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Found 68 results
  1. Content Article
    The use of patient portals to send messages to healthcare teams is increasing. This JAMA Network Open cross-sectional study of nearly 40,000 US patients aimed to find out whether there are differences in how care teams respond to messages from Asian, Black and Hispanic patients compared with similar White patients. The authors found that messages asking for medical advice sent by patients who belong to minoritised racial and ethnic groups were less likely to receive a response from doctors and more likely to receive a response from registered nurses. This suggests these patients receive lower prioritisation during triaging. The differences observed were similar among Asian, Black and Hispanic patients.
  2. Content Article
    This JAMA Network Open study aimed to explore whether standardised patients in a simulated environment can be effectively used to explore racial implicit bias and communication skills among doctors. For this cross-sectional study, 60 doctors were placed in an environment calibrated with cognitive stressors common to clinical environments. The results reflected expected communication patterns based on prior research (performed in actual clinical environments) on racial implicit bias and physician communication. The authors believe that this simulation and the process of its development can inform interventions that provide opportunities for skills development and assessment of skills in addressing racial implicit bias.
  3. Content Article
    The combination of emerging patient safety threats and the growing amount of published patient safety research, patient safety resources and accrediting body standards makes it increasingly difficult to prioritise adopting and implementing evidence-based practices. The US Agency for Healthcare Research and Quality's (AHRQ’s) fourth iteration of Making Healthcare Safer intends to address this issue by publishing evidence-based reviews of patient safety practices and topics as they are completed. This intentional release of updated reviews will aid healthcare organisation leaders in prioritising implementation of evidence-based practices in a timelier way. The report will also help researchers identify where more research is needed and assist policymakers in understanding which patient safety practices have the supporting evidence for promotion.
  4. Content Article
    Older people’s mental health has long been overlooked and poor mental health is often dismissed by health professionals as an ‘inevitable’ part of getting older. And despite NHS Talking Therapies having higher than average recovery rates among the over-65s, this service is less likely to be offered to older people. Commissioned by Age UK, this briefing from the Centre for Mental Health summarises evidence about the mental health of older people in England. It finds that ageist attitudes underpin a system that discriminates against older people, while fatalistic assumptions about what people can expect for their mental health in later life undermine the provision of effective support to promote wellbeing, prevent mental ill health and treat mental health difficulties. The briefing finds that while older people may possess many protective factors for good mental health, they face numerous risk factors, including poorer physical health, reduced mobility and, for some, poverty and racism. Tackling the risk factors and boosting protective factors can increase wellbeing in later life and either prevent or stop the escalation of mental health problems.
  5. Content Article
    A growing awareness of sex and gender bias in evidence has resulted in the development of new tools to address this concern. The Sex and Gender Equity in Research (SAGER) guidelines and the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) are two initiatives designed to foster more transparent research and reporting practices that bridge the gender evidence gap. These tools enable researchers to unravel the complexities that underpin health risks and outcomes and generate more accurate and relevant findings that can inform effective and equitable policies for better health outcomes. This Lancet article looks at the World Health Organization's (WHO's) adoption of GATHER and the SAGER guidelines to tackle sporadic and suboptimal reporting of sex and gender data. The authors argue that this move is pivotal within WHO's broader strategic agenda, which it outlined in the Roadmap to Advance Gender Equality, Human Rights and Health Equity 2023–2030, launched in December 2023.
  6. News Article
    "Cultural and ethnic bias" delayed diagnosing and treating a pregnant black woman before her death in hospital, an investigation found. The probe was launched when the 31-year-old Liverpool Women's Hospital patient died on 16 March, 2023. Investigators from the national body the Maternity and Newborn Safety Investigations (MSNI) were called in after the woman died. A report prepared for the hospital's board said that the MSNI had concluded that "ethnicity and health inequalities impacted on the care provided to the patient, suggesting that an unconscious cultural bias delayed the timing of diagnosis and response to her clinical deterioration". "This was evident in discussions with staff involved in the direct care of the patient". The hospital's response to the report also said: "The approach presented by some staff, and information gathered from staff interviews, gives the impression that cultural bias and stereotyping may sometimes go unchallenged and be perceived as culturally acceptable within the Trust." Liverpool Riverside Labour MP Kim Johnson said it was "deeply troubling" that "the colour of a mother's skin still has a significant impact on her own and her baby's health outcomes". Read full story Source: BBC News, 16 February 2024
  7. Content Article
    The use of AI in medical devices, patient screening and other areas of healthcare is increasing. This Medscape article looks at some of the risks associated with the use of AI in healthcare. It outlines the difficulties regulators face in monitoring adaptive systems, the inbuilt bias that can exist in algorithms and cybersecurity and liability issues.
