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Found 172 results
  1. Content Article
    Electronic health record (EHR) nursing summaries have the potential to support nurses in locating and synthesising patient information. However, nurses’ role-specific perspectives are often excluded in the design of the EHR system. The purpose of this study was to describe nurses’ current use of nursing summaries and vital sign information within them and glean their ideas for design improvements. en clinical inpatient nurses participated in interviews and co-design activities. Nurses hardly use the nursing summary to overview a comprehensive patient's health status. The current design of a nursing summary lacks comprehensive patient information and contains much irrelevant data. Nurses prefer vital signs to be prominently displayed on the summary screen for easy visibility. Involving nurses in the design process can lead to a nursing summary that better meets their needs.
  2. Content Article
    In the past, long before Covid, doctors used to openly discuss complex cases and unexpected deaths on an anonymous basis either in the doctors' mess or in medical grand rounds hosted by their hospital’s clinical education department. What's happened to these forums for learning? Are these clinical conversations alive and well, and helping doctors and nurses alike to learn from safety incidents? Or have medical grand rounds disappeared from practice?
  3. Content Article
    This article by Saoirse Mallorie, Senior Policy Analyst at The King's Fund, looks at the detail behind the results of the 2023 NHS Staff Survey. She highlights that although it looks as though there has been improvement in some areas, staff satisfaction is not where it should be. The article also looks at variation between staff groups in terms of work-related stress, autonomy, belonging and workload, representing these differences visually in graphical form.
  4. Content Article
    This insightful session was inspired by Louise Roe's blog "Why it made sense at the time: Local rationality questions for healthcare investigations". In this webinar from Maternity and Newborn Safety Investigations (MNSI), participants explored the importance of how questions are asked, the local rationality principle, how the local rationality question tool was developed, putting the tool into practice, and had a Q&A session.
  5. Content Article
    Carolyn Cleveland has delivered training on empathy and compassion to healthcare organisations for many years. In this interview, she describes how she came to develop her training approach and outlines how creating a psychologically space environment for individuals to engage with the practice of empathy contributes to safer organisational cultures.
  6. Content Article
    In this article for the Lancet, Richard Horton reflects on the failure of medical education systems around to look after their students. He highlights reports of large proportions of medical students reporting burnout and feeling unappreciated and calls for an overhaul of the medical education system.
  7. News Article
    A group representing hundreds of clinicians has applied to contribute to the Lucy Letby inquiry, to challenge NHS culture around whistleblowing. Their experiences of raising concerns should inform the inquiry, they say. Letby murdered seven babies and attempted to murder another six while working at the Countess of Chester NHS trust between June 2015 and June 2016. The public inquiry is examining how the nurse was able to murder and how the hospital handled concerns about her. "The evidence of this group relating to how whistleblowers are treated, not just at one trust but across the UK, is of huge significance," Rachel di Clemente, of Hudgell Solicitors, acting for the clinicians, said. The group, NHS Whistleblowers, comprising healthcare professionals across the UK, including current and former doctors, midwives and nurses, has written to Lady Justice Thirlwall's inquiry, asking for them to be formally included as core participants. The inquiry has stated it will consider NHS culture. And the group says "a culture detrimental to patient safety" is evident across the health service. "NHS staff who have bravely spoken up about patient-safety concerns or unethical practices deserve to have their voices heard," Dr Matt Kneale, who co-chairs Doctors' Association UK, which is part of the group, said. Read full story Source: BBC News, 21 March 2024
  8. Content Article
    Chris Elston, a patient safety education lead, shares how he used Safety Engineering Initiative for Patient Safety (SEIPS) and Accident Mapping (AcciMap) to learn from a patient safety incident at his Trust.
