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Found 72 results
  1. Content Article
    The last two decades have seen substantial advancement in the practice of team-based, safe care delivery. In parallel, burnout has been recognised as prevalent among US doctors and influenced by workplace structure and experiences. This study assessed US doctors’ perceptions of team-based care delivery and safety climate within their institutions and how these domains were associated with burnout.
  2. Event
    This Hospital at Night Summit focuses on out of hours care in hospitals delivering high quality safe care at night and supporting the wellbeing of those working at night. Through national updates, networking opportunities and case studies this conference provides a practical guide to delivering a high-quality hospital at night service and transforming out of hours services and roles to improve patient safety. The 2024 conference will focus on developing an effective Hospital at Night service and focus on the practicalities of supporting staff at night, improving wellbeing, and fighting fatigue. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/virtual-online-courses/hospital-at-night-summit or email aman@hc-uk.org.uk We have a limited number of free places for this event for members of the hub. Email content@pslhub.org if you are interested. Follow on Twitter @HCUK_Clare #HospitalAtNight
  3. Content Article
    The NHS Staff survey is one of the largest workforce surveys in the world and is carried out every year to improve staff experiences across the NHS. It asks staff in England about their experiences of working for their respective NHS organisations. Of the 1.4 million NHS employees in England, 707,604 staff responded to the survey in 2023.
  4. News Article
    Patient safety has been put at risk by ministers striking a backroom deal with unions to cut the equivalent of 10,000 health service jobs by reducing the working week, NHS bosses have warned. Briefings prepared by the chief executives of Scotland’s NHS boards reveal top management thrown into chaos after appearing to be blindsided by the new health secretary, Neil Gray. Two weeks into the role, Gray, who replaced the scandal-hit Michael Matheson on 8 February met with unions without NHS staff present and signed off sweeping changes to working conditions, setting a deadline to implement them within five weeks. The Scottish Conservatives have called the deal “deeply alarming”, while Labour accused the new health secretary of “standing idly by while chaos looms”. Read full story (paywalled) Source: The Times, 4 March 2024
  5. Content Article
    This project aimed at understanding and tackling the barriers to sufficient hydration, breaks and refreshment facilities for NHS staff. Sherwood Forest Hospitals NHS Foundation Trust was keen to introduce the Royal College of Nursing's (RCN) rest, rehydrate and refuel initiative, and did so through a project led by one of the chief nurse clinical fellows. First, staff were surveyed to understand the current situation and any barriers they may face. This was followed by a trial on two pilot wards, before roll our of a trust-wide campaign.
  6. Content Article
    In the USA, Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions (WHRs) are intended to improve patient safety by reducing resident doctor fatigue. However, compliance with ACGME WHRs is not universal. This study aimed to identify factors that influence resident doctors' decisions to take a post-call day (PCD) off in line with ACGME WHRs. The authors concluded that as most important influencer of residents’ decisions to take a PCD off was related to feedback from their supervisors, compliance with WHRs can be improved by focusing on the residency program’s safety culture.
  7. Content Article
    The relationship between management and the workforce, in very simplistic terms, can be considered one of reward in return for effort. The contracted effort is communicated through a roster. In organisations that have a continuous operation, blocks of effort are distributed to maintain the flow of output. The organisation of effort, then, is a legitimate function of management.  Norman's previous blog looked at performance variability under normal conditions. In this blog, Norman looks at the impact of physiological states and how management’s organisation of effort degrades decision-making.
  8. Content Article
    US healthcare organisations continue to grapple with the impacts of the nursing shortage—scaling back of health services, increasing staff burnout and mental-health challenges, and rising labour costs. While several health systems have had some success in rebuilding their nursing workforces in recent months, estimates still suggest a potential shortage of 200,000 to 450,000 nurses in the United States, with acute-care settings likely to be most affected.1 Identifying opportunities to close this gap remains a priority in the healthcare industry. This article highlights research conducted by McKinsey in collaboration with the ANA Enterprise on how nurses are actually spending their time during their shifts and how they would ideally distribute their time if given the chance. The research findings underpin insights that can help organizations identify new approaches to address the nursing shortage and create more sustainable and meaningful careers for nurses.
