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Showing results for tags 'Communication'.
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Content ArticleTwo years after Baroness Cumberlege shared her damning report, 'First Do No Harm', which highlighted serious failures in response to reports about harmful side effects from medicines and medical devices, too many mesh injured women still continue to be let down by the healthcare system. Women who have been harmed by pelvic mesh surgery have shared a series of appalling accounts of how they have been treated by their doctors while desperately seeking help for their injuries and complications. In this blog, we examine how these comments reveal an underlying misogyny held by many doctors, and a failure to take women’s concerns seriously.
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- Womens health
- Medical device
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News Article
NHS ‘must show patients more respect’
Patient Safety Learning posted a news article in News
The NHS must be more welcoming to patients who often feel they should not bother doctors, the new patient safety commissioner for England has urged. Dr Henrietta Hughes, who takes up the role this week, said it was vital that patients had time to ask questions, despite pressures on the health service. Clinicians and managers need to put themselves in the shoes of their patients, she said, highlighting “highly inappropriate” interactions between doctors and patients that showed “a total lack of care and respect”. Hughes said it was not a surprise that all the groups affected in the Cumberlege report were women. “That’s something which is a societal problem, and it’s really important that the voices of all patients, including those of women, are listened to and taken really seriously,” she said. “Because otherwise untold harm happens and it can not only extend to the individual patient themselves, but to their families, to their children, to their livelihoods. This role is a real opportunity for championing patients’ voices, and also making sure those who are in charge who are able to make the changes, listen and respond appropriately." Read full story (paywalled) Source: The Times, 14 July 2022 -
Content ArticleRates of blood testing in primary care are rising. Communicating blood test results generates significant workload for patients, GPs, and practice staff. This study from Watson et al. explored GPs’ and patients’ experience of systems of blood test communication. The study found that methods of test result communication varied between doctors and were based on habits, unwritten heuristics, and personal preferences rather than protocols. Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety. Text messaging and online methods of communication have benefits, but were perceived by some patients as ‘flippant’ or ‘confusing’. Delays and difficulties obtaining and interpreting test results can lead to anxiety and frustration for patients and has important implications for patient-centred care and patient safety.
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- Tests / investigations
- GP
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News Article
GP test result confusion puts patients at risk
Patient Safety Learning posted a news article in News
Patients are being put at risk because GPs wrongly assume they will actively seek their test results, a study says. Researchers from the University of Bristol said the mismatched expectations could harm patients, with delayed diagnosis a likely result. The study found: “Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety.” Dr Jessica Watson, a GP and doctoral research fellow at the Centre for Academic Primary Care at the university, who led the study, said: “GPs have a medico-legal and ethical responsibility to ensure they have clear, robust systems for communicating test results.” Watson added: “Relying on patients to get in contact and making assumptions about their knowledge of how to do so were particular risks highlighted.” Read full story (paywalled) Source: The Times, 12 July 2022- Posted
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Content ArticleHealthcare is traditionally a hierarchical industry. This structure can foster a culture of division amongst staff that is sometimes made worse by significant differences in background and training. However, in order to make sure care is safe and of a high quality, healthcare teams must develop good teamwork and communication. This is only possible if every member of the team feels respected and is free to speak up when they think something is wrong. In this podcast, host David Feldman speaks to Michael Brodman, Professor and Chair Emeritus in the Department of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai in the US. They discuss how mutual respect is essential for any institution developing a culture of safety and how the problems presented by medical hierarchy can be overcome.
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- Safety culture
- Communication
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Content ArticleThis blog by doctors Clare Rayner and Amali Lokugamage argues that Long Covid rehabilitation needs a wider focus that goes beyond a purely biomedical paradigm to include complementary therapies and methods. The authors—who have both lived with Long Covid for more than two years—argue that although patients were the first to raise concerns about Long Covid, describe its symptoms and patterns and even research the condition, their narratives and voices are not being included in approaches to treatment. While the biomedical evidence surrounding Long Covid is currently limited, they highlight that there is much valuable lived-experience to be found in patient support and campaign groups, and that patients' knowledge should be drawn on to shape policy and guidance about the condition.
