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Found 257 results
  1. Content Article
    Safety leader Helen Macfie describes why she appreciates that Safer Together: A National Action Plan to Advance Patient Safety includes workforce safety as one of its foundational areas.
  2. Content Article
    An innovative approach to managing behaviour in the operating room (OR) using posters with eye symbols has seen positive results. A team of Australian researchers conducted a successful trial to address offensive and impolite remarks within ORs by implementing ‘eye’ signage in surgical rooms. These posters, placed on the walls of an Adelaide orthopaedic hospital’s operating theatre without explanation, effectively reduced poor behaviour among surgical teams. The lead researcher, Professor Cheri Ostroff from the University of South Australia, attributed this outcome to a sense of being ‘watched’, even though the eyes are not real. The three-month experiment targeted a prevalent culture of bullying and misconduct in surgical settings, a problem pervasive not only in healthcare but across various high-stress industries. Professor Ostroff emphasised that besides affecting staff morale and productivity, rude behaviour also has a detrimental impact on patients, particularly in compromising teamwork and communication during surgery, potentially leading to poorer outcomes.
  3. News Article
    Theatre staff at a major hospital “deliberately slowed down” elective activity to limit the number of operations that could be done each day, an NHS England review has been told. The culture in theatres at the William Harvey Hospital in Ashford, run by East Kent Hospitals University Foundation Trust, was a “significant issue” according to an education quality intervention review report into trauma and orthopaedic training at the hospital. The review, dated October and made public by NHSE in December 2023, was launched after concerns were raised by staff at the trust in the General Medical Council’s national training survey, published every July. Problems raised by junior doctors and their supervisors to the NHSE review included perceptions that juniors were made to feel uncomfortable by the trauma theatre team and that there was also “animosity” from the trauma theatre team towards surgeons. The review said trauma theatre staff were heard “bragging” about their behaviour towards surgeons and that they resisted the number of cases scheduled on a list, claiming it was “unrealistic". Read full story (paywalled) Source: HSJ, 19 January 2024
  4. Content Article
    The aim of this study in the Journal of Patient Safety was to identify quantitative evidence for the efficacy of interprofessional learning (IPL) to improve patient outcomes. The authors conducted a systematic review and meta-analysis of quantitative patient outcomes after IPL in multidisciplinary healthcare teams reported in the Medline, Scopus, PsycInfo, Embase and CINAHL databases. The authors believe that their results are the first to demonstrate significant quantitative evidence for the efficacy of IPL to translate into changes in clinical practice and improved patient outcomes. They reinforce earlier qualitative work on the value of IPL.
  5. Content Article
    The rise of the #TheatreCapChallenge in 2017, which saw participants donning surgical caps labelled with their names and roles, promises to be a seemingly simple intervention aimed at improving operating theatre communication and patient safety. This narrative review strives to expand upon the perceived and studied benefits of this intervention and address potential concerns that have arisen with the use of these name and role-labelled surgical caps.
  6. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Sonia talks to us about how her role at NHS Confederation helps her understand the issues facing NHS staff and why she decided to start drawing graphics to communicate important information to patients and staff.
  7. Content Article
    Judy Walker looks at the ways in which team learning can contribute to safety in healthcare using tools such as After Action Review (AAR). She explores research highlighted in Amy Edmondson's new book The Right Kind of Wrong that demonstrates the impact on certain safety indicators of flight crews building a team culture through working together consistently. Judy suggests that gaining insights about co-workers through proximity accelerates the process of learning for teams.
  8. Content Article
    David Logan talks about the five kinds of tribes that humans naturally form—in schools, workplaces, even the driver's license office. He argues that by understanding our shared tribal tendencies, we can help lead each other to become better individuals.
  9. Content Article
    Dr Chris Turner, of Civility Saves Lives and consultant in emergency medicine, was invited by the NHS Highland Medical Education team to lead a series of lectures and workshops exploring the impact of our behaviour on our colleagues and workplace.
  10. Content Article
    Incivility in the workplace, school and political system in the United States has permeated mass and social media in recent years and has also been recognized as a detrimental factor in medical education. This scoping review in BMC Medical Education identified research on incivility involving medical students, residents, fellows and faculty in North America to describe multiple aspects of incivility in medical education settings published since 2000. The results of the review highlight that incivility is likely to be under-reported across the continuum of medical education and also confirmed incidences of incivility involving nursing personnel and patients that haven't been emphasised in previous reviews.
