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Content ArticleOne of the core ambitions of Care Quality Commission is to ensure that the services it regulates have a stronger safety and learning culture. Through their new quality statements, they are looking to assess both ‘safety through learning’ and ‘learning culture’. To ensure they take the best approach to assessing providers on this topic and to ensure they are able to give providers the best quality information on what good looks like in this area, the CQC would like your feedback through this short survey.
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Content Article
Sands is the UK's leading charity working to save babies' lives and support bereaved families. In this blog, Julia Clark and Mehali Patel from the Sands Saving Babies’ Lives research team, draw on their recent Listening Project to illustrate the value of working with bereaved parents. Julia and Mehali argue that hearing and amplifying these unique insights is vital to developing safer, more equitable neonatal and maternity care. -
Content ArticlePeople with kidney failure or chronic kidney disease, whose kidneys have stopped working properly, may need dialysis. This therapy takes over the normal function of the kidneys and removes waste products and excess fluid from the blood. Many people have regular dialysis in hospital, where fluids are filtered by a machine (haemodialysis). In peritoneal dialysis, often carried out at home, a catheter is inserted in the abdomen and left there permanently. A catheter can be inserted under general anaesthetic by a surgeon, or without a general anaesthetic by a physician using a needle (medical insertion). Medical insertions have become more common in recent years due to a lack of access to surgeons and theatre space; they have the advantage of being possible in people who are not well enough to have a general anaesthetic. However, evidence on the safety and efficacy of medical insertions is lacking. This study assessed the number of safety events following catheter insertions for peritoneal dialysis via the medical and surgical route. Researchers explored the reasons for choosing medical, versus surgical catheter insertions.
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Content ArticleSepsis Research FEAT and the James Lind Alliance launched a survey last year giving health and social care professionals and sepsis patients and their carers the unique opportunity to shape future sepsis research. They are now launching phase 2 of the survey.
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News Article
Long Covid blood clues could prompt future trials
Patient Safety Learning posted a news article in News
People with long Covid have evidence of continuing inflammation in their blood, which could help understanding of the condition and how it may be treated, a UK study suggests. It found the presence of certain proteins increased the risk of specific symptoms, such as fatigue, in people sick enough to need hospital treatment. It is unclear whether milder cases of Covid have the same effect on the body. A test remains a long way off - but the findings may prompt future trials. Read full story Source: BBC News, 8 April 2024 Related reading on the hub: Top picks: 12 research papers on Long Covid -
Content ArticleOne in ten severe acute respiratory syndrome coronavirus 2 infections result in prolonged symptoms termed long coronavirus disease (Covid), yet disease phenotypes and mechanisms are poorly understood. This study profiled 368 plasma proteins in 657 participants ≥3 months following hospitalisation. Of these, 426 had at least one long Covid symptom and 233 had fully recovered. The study aimed to understand inflammatory processes that underlie Long Covid. The findings suggest that specific inflammatory pathways related to tissue damage are implicated in subtypes of Long Covid, which might be targeted in future therapeutic trials. Related reading on the hub: Top picks: 12 research papers on Long Covid
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Content ArticleClinical guidelines can contribute to medication errors but there is no overall understanding of how and where these occur. This study aimed to identify guideline-related medication errors reported via a national incident reporting system, and describe types of error, stages of medication use, guidelines, drugs, specialties and clinical locations most commonly associated with such errors.
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Content ArticleThere is a growing momentum around the world to foster greater opportunities for the involvement of mental health service users in their care and treatment planning. In-principle support for this aim is widespread across mental healthcare professionals. Yet, progress in mental health services towards this objective has lagged in practice. Francis et al. conducted a systematic review of quantitative, qualitative and mixed-method research on interventions to improve opportunities for the involvement of mental healthcare service users in treatment planning, to understand the current research evidence and the barriers to implementation. Overarching barriers to shared and supported decision-making in mental health treatment planning were: (1) Organisational (resource limitations, culture barriers, risk management priorities and structure); (2) Process (lack of knowledge, time constraints, health-related concerns, problems completing and using plans); and (3) Relationship barriers (fear and distrust for both service users and clinicians). On the basis of the barriers identified, recommendations are made to enable the implementation of new policies and programmes, the designing of new tools and for clinicians seeking to practice shared and supported decision-making in the healthcare they offer.
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Content ArticleDevolution and decentralisation policies involving health and other government sectors have been promoted with a view to improve efficiency and equity in local service provision. Evaluations of these reforms have focused on specific health or care measures, but little is known about their full impact on local health systems. This study evaluated the impact of devolution in Greater Manchester (England) on multiple outcomes using a whole system approach.