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- Long Covid
- Pandemic
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Content ArticleThis study in the journal Current Problems in Diagnostic Radiology aimed to explore the perspectives of radiology and internal medicine residents on the desire for personal contact between radiologists and referring doctors, and the effect of improved contact on clinical practice. A radiology round was implemented, in which radiology residents travel to the internal medicine teaching service teams to discuss their inpatients and review ordered imaging. Surveys were given to both groups following nine months of implementation. The vast majority of both diagnostic radiology residents and internal medicine residents reported benefits in patient management from direct contact with the other group, leading the authors to conclude that this generation of doctors is already aware of the value of radiologists who play an active, in-person role in making clinical decisions.
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- Radiology
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News Article
Baby died two days after birth despite mum begging doctors to assess her
Patient Safety Learning posted a news article in News
A two-day old baby died just days after his mother begged doctors to assess her ahead of a c-section despite her pregnancy being deemed high risk. Davi Heer-Do Naschimento was born via emergency caesarean section during the early hours of 29 September 2021, after doctors at Royal London Hospital failed to communicate crucial details during handover meetings. An inquest at Poplar Coroners Court heard that his parents, Ruth Heer and Tiago Do Naschimento, had asked numerous times for assistance and were not seen by the obstetrics team the day before her planned caesarean. Tragically, after becoming "feverish" during the night, she was rushed into theatre with Devi sadly dying two days later. Speaking on behalf of the family, Francesca Kohler said that there had been “multiple occasions” throughout the day when Ms Heer and her partner had called for assistance and had raised concerns, but were not attended. She had also not been seen by the obstetrics team and had not been spoken to about the upcoming caesarean section. Read full story Source: My London, 4 July 2022- Posted
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- Baby
- Patient death
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Content ArticleClosed-loop communication—when every test result is sent, received, acknowledged and acted upon without failure—is essential to reduce diagnostic error. This requires multiple parties within the healthcare system working together to refer, carry out tests, interpret the results and communicate them in language the patient can understand. If abnormal test results are not communicated in a timely manner, it can lead to patient harm. This Quick Safety case study looks at the case of a 47-year-old school teacher who had a screening mammogram. The radiologist identified a suspicious area of calcifications, which required follow up. The patient’s GP was not on the same electronic medical record (EMR) as the imaging centre and, because of front office changes, missed the notification to follow up. The patient was told that the radiologist would contact her if the results were abnormal and therefore assumed she was okay. A year later when seeing her GP, the patient was told that she needed follow-up testing and that she had stage 3 cancer. Her lesion had grown significantly, and she now required surgery, chemotherapy and radiation for advanced breast cancer. The case study suggests safety actions that should be considered to prevent this error from happening again.
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- Imaging
- Reports / results
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Content ArticleThis white paper from the Institute for Healthcare Improvement (IHI) describes a framework to guide health care organisations in their efforts to provide safe, equitable, person-centred telemedicine. The framework includes six elements to consider: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design.
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- Telemedicine
- Telehealth
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News Article
Patients' champion 'won't speak to patients'
Patient Safety Learning posted a news article in News
Patients will not be able to directly contact Scotland’s new Patient Safety Commissioner under the role’s proposed remit, according to the Sunday Post. Officials drawing up the job description for the position are proposing patients with concerns and complaints should go through their local health boards instead of dealing directly with the commissioner. Last week, Henrietta Hughes was named as the government’s preferred candidate for the role of Patient Safety Commissioner in England. In that role, Hughes will be able to be directly contacted by the public. Despite being the first UK country to announce the intention to appoint a commissioner two years ago the role in Scotland is not yet filled. The decision not to allow patients to directly contact the commissioner in Scotland has been criticised by Baroness Julia Cumberlege, author of the report, First Do No Harm. She said: “Of course, patients must be able to communicate directly with the commissioner and their office. In our review we said the healthcare system is not good enough at spotting trends in practice and outcomes that give rise to safety concerns. Listening to patients is pivotal to that. “This is why one of our principal recommendations was the appointment of an independent Patient Safety Commissioner, a person of standing who sits outside the healthcare system, accountable to parliament through the Health and Social Care Select Committee." Read full story Source: The Sunday Post, 26 June 2022- Posted
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- Patient
- Patient engagement
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Content ArticleShared decision making involves ensuring patients are able to contribute meaningfully to decisions about their care. Healthcare professionals ensure patients are informed of the options available to them and fully involve patients in making treatment decisions. This report by the Patients Association sets out the views of 1,416 healthcare professionals on shared decision making, expressed in an online survey in Spring 2022. Respondents included GPs, consultants, specialist nurses and practice nurses. The survey found that most healthcare professionals are positive about shared decision making, but feel their ability to practice it regularly is limited by the current situation in the NHS. Many said that lack of time, gaps in the workforce and large caseloads prevented them partnering with patients to make decisions about treatment and care together.