  8. Content Article
    Can anti-bias training help to reduce inequities in health care? A range of stakeholders share their recommendations for how implicit bias training could improve Black maternity outcomes.
  9. Content Article
    Health care algorithms are used for diagnosis, treatment, prognosis, risk stratification and allocation of resources. However, bias in the development and use of algorithms can lead to worse outcomes for racial and ethnic minoritised groups and other historically marginalised populations such as individuals with lower incomes. This study aimed to provide a conceptual framework and guiding principles for mitigating and preventing bias in health care algorithms, in order to promote health and health care equity. The authors suggested five guiding principles: Promote health and health care equity during all phases of the health care algorithm life cycle Ensure health care algorithms and their use are transparent and explainable Authentically engage patients and communities during all phases of the health care algorithm life cycle and earn trustworthiness Explicitly identify health care algorithmic fairness issues and trade-offs Establish accountability for equity and fairness in outcomes from health care algorithms.
  10. Content Article
    Large language models such as OpenAI's GPT-4 have the potential to transform medicine by enabling automation of a range of tasks, including writing discharge summaries, answering patient questions, and supporting clinical treatment planning. These models are so useful that their adoption has been immediate, and efforts are already well underway to integrate them with ubiquitous clinical information systems. However, the unchecked use of the technology has the potential to cause harm. In this article for The Lancet, Janna Hastings looks at the need to mitigate racial and gender bias in language models that may be used in healthcare settings.
  11. Content Article
    Unconscious bias, which is deeply ingrained and often hard to recognise, impacts decisions in ways we may not realise. Implicit bias, shaped by repeated exposure to real-world interactions, also plays a significant role in this phenomenon. As such, in healthcare, intuitive decision-making can be a double-edged sword. It can help during emergencies but can also lead to discrimination and biases, especially in complex situations. In addition, hidden and automatic biases, which are further strengthened by unquestioned repeated practices, have a significant impact on daily healthcare interactions. Historically, gynaecology occupied a marginalised position within the realm of surgical care, often relegated to the status of a ‘Cinderella service’. This perception stemmed from societal attitudes and gender biases, which influenced how gynaecological surgeries were viewed in comparison with other surgical specialties. Gynaecology, being predominantly focused on women's reproductive health, was sometimes considered less prestigious or less prioritised than other surgical fields such as orthopaedic surgery or general surgery.
  12. Content Article
    In this article, inews columnist Kate Lister looks at the andropause, sometimes called the 'male menopause' that can affect men in their later 40s and early 50s. A gradual decline in testosterone levels can contribute to some men developing depression, loss of sex drive, erectile dysfunction and other physical and emotional symptoms. She looks at current research and views around the issue, highlighting her own bias in initially dismissing the idea and linking this to the societal notion that 'only women are hormonal'. She highlights that although the drop in testosterone men experience is not like the sudden hormonal changes that causes the menopause, men can still experience severe symptoms that require treatment with hormone therapy. "Despite my scoffing at the idea, it turns out that the andropause is very much a real thing that can impact some men very badly. The treatment is exactly the same as it is for women struggling with menopause and perimenopause. It’s hormone replacement therapy: this time in the form of testosterone."
  13. Content Article
    In this blog post, Charlotte Augst looks at the impact of the Lucy Letby conviction on views of patient safety and accountability. The case has brought debates about patient safety into the mainstream media and public consciousness, and rather than focus simply on one extreme case, she believes it is important to look into common patterns in the NHS that lead to harm. She highlights that while such an awful case—where a healthcare professional caused deliberate harm to the most vulnerable patients—is shocking, it is also rare. She outlines a need to focus on the systemic issues that are resulting in repeated harm to patients, particularly in maternity services. Patients continue to be harmed because of rifts between management and clinical staff, the inability of the healthcare and regulatory system to really listen to patients, systemic discrimination and cognitive bias. Charlotte argues that while we may find ourselves focusing on the character of a nurse who committed such heinous crimes, we need to pay equal attention to the normalised behaviours and attitudes that harm patients and take place every day throughout the NHS.
