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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. News Article
    Measures to ease the lockdown in the UK could lead to tens of thousands of extra deaths if vulnerable people are not sufficiently protected and health care systems are put under strain, a study has suggested. Boris Johnson announced the first step towards normalcy — allowing unlimited exercise, one on one outdoor social meetings and a return to work for those who cannot do so at home — against a background of flattening infection numbers and fatalities caused by the virus. However in a study published in medical journal The Lancet, research led by University College London (UCL) has warned between 37,000 and 730,000 excess deaths could take place due to the direct and indirect effects of the virus within a year. Lead author Dr Amitava Banerjee said: “Older people, those with one or more underlying conditions and their carers are asking what easing the lockdown might mean for their health. Using data modelling on a number of different scenarios, our findings show the mortality risk for these vulnerable groups increases significantly, and could lead to thousands of avoidable deaths.” Read full story Source: The Independent, 13 May 2020
  2. News Article
    Hospital staff may be carrying SARS-CoV-2, the coronavirus that causes COVID-19 disease, without realising they are infected, according to a study by researchers at the University of Cambridge. Patients admitted to NHS hospitals are now routinely screened for the SARS-CoV-2 virus, and isolated if necessary. But NHS workers, including patient-facing staff on the front line, such as doctors, nurses and physiotherapists, are tested and excluded from work only if they develop symptoms of the illness. Many of them, however, may show no symptoms at all even if infected, as a new study published in the journal eLife demonstrates. The implications of the new study, say senior authors Dr Mike Weekes and Professor Stephen Baker from the Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), are that hospitals need to be vigilant and introduce screening programmes across their workforces. “Test! Test! Test! And then test some more,” Dr Weekes explains. “All staff need to get tested regularly for COVID-19, regardless of whether they have any sort of symptoms – this will be vital to stop infection spreading within the hospital setting.” Read full story Source: University of Cambridge, 12 May 2020
  3. Content Article
    In this article, Dr David Nabarro and John Atkinson discuss the routes out of the coronavirus lockdown. Quality information is at a premium. Decisions will be based on data about the spread of the virus disaggregated by locality. Numbers of people becoming infected will need to be factored into decisions. The goal is to understand the extent of transmission and whether the rate of increase in people infected is starting to reduce.  The sequence for easing a lockdown will vary from place to place. Decision-makers will be considering multiple factors when deciding how best to do this. Here they explore the questions decision-makers will be asking and indicate some of the factors they might consider.  
  4. News Article
    Tens of thousands of cancer patients have not yet received letters advising them to “shield” themselves from the coronavirus threat, The Times has learnt. Peter Johnson, national clinical director for cancer, has written to charities asking for their help in tracing the missing patients and alerting them to the need to take stringent self-protection measures against infection. His appeal comes as the government increased by one million its estimate of the number of people at greatest risk of severe illness should they contract COVID-19. Its new strategy document stated that it had identified 2.5 million people who were “clinically extremely vulnerable and advised to shield”. At the onset of the lockdown in March, ministers estimated the number at 1.5 million. Professor Johnson’s letter, seen by The Times, states: “We are still receiving reports of cancer patients who believe that they should have received a shielding letter but have not yet received one or have not been added to the national list. It is crucial that those who are clinically extremely vulnerable receive a letter advising them to shield. Read full story Source: The Times, 12 May 2020
  5. Content Article
    The impact of COVID-19 on communities of colour in the US is dramatically and disproportionately affecting African-Americans most of all. The reasons are complex, with underlying health conditions (e.g., hypertension, diabetes) acting as one contributing factor. Yet, these health problems, public health experts say, largely reflect the history and ongoing realities of racism in the US that have created barriers to accessing quality health care and the conditions that can lead to better health.