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- Patient engagement
- Decision making
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Content ArticleFinding out a patient's perspective about their care and treatment is a key part of shared decision making, but healthcare professionals do not always proactively do this in practice. This scoping review in the journal Patient Education and Counselling explored the extent to which the personal perspectives of patients are drawn out by clinicians during a consultation, as part of a shared decision making process. It reviewed studies in five databases about shared decision making. The authors found that studies reported low levels of healthcare professionals eliciting patient perspectives, The majority of content healthcare professionals and patients discussed related to physical health, with social and psychological topics mostly unaddressed.
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- Patient engagement
- Decision making
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Content ArticleMuch progress in the world depends on the spread of ideas, says Steven Shorrock in his new blog. There is no shortage of good ideas, and no shortage of bad ones, but ‘good’ and ‘bad’ are relative to our positions, and success and failure are not dependent on either. The success of an idea depends on a multitude of factors, such as the the multiverse of contexts in which it is introduced, the dominant paradigm, the nature of the related problem situation or opportunity, the quality of the idea itself, the communication of the idea, possible unwanted consequences, and the characteristics of the proponents and detractors.
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- Quality improvement
- Leadership
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Content ArticleThis improvement tool is designed to help NHS organisations identify strengths their leadership team and organisation, and any gaps that need work, in seeking to create an environment where people feel safe to speak up with confidence. It should be used alongside Freedom to speak up: A guide for leaders in the NHS and organisations delivering NHS services, which provides full information about the areas addressed in the statements, as well as recommendations for further reading.
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- Speaking up
- Organisational culture
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Content ArticleThis guide provides ideas for how an organisation can adhere to the NHS principles for leaders and managers in seeking to create an environment where people feel safe to speak up with confidence. This guide is designed to be used by any senior team, owner or board in any organisation that delivers NHS commissioned services. This includes all aspects of primary care; secondary care; and independent providers.
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- Speaking up
- Communication
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Content ArticleUnderstanding health information (health literacy) is essential for taking medications correctly, knowing which health services to use and managing long-term conditions. Around half the population struggles to understand health information, and the most disadvantaged groups in society are most likely to have limited health literacy. Improving health literacy is therefore key to tackling health inequalities and improving health outcomes for everyone. This resource collection from the National Institute for Health and Care Research (NIHR) brings together messages from research highlighted in NIHR Alert summaries. It includes research on the impact of unclear health messages, how we can help people understand health information and which groups of the population may need extra support.
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- Health literacy
- Health inequalities
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Content ArticleIn a series of blogs, Gina Winter-Bates, Associate Nurse Director Quality and Safety at Solent NHS Trust, shares her experience of implementing Safety Chats. In this final blog of the series, Gina shares the next steps for Safety Chats in her Trust and how they will be building more ways of supporting staff to discuss safety, to seek advice and support, and to receive clear assistance when things have gone wrong.
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- Organisational culture
- Communication
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation explores medicines omission among patients with learning disabilities who are cared for in medium and low secure wards in mental health hospitals. A medicine omission is when a patient doesn't receive medicines that have been prescribed to them, and the investigation focused on a number of factors that could contribute to omission: the environment in which medicines administration takes place the availability and use of learning disability nurses in these environments the skills required for nurses to help patients with learning disabilities be involved in choices about their medicines. For it's reference event, the investigation looked at the case of Luke, who was detained in a medium secure ward of a mental health hospital. He spent 21 months on the ward before moving into a low secure ward at the same hospital, where he stayed for a further 11 months. Both wards were specifically designated for patients with learning disabilities. While at the hospital, there were a number of periods when Luke was not given the physical health medication he had been prescribed for his diabetes and high cholesterol. Although Luke’s medication record regularly noted that Luke refused the medication, Luke and his Mother disagreed with this version of events, stating that other factors led to Luke’s medicine omissions.