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Content ArticleHealth Services Research (HSR) conceptual models examine the complexity and “basic science” of patient safety. HSR methods can help quantify patient safety problems, enhance their understanding, and develop and test solutions. However, preventable harm persists and even worsened during the pandemic. One reason is inadequate attention and investment in patient safety over the past two decades. Significant investments are still needed to measure the burden of different patient safety events across settings and to address emerging safety threats. Solutions need to be developed, evaluated, and implemented through rigorous research to ensure widespread, effective adoption. Multidisciplinary strategies are required both to mitigate safety threats before they lead to patient harm, and to close the implementation gap. Outside of AHRQ and VA funding, patient safety research in the United States is underfunded. Efforts to translate HSR to patient care, policy, and clinical practice is essential for patient safety improvements. These efforts require health services researchers to go beyond publishing a paper; they must work closely with healthcare organizational leaders, clinicians, policymakers, and patients to ensure their findings are acted upon, and to help propose and test solutions. The National Center for Patient Safety (NCPS) offers an excellent model to do so by funding dedicated patient safety centres of inquiry (PSCIs) nationally. PSCIs focus on research and implementation activities that promote organization-wide learning. The PSCI model adds significant value to creating a learning health system for safety that invests in patient safety data gathering, analysis, learning, and actionable improvements.
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Content ArticleIn this episode, Dr Paul Grime, Chairman of the Safer Healthcare and Biosafety Network, speaks to Jonathan Pearce, Chief Executive of Antibiotic Research UK. Jonathan has nearly 20 years’ experience as a CEO in the UK charity sector and has led a number of national organisations, including DKMS UK, Lymphoma Action and Adoption UK. Safety Talks is a podcast series as part of the Safety for All Campaign, launched to shine a light on the symbiotic relationship and benefits of integrating the approach to deliver healthcare worker safety and patient safety.
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Content ArticleThis Lancet article highlights three challenges to measuring and analysing social determinants of health (SDoH) for which data science—a cross-disciplinary set of skills to make judgements and decisions with data by using it responsibly and effectively—can be harnessed. The three challenges the authors examine are: Data necessary for capturing the exposure of interest at multiple levels appropriately are not always available nor easy to measure. SDoH are distal to individual health outcomes compared to biomedical determinants such as comorbidities. The distal placement of SDoH in relation to health outcomes results in requires long periods of time to observe their effect.
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News ArticleWhile the importance of translating evidence into policies and practices is widely acknowledged by evidence producers, intermediaries, users, and funders, there is much less agreement on suitable mechanisms for promoting effective evidence use. As a response, the World Health Organization (WHO) has initiated an extensive and inclusive research priority-setting exercise in Knowledge Translation (KT) and Evidence-informed Policy-making (EIP) through a series of technical consultations. This priority-setting initiative, coordinated by the Evidence to Policy and Impact Unit in WHO’s Science Division, involves national and international researchers, practitioners, and organizations across all WHO regions. Collectively, they will assess the evidence base for effective research utilization in decision-making. The overarching goal of this project is to maximize the impact of KT and EIP research to promote the translation of evidence into effective policies that enhance population health and well-being. Key objectives include: Efficiency and Synergy: Streamlining research efforts in KT and EIP. Strategic Funding: Directing research funding toward identified priority areas. Effective Approaches: Enhancing understanding of evidence use for policy-making. Collaboration: Promoting cross-sectoral collaboration in KT and EIP research. Awareness: Championing for evidence-informed policy-making at all levels. In the first half of the 2024, global experts – selected during an open call – are now actively participating in a series of consultations to identify gaps and opportunities in KT and EIP research. The consultations provide a pivotal opportunity for participants to discuss current research gaps, harmonize terminology and chart a course toward shared priorities. Read full story Source: WHO, 22 March 2024
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Content ArticleThis article analyses the phenomenon of epistemic injustice within contemporary healthcare. It begins by detailing the persistent complaints patients make about their testimonial frustration and hermeneutical marginalisation, and the negative impact this has on their care. The authors offer an epistemic analysis of this problem using Miranda Fricker's account of epistemic injustice. They detail two types of epistemic injustice, testimonial and hermeneutical, and identify the negative stereotypes and structural features of modern healthcare practices that generate them. They claim that these stereotypes and structural features render ill persons especially vulnerable to these two types of epistemic injustice. The authors end by proposing five avenues for further work on epistemic injustice in healthcare. "Without the narrative acts of telling and being heard, the patient cannot convey to anyone else – or to self – what he or she is going through. More radically and perhaps equally true, without these narrative acts, the patient cannot himself or herself grasp what the events of illness mean."
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Content ArticleImproving maternity care is a key Government and National Institute for Health and Care Research (NIHR) priority. In March 2024, an NIHR Evidence webinar showcased research from their recent Collection, Maternity services: evidence to support improvement. This summary includes videos of researchers’ presentations and captures some of the points raised in the webinar Q&A. It highlights seven features of safety in the maternity units, kind and compassionate care around the induction of labour, and the role of hospital boards in improving maternity care.
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Content ArticleResearch conducted by a team at the University of Birmingham delves into the intricate dynamics of empathy towards patients and colleagues, revealing insights that challenge conventional wisdom. Empathy is widely recognised as a cornerstone of medical care. Increased physician empathy has been linked to better patient outcomes and satisfaction, yet there has been little exploration of its presence in surgical training. The study involved interviews with 10 surgical trainees at various stages of their careers to uncover a nuanced understanding of empathy within the profession. Contrary to the widely documented decline in empathy among medical students and professionals, participants described their experiences as a balance between empathy and the demands of surgical practice. Participants acknowledged the importance of empathy in patient care but highlighted the challenges of maintaining it amid the pressures of a surgical environment. They described a delicate balance between understanding patients’ needs and the efficiency required to manage high patient volumes and demanding workloads. The study revealed how empathy evolves throughout a surgeon’s career. Whilst some trainees experienced desensitisation to emotional stimuli, many described increased empathy as they gained more experience and exposure to patient care.
