaves gaps, and this can be a potential barrier to its adoption and potentially lead to misuse and disappointing results. The article provides a self-reflective analysis of FRAM use cases to provide further methodological guidance for successful application of FRAM to improve patient safety.
-
News ArticleThe UK is becoming “the sick person of the wealthy world” because of the growing number of people dying from drugs, suicide and violence, research has found. Death rates among under-50s in the UK have got worse in recent years compared with many other rich countries, an international study shows. While mortality from cancer and heart disease has decreased, the number of deaths from injuries, accidents and poisonings has gone up, and got much worse for use of illicit drugs. The trends mean Britain is increasingly out of step with other well-off nations, most of which have had improvements in the numbers of people dying from such causes. The increase in drug-related deaths has been so dramatic that the rate of them occuring in the UK was three times higher in 2019 – among both sexes – than the median of 21 other countries studied. The findings are contained in a report by the Health Foundation thinktank, based on an in-depth study of health and death patterns in the 22 nations by academics at the London School of Hygiene and Tropical Medicine (LSHTM). “The UK’s health is fraying,” they concluded. Read full story Source: The Guardian, 20 May 2025
-
Content Article
Tackling bias in healthcare (29 April 2025)
Patient Safety Learning posted an article in Health inequalities
Bias in the way medical research is carried out means that new medicines for diseases such as cancer – as well as the tools used to diagnose patients with some conditions – are disproportionally tested on people of European heritage. This can lead to those not represented in the data being misdiagnosed as well as some treatments not working as well as they should. From the Ghanaian scientist helping to develop cancer treatments which work better for African people, to the team in England using AI to diagnose dementia in communities where English isn’t widely spoken, in this programme we will meet the solution-seekers trying to make healthcare more equal. -
Content ArticleMany errors in surgical patient care are caused by poor non-technical skills (NTS). This includes skills like decision-making and communication. How often these errors cause harm and death is not known. This goal of this study was to report how many surgical deaths are associated with NTS errors in Australia by assessing all surgical deaths from 2012 to 2019. Some 64% of cases had an NTS error linked to death. Decision-Making and Situational Awareness errors were the most common. The results of this study can be used to guide improvement and reduce future errors and patient death.
-
Content ArticlePatient safety culture (PSC) is crucial for reducing medical errors and improving patient outcomes globally. This study aims to identify key improvement targets in China’s PSC to promote a safer healthcare environment. It found that while teamwork is a notable strength, there is room to enhance the nonpunitive response to errors. Improving feedback and communication practices can further bolster openness and collaboration within teams, leading to an overall healthier work environment.
-
Content Article
Patient safety articles by Professor Braithwaite
Patient Safety Learning posted an article in Research papers
Professor Jeffrey Braithwaite is Founding Director of the Australian Institute of Health Innovation, Director of the Centre for Healthcare Resilience and Implementation Science and Professor of Health Systems Research at Macquarie University. Professor Jeffrey Braithwaite is a leading health services and systems researcher with an international reputation for his work investigating and contributing to systems improvement. He has particular expertise in the culture and structure of acute settings, leadership, management and change in health sector organisations, quality and safety in healthcare, accreditation and surveying processes in the international context and the restructuring of health services. Professor Braithwaite is well known for bringing management and leadership concepts and evidence into the clinical arena and he has published extensively, with over 788 refereed contributions (including 15 edited books, 95 book chapters, 506 articles and 65 refereed conference papers; and 320 peer-reviewed abstracts and posters; and 231 other publications, e.g., international research reports). Links to some of Professor Brainthwaite's work can be found below. Patient safety articles by Professor Braithwaite Implementation Science and Translational Health Research Articles by Professor Braithwaite Resilient healthcare series Professor Jeffrey Braithwaite on patient safety and health systems improvement -
Content ArticleEnsuring Patient Safety in healthcare is essential and requires efficient methods to reduce risks and improve the quality of care. Although incident reporting tools are commonly used to identify possible and actual care failures, their efficacy differs among various environments. The aim of this study was to evaluate the effectiveness of incident reporting tools in enhancing patient safety.