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- Learning disabilities
- Medication
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Content ArticleMental and physical health are closely related, and people who live with long-term physical conditions are twice as likely to have poor mental health as those who do not. The Covid-19 pandemic is likely to have increased this trend. This report looks at the lived experience of people living with long-term conditions, their family members and the healthcare professionals who work with them, to understand the relationships between having a long-term illness and people’s emotional and mental wellbeing. It aims to identify ways of improving people’s experiences and outcomes. The report covers: the impact long-term conditions can have on people, their relationships and jobs. what helps people deal with this impact. what support is already available and works. what needs to change to better emotionally support people living with long-term physical ill-health. This report was coproduced by National Voices and Centre for Mental Health, with support from a range of long-term conditions charities.
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- Mental health
- Underlying health conditions
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Content ArticleCheshire and Merseyside Health and Care Partnership has published this consensus document on the interface between primary and secondary care. It aims to ensure healthcare providers ensure access to the right care to give patients the best outcomes. It contains a set of clinically-led principles to ensure pathways have a common structure of good quality, patient-centred communication. It includes a number of guiding principles that encourage staff to ensure: the patient is at the centre of decision making actions taken are completed in a timely way actions are undertaken by the most appropriate individual or team decisions and actions are understood by all.
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- Primary care
- Hospital ward
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Content ArticleThe Belfast Health Trust failed to intervene quickly enough in the practice of a doctor which led to Northern Ireland's largest ever patient recall, the Independent Neurology Inquiry has found. More than 5,000 former patients of neurologist Michael Watt were invited to have their cases examined for possible misdiagnoses. Among the conditions being treated were stroke, Parkinson's disease and multiple sclerosis (MS). The inquiry found "numerous failures". The Independent Neurology Inquiry concluded that the combined effect of the failures ensured that patterns in the consultant's work were missed for a decade.
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- Medicine - Neurology
- Investigation
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Content Article
PRSB: 'About Me' standards
Patient Safety Learning posted an article in Patient-centred care
The About Me standard helps people share information about what is most important to them with health and care professionals so that staff can provide better, more person-centred care whenever and wherever it is needed. About Me information may include things like how best to communicate with the person, put them at ease during treatment, their spiritual or religious beliefs, or what arrangements to make for family or pets if they are hospitalised. The Professional Record Standards Body (PRSB) has published a standard outlining how About Me information should be documented and shared in health and care records. #CareAboutMe aims to raise widespread awareness of the About Me standard and the improvements it can make to the quality of care administered in health and care, as well as the positive impact it can have on people’s quality of life and health. PRSB wants to help every person share information about ‘what matters to me’ by using PRSB’s About Me standard. The goal is to help professionals provide better care and for people to experience lasting benefits to their health and wellbeing.e hospitalised.- Posted
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- Standards
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Content Article
Human factors - Safer surgery checklist (June 2022)
Patient-Safety-Learning posted an article in Surgery
This literature review in The Operating Theatre Journal looks at 'How industry has helped healthcare better understand human factors'. The author, Nigel Roberts, Theatre Lead at the University Hospitals of Derby and Burton, looks at this question in relation to teamwork, leadership, situational awareness, communication and culture.- Posted
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- Human factors
- Surgery - General
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation explores issues around patient handover to emergency care. Patients who wait in ambulances at an emergency department are at potential risk of coming to harm due to deterioration or not being able to access timely and appropriate treatment. HSIB has published an interim report outlining early investigation findings, and recommends a national response to tackle this urgent issue. Findings so far emphasise that an effective response should consider the interactions of the whole system: an end-to-end approach that does not just focus on one area of healthcare and prioritises patient safety. For its reference case, the investigation looks at the case of a patient who was found unconscious at home and taken to hospital by ambulance. The patient was then held in the ambulance at the emergency department for 3 hours and 20 minutes, and during this wait their condition did not improve. They were taken directly to the intensive care unit where they remained for nine days before being transferred to a specialist centre for further treatment.
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- Transfer of care
- Emergency medicine
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