  6. News Article
    Care home operators have accused the UK government of “a complete system failure” over testing for COVID-19 after officials repeatedly deflected responsibility for the task and left vulnerable residents unchecked. As ministers admitted it will be more than three weeks before all homes are offered tests, care home managers said lives have been put at risk and conditions for dementia sufferers worsened because of the government’s failure so far to test hundreds of thousands of staff and residents. The programme was announced by the health secretary, Matt Hancock, two weeks ago but only tens of thousands of people have been tested. Public Health England (PHE), the Care Quality Commission (CQC) and the Department of Health and Social Care (DHSC) have repeatedly passed the buck about who should carry out the tests, according to correspondence with care homes seen by the Guardian. When Nottingham Community Housing Association (NCHA) tried to get tests for its care home residents and staff, a PHE official said it didn’t know anything about testing residents, before pointing them to the CQC. PHE then changed its mind again saying it would send the tests, but when they failed to arrive, PHE reversed again saying CQC was responsible. “It is very frustrating because we can’t effectively manage the risk without knowing [who has the virus],” said Holly Dagnall, director of homes and wellbeing at NCHA. Read full story Source: The Guardian, 12 May 2020
  7. Content Article
    The impact of the virus that causes COVID-19 could hardly be more disparate. While billions are stuck at home and restricted by social-distancing guidelines, millions of people must still put themselves and their families at risk by continuing to go to work. Millions are coping with the requirement of effectively working from home, but millions more have lost their jobs and don’t know how they will pay for housing or food. And for those who contract the virus, its effects span from nothing at all to death. Derek Feeley discusses these inequities in an article for the Institute of Healthcare Improvement.
  8. Content Article
    Carmel is a staff nurse on a trauma and orthopaedic ward in Liverpool. She’s also an RCN steward and chair of her RCN branch. Since the COVID-19 pandemic took hold she’s been recording an audio diary of how it’s had an impact on her personal and professional life. Here you can listen to the full audio diary in three chapters or read the highlights.
  9. Content Article
    Nadia Whittome, an MP, went back to work in social care when the pandemic struck but was dismissed when she spoke out about the lack of personal protective equipment (PPE) faced by workers on the frontline. She recounts her experience in a blog to the Guardian.
  10. Event Comment

    Hi Phoebe. Here's the link to the webinar recording - https://www.bigmarker.com/closerstill-media/Patient-Safety-Time-for-Questions-Non-Covid-19-care-and-treatment?bmid=17f5c7b4d6f4
  11. Content Article
    The government's plan to rebuild the UK for a world with COVID-19. Inevitably, parts of this plan will adapt as we learn more about the virus. The government will set up ‘dedicated team’ to look for innovative ways for the NHS to continue treating people for coronavirus, while also providing care for non-covid health issues. It outlines a phased recovery approach and the roadmap to lift restrictions step by step.
  12. News Article
    Tens of thousands of outpatient video consultations have been carried out by NHS trusts following the national rollout of a digital platform to support the coronavirus response. Digital healthcare service Attend Anywhere was introduced across the country at the end of March after NHSX chief clinical information officer Simon Eccles called for its rapid expansion. There has been a major push to boost digital healthcare services across the country in order to support the national response to coronavirus. Much of primary care has already switched to working virtually. Undertaking hospital outpatient appointments digitally has been identified as a way of keeping patients safe by removing their need to travel. There have now been more than 79,000 consultations with Attend Anywhere. The number of consultations started at around 200 per day, but has rapidly increased to more than 6,000 per day. Data released by NHS Digital showed that GPs moved swiftly to change their practice model in the face of COVID-19. The proportion of appointments conducted face-to-face nearly halved and the proportion of telephone appointments increased by over 600 per cent from 1 March to 31 March as GPs moved to keep patients out of surgeries except when absolutely necessary. However, concerns have been raised over the limitation of remote appointments, particularly in mental health services. Royal College of GPs chair Martin Marshall raised concerns that video appointments could make it difficult for doctors to diagnose and manage patients’ conditions during the pandemic. Read full story Source: HSJ, 11 May 2020
  13. News Article
    The government said it will set up ‘dedicated team’ to look for innovative ways for the NHS to continue treating people for coronavirus, while also providing care for non-covid health issues. In its pandemic recovery strategy published today, the government also said step-down and community care will be “bolstered” to support earlier discharge from acute hospitals. The 60-page document contained little new information about plans for NHS services, but said: “The government will seek innovative operating models for the UK’s health and care settings, to strengthen them for the long term and make them safer for patients and staff in a world where COVID-19 continues to be a risk. “For example, this might include using more telemedicine and remote monitoring to give patients hospital-level care from the comfort and safety of their own homes. Capacity in community care and step-down services will also be bolstered, to help ensure patients can be discharged from acute hospitals at the right time for them". To this end, the government will establish a dedicated team to see how the NHS and health infrastructure can be supported for the COVID-19 recovery process and thereafter. Read full story Source: 12 May 2020