  11. Content Article
    A substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect. Leape et al. identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behaviour in the health care setting: disruptive behaviour; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behaviour; passive disrespect; dismissive treatment of patients; and systemic disrespect. At one end of the spectrum, a single disruptive physician can poison the atmosphere of an entire unit. More common are everyday humiliations of nurses and physicians in training, as well as passive resistance to collaboration and change. Even more common are lesser degrees of disrespectful conduct toward patients that are taken for granted and not recognised by health workers as disrespectful. Disrespect is a threat to patient safety because it inhibits collegiality and cooperation essential to teamwork, cuts off communication, undermines morale, and inhibits compliance with and implementation of new practices. Nurses and students are particularly at risk, but disrespectful treatment is also devastating for patients. Disrespect underlies the tensions and dissatisfactions that diminish joy and fulfilment in work for all health care workers and contributes to turnover of highly qualified staff. Disrespectful behaviour is rooted, in part, in characteristics of the individual, such as insecurity or aggressiveness, but it is also learned, tolerated, and reinforced in the hierarchical hospital culture. A major contributor to disrespectful behaviour is the stressful health care environment, particularly the presence of “production pressure,” such as the requirement to see a high volume of patients.
  12. Content Article
    NHS England has launched this framework on the expectations of NHS line managers in relation to people management. The report contains a recommendation to create a clear view on the expectations of line managers in the service in relation to people management and the implications for provision of people services.
  13. Content Article
    In this interview, Derek Feeley, IHI President Emeritus and Senior Fellow shares the work of the Health Improvement Alliance Europe (HIAE) workgroup related to curiosity. He outlines five simple rules linked to complexity theory, which states that if you are trying to make sense of a complex situation, you should create simple, order-generating rules. The five simple rules are: Ask rather than tell. Listen to understand rather than to respond. Hear every voice rather than only those easiest to hear.  Prioritise problem framing rather than problem solving. Treat vulnerability as a strength rather than a weakness.
  14. Content Article
    This infographic by artist Sonia Sparkles was produced for Portsmouth Hospitals NHS Trust to outline what patients can expect from healthcare staff when attending an appointment at or staying in hospital. It covers navigating he hospital, what to expect from an appointment and standards for staff attitudes. A wide range of graphics relating to patient safety, healthcare and quality improvement is available on the Sonia Sparkles website.
  15. Content Article
    This article by Jesse Lyn Stoner, argues that leading without relying on authority is a higher evolutionary skill. It supports developing adult relationships based on mutual objectives and creates work environments grounded in respect for human dignity. Stoner outlines “The 8 Portals of Influence” – Ways to Influence Without Authority.
  16. Content Article
    Achieving shared interpersonal understanding between healthcare professionals, patients and families is a core patient safety challenge around the world. The SACCIA model promotes safe communication practice amongst healthcare teams and between providers patients. It was developed by Professor Annagret Hannawa, Director of the Center for the Advancement of Healthcare Quality & Safety in Switzerland. The interpersonal processes that are captured in the SACCIA acronym are considered 'safe' because they lead to a shared understanding between all care participants: Sufficiency Accuracy Clarity Contextualization Interpersonal Adaptation The five SACCIA competencies emerged from a communication science analysis of hundreds of critical healthcare incidents. They were identified as common deficient interpersonal processes that often cause and contribute to preventable patient harm and insufficient care. They therefore represent an evidence-based set of core competencies for safe communication, which constitute the vehicle to patient care that is safe, efficient, timely, effective and patient-centred.
  17. Content Article
    For surgical teams, high reliability and optimal performance depend on effective communication, mutual respect, and continuous situational awareness. Surgeons who model unprofessional behaviours may undermine a culture of safety, threaten teamwork, and thereby increase the risk for medical errors and surgical complications. This article in JAMA Surgery aimed to assess whether patients of surgeons with a higher number of coworker reports about unprofessional behaviour experience a higher rate of postoperative complications than patients whose surgeons have no such reports. The authors found that  patients whose surgeons had a higher number of coworker reports had a significantly increased risk of surgical and medical complications. These findings suggest that organisations interested in ensuring optimal patient outcomes should focus on addressing surgeons whose behaviour toward other medical professionals may increase patients’ risk for adverse outcomes.
  18. Content Article
    How we treat each other at work has an enormous impact on how teams perform—with potentially fatal consequences if you work in healthcare. Chris Turner, consultant in emergency medicine and founder of Civility Saves Lives, reveals the shocking impact of rudeness in the workplace. He highlights the importance of understanding the complex realities of practice and communication between healthcare professionals in different team environments, if we are to learn from patient safety incidents.