  9. News Article
    A growing number of doctors plan to leave the profession due to burnout and dissatisfaction, the General Medical Council has said, highlighting fears that the government’s long-term strategy for the NHS may have come too late. The GMC’s annual report on the medical workforce said the benefits of measures announced by the government in the NHS long-term workforce plan in June, such as the ambition to create more medical school places, “will only start to be seen a decade from now”. The report found that the number of licensed doctors increased in 2022, with 23,838 joining and 11,319 leaving. However, it said there were “still high vacancy rates and workforce pressure”, and that the rate of doctors leaving the profession was returning to pre-pandemic levels, at 4% last year. The GMC warned there were “worrying signs” that a growing number “plan to leave the profession as a result of high levels of dissatisfaction and high risk of burnout”. It added that there may be “a limited window of opportunity to address current issues” before more medics leave. Read full story Source: The Guardian, 12 November 2023
  10. Content Article
    This study from Allan et al. investigates whether nurses working for a national medical telephone helpline show evidence of “decision fatigue,” as measured by a shift from effortful to easier and more conservative decisions as the time since their last rest break increases. The study found that for every consecutive call taken since last rest break, the odds of nurses making a conservative management decision (i.e., arranging for callers to see another health professional the same day) increased by 5.5% from immediately after 1 break to immediately before the next. Decision-making was not significantly related to general or cumulative workload (calls or time elapsed since start of shift). The authors concluded that every consecutive decision that nurses make since their last break produces a predictable shift toward more conservative, and less resource-efficient, decisions. Theoretical models of cognitive fatigue can elucidate how and why this shift occurs, helping to identify potentially modifiable determinants of patient care.
  11. News Article
    The NHS has to train two GPs to produce one full-time family doctor because so many have started to work part-time, new research reveals. The finding helps explain why GP surgeries are still struggling to give patients appointments as quickly as they would like, despite growing numbers of doctors training to become a GP. The disclosure is contained in a report by the Nuffield Trust health thinktank that lays bare the large number of nurses, midwives and doctors who quit during their training or early in their careers. “These high dropout rates are in nobody’s interest,” said Dr Billy Palmer, a senior fellow at the thinktank and co-author of the report. “They’re wasteful for the taxpayer, often distressing for the students and staff who leave, stressful for the staff left behind, and ultimately erode the NHS’s ability to deliver safe and high-quality care.” Read full story Source: The Guardian, 28 September 2023
  12. News Article
    One in twenty people in the UK who are neither employed nor seeking paid work are suffering from Long Covid, with the figure more than doubling in the past year, official data has revealed. The proportion is far higher than for the 1 in 29 people who are unemployed but seeking work who have long Covid symptoms, or the one in 30 employed people who are sufferers, data released by the Office for National Statistics (ONS) shows. Individuals who are not employed and are not looking for paid work are classified as being economically inactive. The data suggests the long-term impacts of the virus could be driving people into this category, or into retirement. Read full story Source: The Guardian, 4 August 2022
  13. News Article
    The number of GPs seeing patients outside standard surgery hours in Scotland has dropped by almost a quarter in three years. Nurses and paramedics have had to fill in for doctors in the out-of-hours urgent care centres because GPs could not be found to cover the shifts. Some health boards have had to close their centres and send patients to overstretched A&Es instead because of the GP shortage. Dr Andrew Buist, chairman of the British Medical Association’s Scottish GP committee, said, “Patient demand is outstripping GP capacity across the whole service, including out-of-hours. We simply do not have enough GPs in Scotland. Those who are working in out-of-hours may be doing more hours now than they perhaps did in 2019 which comes as no surprise if there are fewer GPs to go around but it is unsustainable and puts those working in the service at risk of exhaustion and burnout.” Read full story (paywalled) Source: The Times, 15 February 2023
  14. News Article
    Some doctors say that however reasonable guidelines may seem, their cumulative burden causes “constant frustration” to medical practice. A team of doctors wrote a study last year for the Journal of General Internal Medicine which suggested that if an American doctor followed all of the guidelines for preventive, chronic and acute disease care issued by well-known medical groups, it would require nearly 27 hours per day. Guidelines have become “a constant frustration,” said Dr. Minna Johansson, a general practitioner in Uddevalla, Sweden, who also directs the Global Center for Sustainable Healthcare at the University of Gothenburg. “A lot of guidelines may seem reasonable when considered in isolation, but the cumulative burden of all guideline recommendations combined is absurd.” Read full story (paywalled) Source: New York Times, 14 February 2022
  15. Content Article
    This study in the British Journal of Nursing aimed to explore whether fatigue, workload, burnout and the work environment can predict the perceptions of patient safety among critical care nurses in Oman. A cross-sectional predictive design was used on a sample of 270 critical care nurses from the two main hospitals in the country's capital, with a response rate of 90%. The authors found a negative correlation between fatigue and patient safety culture (r= -0.240), which indicates that fatigue has a detrimental effect on nurses' perceptions of safety. There was also a significant relationship between work environment, emotional exhaustion, depersonalisation, personal accomplishment and organisational patient safety culture. Regression analysis showed that fatigue, work environment, emotional exhaustion, depersonalisation and personal accomplishment were predictors for overall patient safety among critical care nurses.