  14. News Article
    The Joint Committee on Human Rights has published a report on the contact tracing app, concluding that if effective, the app could pave the way out of the current lockdown restrictions and help prevent the spread of coronavirus, but there are significant concerns regarding surveillance and the impact on other human rights which must be addressed first. Last month the Committee launched their inquiry into the Government’s response to Covid-19: human rights implications. Following this, the Committee has produced a Reportthat outlines the key actions the Government must take to ensure that the app respects human rights including the right to privacy and non-discrimination at the same time as enabling individuals to move around more freely whilst helping to prevent the spread of the virus. The Chair of the Committee, Harriet Harman MP, said: “Assurances from Ministers about privacy are not enough. The Government has given assurances about protection of privacy so they should have no objection to those assurances being enshrined in law." "The contact tracing app involves unprecedented data gathering. There must be robust legal protection for individuals about what that data will be used for, who will have access to it and how it will be safeguarded from hacking. Parliament was able quickly to agree to give the Government sweeping powers. It is perfectly possible for parliament to do the same for legislation to protect privacy.” Read full story Source: www.parliament.uk, 7 May 2020
  15. News Article
    Drugs that could relieve the symptoms of coronavirus in vulnerable patients and help them avoid admission to hospital are to begin trials in homes across the UK. The experiment, led by a team at Oxford University, seeks to test pre-existing treatments for older people in the community who show signs of the disease. Known as Principle, or “Platform Randomised trial of interventions against Covid-19 in older People”, it is the first to take place in primary care settings such as health clinics. Read full story (paywalled) Source: The Independent, 12 May 2020
  16. News Article
    The number of deaths linked to coronavirus in care homes in England and Wales has fallen, figures show. The Office for National Statistics analysis showed there were 2,423 fatalities where the virus was mentioned on the death certificate in the week ending 1 May. That is down from nearly 2,800 the week before. More than 8,300 deaths in care homes have been linked to virus since the epidemic started. The number of hospital deaths have been falling since early April but the government and care sector had been struggling to contain outbreaks in care homes. Despite the drop, the virus is still have a major impact on the overall number of deaths in care homes. The total number seen in the week to 1 May is still nearly three times higher than you would normally expect. That means there a large number of deaths happening where the cause is unclear. One suggestion has been that the lack of testing in care homes has meant coronavirus has not always been listed on death certificates when it should. Read full story Source: BBC News, 12 May 2020
  17. Content Article
    The CARe QI handbook is based on research in a range of healthcare organisations and settings, including acute care, primary care, care homes, oral health and community settings. It was designed to provide practical tools to apply ideas from resilient healthcare to quality improvement. 
  18. News Article
    The NHS will this week begin to publish the numbers of people who are dying from coronavirus in mental health and learning disability units, the government has announced. England's national medical director Stephen Powis told the Downing Street daily press briefing that the figures would be published on an "ongoing basis" after calls to paint a clearer picture of the problem. It comes as figures from the Care Quality Commission showed a sharp increase in deaths among mental health patients compared to last year. Asked by The Independent whether the numbers could be made public, he replied: "Yes, I can commit that we will publish that data. "We've been looking at how we can do that; we publish deaths daily, we're looking at how we can report on those groups and I can commit that from next week we'll be publishing data on learning disabilities, autism, and mental health patients who have died in acute hospitals and we will do that on an ongoing basis." Read full story Source: The Independent, 9 May 2020
  19. Content Article
    Root Cause Analysis (RCA) is a generic method used in quality improvement and patient safety projects. In patient safety, it should help teams to ‘get to the bottom’ of the circumstances that led or could lead to an incident and take appropriate and effective action to prevent the recurrence of the incident or minimise the probability of recurrence. Find out more about RCA in this Healthcare Quality Quest booklet.
  20. Content Article
    The steps that need to be taken to end the coronavirus crisis are not unknown; they are clear and informed by evidence and the experience of other countries. The public deserves a plan of action to ease and ultimately lift restrictions in a careful manner that does not risk a resurgence of the epidemic, resulting in an endless cycle of infection waves and economic depression. In this article, Emanuel et al. outline the steps the federal government and states need to take and systems to implement, at a minimum, to prevent a second wave and allow a return to some degree of normal life.