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Content ArticleThe aim of this study from Aiken et al. was to determine the well-being of physicians and nurses in hospital practice in Europe, and to identify interventions that hold promise for reducing adverse clinician outcomes and improving patient safety. The study found that poor work/life balance (57% physicians, 40% nurses), intent to leave (29% physicians, 33% nurses) and high burnout (25% physicians, 26% nurses) were prevalent. Rates varied by hospitals within countries and between countries. Better work environments and staffing were associated with lower percentages of clinicians reporting unfavourable health indicators, quality of care and patient safety. The effect of a 1 IQR improvement in work environments was associated with 7.2% fewer physicians and 5.3% fewer nurses reporting high burnout, and 14.2% fewer physicians and 8.6% fewer nurses giving their hospital an unfavourable rating of quality of care. Improving nurse staffing levels (79% nurses) and reducing bureaucracy and red tape (44% physicians) were interventions clinicians reported would be most effective in improving their own well-being, whereas individual mental health interventions were less frequently prioritised.
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Content ArticleThe aim of this study was to quantify the difference in weekday versus weekend occupancy, and the opportunity to smooth inpatient occupancy to reduce crowding at children's hospitals. They study found that hospitals do have substantial unused capacity, and smoothing occupancy over the course of a week could be a useful strategy that hospitals can use to reduce crowding and protect patients from crowded conditions.
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Content ArticleDoctors working in temporary positions (known as locums) are a key component of the medical workforce and provide necessary flexibility and additional capacity for NHS organisations and services. There have been concerns about the quality and safety of locum practice and the way NHS uses locum doctors. The number of doctors working as locums, and the costs of this to the NHS have caused some concerns nationally in recent years. It has also been suggested that locum doctors may not provide as good a quality of care as permanent doctors. Research carried out by a team at the University of Manchester provided important new information on these issues. The findings indicated that locum working and how locums were integrated into organisations could pose significant challenges for patient safety and quality of care.
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Content ArticleSafetyNet brings together the collective efforts of the six NIHR Patient Safety Research Collaborations (NIHR PSRCs).across England in addressing patient safety challenges of strategic importance. The quarterly SafetyNet newsletter offers you the opportunity to find out about the exciting research and collaborations that are happening across the safety centres and wider organisations.
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Content Article
NIHR Patient Safety Research Collaborations
Patient Safety Learning posted an article in Research, data and insight
NIHR Patient Safety Research Collaborations (PSRCs) are partnerships between universities and NHS trusts that support patient safety research. There are six PSRCs in England, aiming to bring patient safety discoveries to frontline NHS services. -
Content ArticleAround 1 in 5 children have eczema (also known as atopic eczema or atopic dermatitis). They typically have inflamed and dry, itchy skin. During flare-ups (periods of worsening symptoms), their skin becomes vulnerable to cracks, bleeding and infection. Eczema impacts quality of life; it can impair sleep, ability to concentrate at school, self-confidence and mood. The condition is usually long-term (chronic), although it improves, or even clears completely, in some children as they get older. Even so, it is one of the most common reasons for children and young people to seek medical care. Community pharmacists and GPs are the first port of call and, while there is no cure, treatments can soothe sore skin, reduce itching, improve the appearance of the eczema, and reduce infections.
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Content ArticleDiagnostic errors cause significant patient harm. The clinician’s ultimate goal is to achieve diagnostic excellence in order to serve patients safely. This can be accomplished by learning from both errors and successes in patient care. However, the extent to which clinicians grow and navigate diagnostic errors and successes in patient care is poorly understood. Clinically experienced hospitalists, who have cared for numerous acutely ill patients, should have great insights from their successes and mistakes to inform others striving for excellence in patient care.
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Content ArticleWomen and people born biologically female have unique health needs across the life span, and their health outcomes often differ from those of men. Although women make up greater than half of the world’s population, these unique needs remain both insufficiently understood, due to decades of exclusion from scientific and medical research, and inadequately addressed, due to systems and cultures that often dismiss or devalue their experiences. This article discusses highlights from the National Academy of Medicine's Annual Meeting Scientific Symposium in October 2023 on the subject of women’s health. It looks at improving representation in research, bridging the gap in terms of social determinants of health and the need to reassess and research the female chromosomal makeup.
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Content ArticleDiagnostic delays in the emergency department (ED) are a serious patient safety concern. This retrospective cohort study included children treated at 954 EDs across 8 states, and examined the association between ED volume and delayed diagnosis of first-time diagnosis of an acute, serious conditions (e.g., bacterial meningitis, compartment syndrome, stroke). The researchers found that EDs with lower pediatric volume had higher rates of delayed diagnosis across 23 serious conditions.