  9. Content Article
    This article tells the story of how the This Is My Story (TIMS) initiative developed at John Hopkins Medicine, and how it is giving care teams a humanising window into the lives of patients who can’t speak for themselves. Initiated by Chaplain Elizabeth Tracey, who saw the toll not being able to communicate with intubated patients was having on healthcare workers during the first wave of the Covid-19 pandemic, TIMS provides healthcare teams with a short audio recording about each patient. The patient's family shares details about their loved one, such as information on hobbies, personal interests and the patient's career. Staff have reported the TIMS recordings having a big impact on how they view their patients, and the scheme has been rolled out across John Hopkins services.
  10. Content Article
    The NHS regularly uses temporary staff to fill gaps in its workforce. This investigation explored the challenges of involving temporary clinical staff (bank only staff, agency staff and locum doctors working within trusts) in local trusts’ patient safety investigations. Trust-level investigations are important because they are a way to identify learning to improve healthcare systems, with the aim of reducing the potential for harm to patients. Identifying learning requires staff to be engaged in an investigation; if temporary staff are not involved, learning may be lost, posing a risk to patient safety. HSSIB identified this risk following analysis of serious incident reports provided by acute and mental health NHS trusts. To explore the issue further, the investigation carried out site visits and engaged with NHS trusts, providers of bank staff, agencies that supply staff to NHS trusts, substantive (permanent) NHS staff, bank and agency staff, and a range of national stakeholders.
  11. Content Article
    This case study shares learning from the approach to retention at University Hospitals Birmingham. In particular it highlights how the trust adopted a new approach to organisational culture and staff engagement which has had a positive impact on staff retention. Effective use of data is a key element and has played a key role in making progress. The trust still faces challenges but has improved retention and is moving in right direction.
  12. Content Article
    Enthusiasm has grown about using patients’ narratives—stories about care experiences in patients’ own words—to advance organisations’ learning about the care that they deliver and how to improve it, but studies confirming association have not been published. This study assessed whether primary care clinics that frequently share patients’ narratives with their staff have higher patient experience survey scores. It found that sharing narratives with staff frequently is associated with better patient experience survey scores, conditional on confidence in knowledge. Frequently sharing useful patient narratives should be encouraged as an organizational improvement strategy. However, organisations need to address how narrative feedback interacts with their staff’s confidence to realize higher experience scores across domains.
  13. Content Article
    This month marks two years of the hub's Patient Safety Spotlight interview series. Patient Safety Learning's Content and Engagement Manager Lotty Tizzard reflects on the value of sharing personal insights and identifies the key patient safety themes that interviewees have highlighted over the past two years.
  14. News Article
    The NHS has been accused of putting patients' lives at risk after it allowed hundreds of staff, including senior consultants and managers, to work thousands of miles from the UK. A Mail on Sunday investigation has discovered that NHS staff at every level are working remotely in places as far flung as Australia and Japan. Critics last night warned that the 'unacceptable and dangerous' arrangements could threaten patient safety. Professor Karol Sikora, a former director of the World Health Organisation cancer programme, said: "Allowing staff to work from abroad is a huge mistake that can only undermine patient safety and the efficacy of treatment." At least 335 NHS staff from 33 trusts have been allowed to work abroad in the past two years, according to data from Freedom of Information requests. Until last year, Constantine Fragkoulakis, 42, was employed as a consultant radiologist at Sherwood Forest Hospitals Foundation Trust in Nottinghamshire. The trust said its radiologists "routinely interpret images and write reports away from the hospitals where they are based". But Mr Fragkoulakis admitted there had been "a lot of IT issues, so there was no patient care involved or clinical work'. He added: 'Essentially it was just meetings that I did." Another consultant radiologist, Branimir Klasic, 50, is being allowed to work two weeks each month in Croatia by the Aneurin Bevan University Health Board in South Wales. It said recruitment was "increasingly challenging" and that it was "open to exploring ways of working that ensures we can provide the skills and expertise that our patients need". A Department of Health spokesman said: "We are clear that ways of working, which are agreed between NHS employers and its staff, should never impact on NHS patients or services." Read full story Source: Daily Mail, 10 February 2024
  15. Content Article
    "Our #health system in the UK is in a mess. It has failed to modernise (by this I mean to become fully accountable to #patients and the public, and truly patient-led). Instead, the system has become more and more hierarchical, bureaucratic and crony ridden, mostly as a result of constant meddling and pointless reorganisations instigated by politicians. All political parties in government for the past 30 years have had a hand in this decline." This is my view? What is yours? A new Inquiry gives us all an opportunity to have our say. I am proud to have worked in and for the NHS for most of my working life; proud to have been trained in the #NHS and proud of the work being carried out by clinical teams today. Great work which has benefited patients, often not because of the leadership but despite of the leadership. I'm retired so I can say what I like. If I were working and said anything even vaguely like criticism, however constructive it was, I would be out of a job and my career would be blighted for life. I'm speaking from experience here, unfortunately. I urge everyone to respond to the consultation (link below). In your response think forensically and write it as a statement of truth. Acknowledge the successes and areas that have delivered safe and effective services. If you are being critical give examples and say if it is an opinion or back up what you say with evidence. If we work together across boundaries we can develop a truly patient-led NHS.