  19. Content Article
    The aim of this study in the journal Pediatrics was to explore the impact of rudeness on the performance of medical teams. Twenty-four NICU teams participated in a training simulation involving a preterm infant whose condition acutely deteriorated due to necrotizing enterocolitis. Participants were informed that a foreign expert on team reflexivity in medicine would observe them. Teams were randomly assigned to either exposure to rudeness (in which the expert’s comments included mildly rude statements completely unrelated to the teams’ performance) or control (neutral comments). The videotaped simulation sessions were evaluated by three independent judges (blinded to team exposure) who used structured questionnaires to assess team performance, information-sharing and help-seeking. The authors concluded that rudeness had adverse consequences on the diagnostic and procedural performance of NICU team members. Information-sharing mediated the adverse effect of rudeness on diagnostic performance, and help-seeking mediated the effect of rudeness on procedural performance.
  20. News Article
    Delays in patient care and a lack of consultant support have left junior medics fearing for their mental health, an NHS England investigation has discovered. Junior doctors described haematology services delivered from University Hospitals Birmingham’s Heartlands Hospital as “chaotic”. Their concerns are raised in a report by NHS England Workforce, Training and Education (formerly Health Education England). UHB’s haematology service has been under scrutiny since 2021, when HSJ revealed whistleblower concerns over patient safety, including a series of blood transfusion’ never’ events. The WTE team visited UHB in April. As a result, the haematology service is now subject to the General Medical Council’s enhanced monitoring regime. This means intensive support is given to trainees and the trust to improve medical training. UHB’s obstetrics and gynaecology department is also under enhanced monitoring. The WTE report warns that consultants working across multiple sites left trainee medics at Heartlands without sufficient support and supervision. Most conversations with consultants were via telephone, leaving juniors feeling “unsupported and insecure”. The report stated: “Trainees described the workload … as chaotic and some reported the stress … was affecting their mental health… Some reported they do not feel valued, and the panel heard examples of people crying every day. Most described their roles as 100 per cent service provision… [they] reported very limited learning opportunities overall.” Read full story (paywalled) Source: HSJ, 24 August 2023
  21. Content Article
    According to the last AHPRA Medical Training Survey, a third of doctors in training in the USA had experienced or witnessed bullying, harassment or discrimination in the workplace. The person responsible was usually a colleague and concerningly, only a third of those who witnessed or experienced this behaviour reported it. In this article, Josh Inglis explains why we can’t continue to overlook unprofessional behaviour in our workplace, because doing so is causing harm to ourselves, our patients and the profession, and what we can do about it.
  22. Content Article
    The aim of the study was to explore the factors that affect the safety attitude and teamwork climate of Cyprus maternity units and Cypriot midwives. The study found that the safety climate in the maternity settings was negative across all six safety climate domains examined. The higher mean total score on team work and safety climate in the more experienced group of midwives is a predominant finding for the maternity units of Cyprus. It could be suggested that younger midwives need more support and teamwork practice, in a friendly environment, to enhance the safety and teamwork climate through experience and self-confidence.
  23. Content Article
    There are signs that some US healthcare organisations are scoring some successes in addressing the worker morale and retention crisis. But data from Press Ganey surveys shows that there is a widening gap between the most- and least-successful organisations. This article draws lessons from the former. It discusses three key elements needed to engage workers, make them more resilient, and make them feel more aligned with their leaders.
  24. Content Article
    This blog (attached below) explores how far the nature of our relationships at work have an impact on patient safety. Lesley Parkinson – the executive director of Restorative Thinking, a social enterprise working to introduce and embed restorative and relational practice in the NHS and across public sector organisations – explores how six restorative practice habits add value in multiple teams and scenarios. You can also order Lesley's book Restorative Practice at Work Six habits for improving relationships in healthcare settings.
  25. Content Article
    This guidance on implementing human factors in anaesthesia has been produced by the Difficult Airway Society and the Association of Anaesthetists. Human factors is an evidence-based scientific discipline used in safety critical industries to improve safety and worker wellbeing; implementing human factors strategies in anaesthesia has the potential to reduce the reliance on exceptional personal and team performance to provide safe and high-quality patient care. A three-stage Delphi process was used to formulate a set of 12 recommendations: these are described using a ‘hierarchy of controls’ model and classified into design, barriers, mitigations and education and training strategies.
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