  21. News Article
    Ministers have asked local directors of public health to take charge of COVID-19 testing in English care homes in what will be seen as a tacit admission that centralised attempts to run the programme have fallen short. In a letter to sector leaders, seen by the Guardian, the care minister, Helen Whately, acknowledged that testing of care home residents and staff needs to be “more joined up”. She describes the new arrangements as “a significant change”. Under the new approach, public health directors employed by local councils will take lead responsibility for arranging the testing of some 400,000 care home residents and 500,000 staff, in discussion with directors of adult social services, local NHS bodies and regional directors of Public Health England (PHE). Critically, the local public health directors will decide which homes should have priority in the testing programme, which is still working up to a capacity of 30,000 tests a day for the sector. The switch is a conspicuous, if belated, vote of confidence in local government’s ability to help get a grip on the Covid crisis. There has been frustration and incomprehension that public health teams have until now been left as bit-players in the testing programme and in tracking and tracing carriers of the virus. Read full story Source: The Guardian, 8 May 2020
  22. News Article
    The NHS in London is planning to “fundamentally shift the way we deliver health and care” in the wake of coronavirus, according to documents obtained by HSJ. The plans from NHS England and Improvement’s London office say leaders should: Plan for elective waiting times to be measured at integrated care system level, rather than trust level. Accept “a different kind of risk appetite than the one we are used to”. Expect decisions from the centre on the location of cancer, paediatric, renal, cardiac, and neurosurgical services. Plan for a permanent increase in critical care capacity. Transform to a “provider system able to be commissioned and funded on a population health basis”. Work towards “a radical shift away from hospital care”. Expect “governance and regulatory landscape implications” plus “streamlined decision-making”. The document, titled Journey to a New Health and Care System, says there are three “likely” phases, with the final new system in place “from November 2021”. The preceding two phases are “action programmes” over the next 12 to 15 months which will be about reconfiguring services to deal with “immediate covid, non-covid and elective need”, and “transition” when the move to new configurations is evaluated and “public consent” sought. Read full story Source: HSJ, 11 May 2020
  23. News Article
    The deaths of more than 50 hospital and care home workers have been reported to Britain’s health and safety regulator, which is considering launching criminal investigations, the Guardian has learned. The Health and Safety Executive (HSE), which investigates the breaking of safety at work laws, has received 54 formal reports of deaths in health and care settings “where the source of infection is recorded as COVID-19”. These are via the official reporting process, called Riddor: Reporting of Injuries, Diseases and Dangerous Occurrences. Separately, senior lawyers say any failures to provide proper personal protective equipment (PPE) may be so severe they amount to corporate manslaughter, with police forces drawing up plans to handle any criminal complaints. Despite weeks of pleading, frontline medical staff complain that PPE is still failing to reach them as hospitals battle the highly contagious virus. Senior barristers say criminal investigations should be launched, and that there are grounds to suspect high-level failures. Read full story Source: The Guardian, 10 May 2020
  24. News Article
    About 8,000 more people have died in their own homes since the start of the coronavirus pandemic than in normal times, a Guardian analysis has found, as concerns grow over the number avoiding going to hospital. Of that total, 80% died of conditions unrelated to COVID-19, according to their death certificates. Doctors’ leaders have warned that fears and deprioritisation of non-coronavirus patients are taking a deadly toll. Doctors’ leaders have warned that some sick people are too scared to go to hospital and are aware that much of the usual NHS care had been suspended in the pandemic. “These figures underline that the devastation wrought by Covid-19 spreads far beyond the immediate effects of the illness itself,” said Dr Chaand Nagpaul, the council chair of the British Medical Association. “While all parts of the NHS have rallied round in a bid to meet the immediate rocketing demand caused by the pandemic, more than half of doctors in a recent BMA survey have told us that this is worsening the care of non-Covid patients.” Read full story Source: The Guardian, 8 May 2020
  25. News Article
    Surgeons have invented a new device to make it safer to diagnose some cancers during the coronavirus pandemic. Most nose and throat investigations have been cancelled due to increased risks of medics contracting COVID-19 via patients' coughs and sneezes. Two consultants have developed a device that clips over patients' masks and protects front-line workers. The West Midlands-based doctors want to raise £50,000 they say is enough to make devices for use across the NHS. Chris Coulson, a consultant ear, nose and throat surgeon at University Hospitals Birmingham NHS Foundation Trust, said procedures involving an endoscope to examine the nose or throat were known to put clinicians at a significantly increased risk of contracting coronavirus. "When clinicians carry out a nasendoscopy it can make patients cough, sneeze, and splutter - which risks spreading the virus to doctors, nurses and therapists," he said. His company endoscope-i Ltd, co-founded with Ajith George, a consultant head and neck surgeon at University Hospitals North Midlands, has now developed the SNAP. It clicks on to a conventional surgical mask, creating a hole through which the clinician can pass an endoscope directly into a patient's nose. A valve means, despite there being a hole, any coughs, sneezes or splutters are caught within the mask. Mr George said: "If we can raise the money needed to produce the devices, we can keep looking after patients and ensure that diagnosis and treatment is not delayed." Read full story Source: BBC News, 11 May 2020
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