  14. News Article
    Doctors and nurses often “weight-shame” people who are overweight or obese, leaving them feeling anxious, depressed and wrongly blaming themselves for their condition, research has found. Such behaviour, although usually the result of “unconscious weight bias”, leads to people not attending medical appointments, feeling humiliated and being more likely to put on weight. Dr Anastasia Kalea and colleagues at University College London analysed 25 previous studies about “weight stigma”, undertaken in different countries, involving 3,554 health professionals. They found “extensive evidence [of] strong weight bias” among a wide range of health staff, including doctors, nurses, dieticians, psychologists and even obesity specialists. Their analysis found that a number of health professionals “believe their patients are lazy, lack self-control, overindulge, are hostile, dishonest, have poor hygiene and do not follow guidance”, said Kalea, an associate professor in UCL’s division of medicine. She added: “Sadly, healthcare, including general practice, is one of the most common settings for weight stigmatisation and we know this acts as a barrier to the services and treatments that can help people manage weight. “An example is a GP that will unconsciously show that they do not believe that the patient complies with their eat less/exercise more regime they were asked to follow as they are not losing weight." “The result is that patients are not coming back or they delay their follow-up appointments, they avoid healthcare prevention services or cancel appointments due to concerns of being stigmatised due to their weight.” Read full story Source: The Guardian, 10 August 2022
  15. News Article
    Staff endured a “toxic and difficult working environment” at a maternity unit an employment tribunal has found. The tribunal panel said that the case of a black midwife, Kemi Akinmaji, who partially won her case against East Kent Hospitals University Foundation Trust for racial discrimination showed “there were wider issues beyond the specific allegations before us and which were possibly related to race”. The tribunal judgment said: “The evidence we heard reflected a toxic and difficult working environment generally where the claimant and colleagues were shouted and sworn at over differences of professional opinion. There was some evidence before us that there were wider issues beyond the specific allegations before us and which were possibly related to race… “There is evidence of wider bullying of the claimant in the way the group of colleagues treated the claimant… We’ve also heard that the previous grievance had highlighted risks in respect of unconscious bias and identified recommendations which were not actioned. “The race champion was not appointed and the unconscious bias training not sufficiently followed through. We also heard evidence of staff being wary of further such complaints. These matters were all concerning but we had to limit ourselves to the specific allegations brought by the claimant and which the respondent had been given an opportunity to address.” Read full story (paywalled) Source: HSJ, 1 March 2023
  16. News Article
    Unconscious bias in the UK healthcare system is contributing to the stark racial disparity in maternal healthcare outcomes, a conference has heard. The Black Maternal Health Conference UK, also heard that black women not being listened to by healthcare professionals was also a contributing factor. The conference, organised by The Motherhood Group, was arranged to highlight the racial inequality in maternal healthcare and the disparity in maternal mortality between white, ethnic minority and black women in the UK. Black women in the UK are four times more likely to die in pregnancy and childbirth than white women, according to a report published by MBRRACE-UK. Asian women are twice as likely to die in pregnancy or childbirth. Sandra Igwe, who founded the NGO The Motherhood Group in 2016 after the traumatic birth of her daughter, told the PA Media that the event was an opportunity to “bridge the community, stakeholders, professionals, [and] government”, de-stigmatise mental health and bring about change to improve black maternal health. “There are so many stats – so why wouldn’t we have a whole day’s conference dedicated to addressing these, just scratching the surface of some of the stats?” Charities and activists have been raising alarm bells about the dangerous consequences of unconscious bias in maternal healthcare for many years. Igwe co-chaired the Birthrights inquiry, a year-long investigation into racial injustice in the UK maternity services, which heard testimony from women, birthing people, healthcare professionals and lawyers and concluded that “systemic racism exists in the UK and in public services”. Read full story Source: The Guardian, 20 March 2023 Sandra Igwe is our hub topic lead for Black Maternal Health. Read our recent interview with Sandra.