  16. Content Article
    Sickness absence in the English NHS in 2022 was 5.6% – higher than the 4.3% rate three years earlier pre-covid, and totalling some 27 million days sickness absence. Moreover, 54.5% of staff reported they had gone into work in the previous three months despite not feeling well enough to perform their duties. This is a challenge for staff, managers, employers and occupational health services. Sickness absence measured and reported accurately can help identify trends that may assist with both understanding individual causes and preventing or mitigating sickness absence patterns by addressing their root causes. The NHS, along with many other public sector organisations, however, relies on a system of sickness absence measurement called the “Bradford Factor” which some suggest is counterproductive, without research underpinning and needs to be replaced. The Bradford Factor is a system which creates individual level, “trigger points” at which line managers consider investigation which may lead to disciplinary action to supposedly prompt improved attendance and referral to occupational health. The NHS’s over reliance on the Bradford Factor is potentially discriminatory and highlights the urgent need for a shift in how the service manages sickness absence, writes Roger Klein in this HSJ article.
  17. Content Article
    This guide by the Health Foundation can be used to make the case for improvement to policy, executive, operational and front-line audiences, and to initiate and support conversations about the benefits of improvement approaches among key stakeholders. The guide is divided into four broad areas improvement approaches can benefit: the health and care workforce patients, service users and society  organisations and system-level bodies. Specific examples are given for each area, illustrating the diverse and multi-faceted benefits that come from improvement approaches.
  18. Content Article
    There are around 1.3 billion people in the world with a disability, but in many settings, the understanding of reasonable adjustments among healthcare workers is inadequate to provide the same quality of care for people with disabilities as individuals without disabilities. Inclusive healthcare requires improvements in accessibility and training for healthcare professionals. Some progress is being made and medical education in some countries now includes disability, human rights and reasonable adjustments in education and training. This Lancet article outlines global examples of attempts to improve healthcare workers' understanding of disabilities and inclusion.
  19. Content Article
    Reporting behaviour associated with safety-related accidents, incidents and hazards is a concern for many managers, regulators, safety specialists, operational staff and patients. In this blog, Stephen Shorrock looks at the many influences on reporting behaviour and how these influences are interrelated.
  20. Content Article
    The prevalence of noncommunicable diseases (NCDs) or chronic diseases is increasing in Europe. NCDs now account for 90% of deaths in the WHO European Region, yet most health systems were developed to treat and care for people with acute conditions. Health care services are still lagging behind in terms of responding to the particular needs of those living with chronic conditions, including diabetes, cardiovascular disease (hypertension and heart failure) and respiratory diseases (asthma and chronic obstructive pulmonary disease).  Policy-makers and health-care managers are working to better organize health services to reflect and cater to the needs of these patients, for example by strengthening integrated primary health-care services. Important work is also needed to increase people’s knowledge, skills and confidence to manage their own conditions on a day-to-day basis, outside of health-care settings. Patients spend on average 2 hours per year with their health professional and the rest of the time they need to take care of their health themselves. Supporting patients to self-manage their condition is crucial to improving outcomes and reducing anxiety and complications.  WHO Regional Office for Europe has published a new “how-to” guide for policy-makers, health professionals, and education and training bodies on therapeutic patient education (TPE). The guide covers commissioning, designing and delivering TPE services and training programmes for health professionals. It also looks at the evidence and theory underpinning patient education, outlines key components for delivering a high-quality service and identifies implementation opportunities and barriers. 