  16. Content Article
    This study in The Journal of Nursing Administration aimed to investigate the relationship between sleep deprivation and occupational and patient care errors among staff nurses who work the night shift. A cross-sectional correlational design was used to evaluate relationships between sleep deprivation and occupational and patient care errors in 289 hospital night shift nurses. The study found that more than half (56%) of the sample reported being sleep deprived. Sleep-deprived nurses made more patient care errors. Testing for associations with occupational errors was not feasible because of the low number of occupational errors reported.
  17. Content Article
    This chapter in Patient Safety and Quality: An Evidence-Based Handbook for Nurses outlines how fatigue and sleepiness impact on the performance of nurses and consequently on patient safety. It highlights safety practices that can be implemented to counter the effects of fatigue, including restrictions on working hours, napping, use of bright lights and exercise.
  18. Content Article
    NHS trusts have often reported emergency department doctors having low levels of satisfaction and high rates of burnout, leading to a high turnover. In 2017, Brighton and Sussex University Hospitals (BSUH) and Western Sussex Hospitals merged to form University Hospitals Sussex NHS Foundation Trust. The Trust found that the organisation of shifts at Royal Sussex County Hospital (RSCH) and Princess Royal Hospital (PRH) and lack of flexibility were adding to the strain already felt by doctors working in the high pressure emergency department. To combat the pressure consultants and other doctors were under, the Trust implemented a system to help improve rota design and flexible working. The hope was that the system would help the trust retain and recruit staff, whilst saving locum costs and improving patient care.
  19. Content Article
    Fatigue and sleep deprivation may affect healthcare professionals' skills and communication style and also may affect clinical outcomes. However, there are no current guidelines limiting the volume of deliveries and procedures performed by a single individual, or on the length of time that they can be on call. This Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG) analyses research relating to fatigue and performance in healthcare professionals in order to make recommendations to doctors and managers to improve staff and patient safety.
  20. Content Article
    Laura Pickup and Suzy Broadbent present on the impact staff fatigue has on patient safety.
  21. Content Article
    Over 3 million people in Britain—more than 1 in 8 of the workforce—regularly work at night, many providing essential, critical services on which Britain’s smooth running depends. They are doctors, nurses, police, firefighters, paramedics, transport and maintenance crews, cleaners, call-centre workers, bakers, security guards, factory workers … all ensuring your life runs like clockwork in the daytime. For them, the experience of working against their body clocks, of feeling jet-lagged, isn’t an occasional annoyance due to travel—it’s a regular fact of life. We must recognise that when we ask people to work at night that there are consequences. As well as increased risks of long-term health problems associated with shiftworking, night workers are vulnerable in other ways, including a significantly increased risk of death by accident just trying to get home to their beds in the morning.
  22. Content Article
    When resident physicians work shifts of extended duration, the risks of patient harm and occupational injury increase, even among experienced resident physicians, write Charles Czeisler and colleagues in this BMJ opinion piece.
  23. Content Article
    Healthcare settings are high-risk environments for fatigue and staff burnout. The Need For Recovery (NFR) scale quantifies inter-shift recovery, which contributes to cumulative fatigue and may precede occupational burnout. Advanced clinical practitioners (ACPs) are an established feature of the emergency medicine workforce in the UK, however, little is known about factors affecting their inter-shift recovery, fatigue or how NFR correlates with formal burnout inventories.
  24. Content Article
    Regulators, organisations, communities and workers often struggle with how to manage shift duration and address associated risks from fatigue and sleepiness, while continuing to meet the societal demands for work. This article in the Journal of Clinical Sleep Medicine proposes a series of guiding principles help design a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.
  25. Content Article
    In a series of blogs for the hub, we will be highlighting the impact fatigue has on staff and patients. In their first blog, Emma Plunkett and Nancy Redfern, part of the Joint Working Group on Fatigue, shared how they became involved in investigating night shift fatigue, setting up the Joint Working Group on Fatigue and the aims of the #FightFatigue campaign. In this second blog, Emma and Nancy are joined by Roopa McCrossan to highlight how tiredness can impact on our performance, the patient and staff implications of fatigue, and the actions that need to be taken not only at an organisational level to improve culture, but the effort required at national level too.
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