  17. Content Article
    This blog for Refinery 29 by journalist Sarah Graham examines the gender health gap, a term used to describe the inequalities in treatment and health outcomes that men and women experience. She talks about the stories relating to sexism and institutional bias she has come across during her time as a health journalist, that result in poor care experiences and outcomes for women. While acknowledging that women should not have to make extra effort to be heard by the health system, Sarah offers tips for women to help them voice their concerns and improve their chances of being listened to by medical professionals.
  18. Content Article
    This article by the Betsy Lehman Center in Massachusetts draws attention to research by ECRI, a US non-profit research and risk management firm, which shows that efforts to address racial inequalities in medical care need to include an examination of the way in which patient safety events are reported. Research by ECRI shows that existing patient safety reporting systems may be undercounting events experienced by patients who are Black , Latino or from other ethnic groups. It also highlights that racial, ethnic and other demographic data about patients is missing in adverse event reports from most US healthcare organisations.
  19. Content Article
     In the wake of the Covid-19 pandemic, we are all too aware of the urgent health inequalities that plague our world. But these inequalities have always been urgent: modern medicine has a colonial and racist history. Here, in an essential and searingly truthful account, Annabel Sowemimo unravels the colonial roots of modern medicine. Tackling systemic racism, hidden histories and healthcare myths, Sowemimo recounts her own experiences as a doctor, patient and activist. Divided exposes the racial biases of medicine that affect our everyday lives and provides an illuminating - and incredibly necessary - insight into how our world works, and who it works for.
  20. Content Article
    In this video Kenny Gibson, Head of Safeguarding for NHS England and NHS Improvement, explains what trauma informed care is and describes the role of healthcare professionals in recognising trauma in colleagues and patients. He talks about the importance of overcoming unconscious bias around whether individuals have experienced trauma and outlines the importance of avoiding retraumatising victims. He also highlights that healthcare professionals can play a key role in bringing hope to people who have been traumatised.
  21. Content Article
    This online course by NHS England helps participants learn how to engage with different people and communities to reduce inequalities and ensure inclusive access to healthcare. It involves three hours of study time per week over two weeks and aims to equip healthcare professionals to: help the people they work with access healthcare services understand how people have different experiences in their access to healthcare explore inclusive engagement activities develop an awareness of implicit bias and underrepresentation
  22. Content Article
    Women often have worse asthma than men, and female sex hormones can affect the condition. Asthma and Lung UK are conducting a survey to find out more about women's experience of asthma - women with asthma and those that care for them are invited to take the survey, which takes about five minutes to complete and is completely anonymous. Asthma and Lung UK have also published a report, Asthma is Worse for Women, outlining the need for more research into asthma and female sex hormones.
  23. Content Article
    In this blog for Refinery 29, journalist L'Oréal Blackett discusses the additional risk and associated worries faced by black pregnant women in the UK. With black women four times more likely to die in childbirth than white women, and 40% more likely to suffer a miscarriage, she examines what action the government is taking to improve outcomes for black women and their babies. She speaks to a number of campaigners who highlight the importance of including black women at every stage of research and policy to tackle race-based health inequalities, and who question whether this is being done by the UK government's new Maternity Disparities Taskforce. She also argues that empowering women to make informed, evidence-based decisions is the most effective way to improve maternal safety for black women.
  24. Content Article
    ECRI's annual Top 10 list helps organisations identify imminent patient safety challenges. The 2022 edition features many first-time topics, and emphasis is on potential risks that could have the biggest impact on patient health across all care settings. The number one topic on this year’s list has been steadily growing throughout the COVID-19 pandemic and impacts patients and staff on all levels: staffing shortages. Prior to 2021, there was a growing shortage of both clinical and non-clinical staff, but the problem has grown exponentially. In early January 2022, it was estimated that 24% of US hospitals were critically understaffed, while 100 more facilitates anticipated facing critical staff shortages within the following week. The list includes diagnostic and vaccine-related errors that can impact patient outcomes. In addition, several topics on this year's list reflect challenges that have arisen as a result of the stresses associated with delivering care during a global pandemic.
  25. Content Article
    In this article for the Evening Standard, journalist Susannah Butter talks to Caroline Criado Perez about her book, 'Invisible Women, Exposing Data Bias in a World Designed for Men'. Criado Perez discusses inequalities faced by women in healthcare, including delayed diagnosis, misdiagnosis and exclusion from medical research. The article also looks at tech solutions being founded by women to fill gaps and address these inequalities.
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