  21. Content Article
    Efforts to increase physician engagement in quality and safety are most often approached from an organisational or administrative perspective. Given hospital-based physicians’ strong professional identification, physician-led strategies may offer a novel strategic approach to enhancing physician engagement. It remains unclear what role medical leadership can play in leading programmes to enhance physician engagement. In this study, Rotteau et al. explore physicians’ experience of participating in a Medical Safety Huddle initiative and how participation influences engagement with organisational quality and safety efforts. They found that The Medical Safety Huddle initiative supports physician engagement in quality and safety through intrinsic motivation. However, the huddles’ implementation must align with the organisation’s multipronged patient safety agenda to support multidisciplinary collaborative quality and safety efforts and leaders must ensure mechanisms to consistently address reported safety concerns for sustained physician engagement.
  22. News Article
    The NHS could struggle to cope with a catastrophic flu season after leading medics warned of plunging flu vaccine uptake among its frontline staff. NHS figures show just 39% of frontline staff had a flu vaccine in November, down from 52% in November 2020. The worrying statistics mean the already under-strain service could lose crucial staff to illnesses and risk spreading the virus during its busiest winter period. Speaking to The Independent, Dr Adrian Boyle, president of the Royal College of Emergency Medicine said: “We are concerned about staff vaccination against flu. Post-pandemic, there is a certain lack of appetite and there is probably a degree of apathy about staff getting vaccinated against flu, and we think that’s a problem. “We need to be doing more to get stuff vaccinated against flu.” He added: “I think societally and as healthcare practitioners, I think we have a moral duty to get ourselves vaccinated so we don't create gaps by going off sick and we don't infect our patients.” Read full story Source: The Independent, 21 December 2023
  23. Content Article
    The aim of this project was to introduce and evaluate the Call 4 Concern© (C4C) service, which provides patients and relatives with direct access to critical care outreach services (CCOS). This allows patients and relatives an additional platform to raise concerns related to the clinical condition and facilitate early recognition of a deteriorating patient. The introduction of Call 4 Concern at a district general hospital was inspired by the Royal Berkshire Hospital, where staff have been pioneering the service in the UK since 2009. They were able to demonstrate the potential to prevent clinical deterioration and improve the patients' and relatives' experiences.  The project was originally inspired by the Condition H(elp) system in the USA, which was set up following the death of an 18-month-old child who died of preventable causes. Similar tragic cases in the USA and the UK have prompted campaigning by affected families, resulting in the widespread adoption of comparable services. The project was rolled out in the authors' trust for all adult inpatients. There was a 2-week implementation phase to raise awareness. Between 22 February 2022 and 22 February 2023, the CCOS team received 39 C4C referrals, representing approximately 2.13% of the total CCOS activity. Clinical deterioration of a patient was prevented in at least three cases, alongside overwhelming positive feedback from service users.
  24. Event
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    Themed Together to Regenerate Health and Care, the programme will showcase inspirational improvement work from all sectors and explore how we can create a system of health and care that truly meets the needs of our communities. You can now explore six new topic streams - Safety, People, Population, Change, Leadership and Science, and find sessions that address the challenges that you and your organisation face. Register
  25. Content Article
    High reliability organisations are organisations that work in situations that have the potential for large-scale risk and harm, but which manage to balance effectiveness, efficiency and safety. They also minimise errors through teamwork, awareness of potential risk and constant improvement. This evidence scan collates empirical evidence about the characteristics of high reliability organisations and how these organisations develop within and outside healthcare.
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