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Found 1,234 results
  1. Content Article
    The purpose of the US Joint Commission's National Patient Safety Goals is to improve patient safety. The goals focus on problems in healthcare safety in the USA and how to solve them. They include identifying patients correctly, improving staff communication, use medicine safely, use alarms safely, prevent infection, identify patient safety risks and prevent mistakes in surgery.
  2. Content Article
    The objective of this US-based study, published in The Joint Commission Journal of Quality and Safety, was to present safety briefings as a method for discovering and addressing safety events in a paediatric emergency room, describe how professionals perceive them, and characterize the classification and evolution of the incidents identified.
  3. Content Article
    Last week a letter signed by 435 GP practice staff on access to GP practices was published in The Times. The letter was drafted by a group of grass root GPs, in response to the recent misleading allegations that GPs have been “closed” during the pandemic. These headlines damage the reputation and morale of the workforce. Responsible media reporting is a patient safety issue, as those patients who believe this false rhetoric may not seek help for worrying symptoms. We have already seen reduced rates of cancer diagnosis during the pandemic by around 40%, along with reduced presentations of other major non-covid illnesses. Irresponsible media may also cause inappropriate use of emergency departments and the NHS 111 helpline, which adds further pressure on our secondary care colleagues at a critical time for the NHS. GPs Simon Hodes and Neena Jha discuss this further in this BMJ Opinion article.
  4. Content Article
    The NHS is full of dedicated staff who, at a one-to-one level with patients, offer deeply personal and compassionate care. But too often the system as a whole seems institutionally deaf to the patient voice. This report from the Patient Experience Library explores the reasons for that. It shows how the NHS – at an institutional and cultural level – fails to take patient experience evidence seriously enough. It calls for a few simple and entirely feasible steps that would strengthen evidence-based practice and ensure that the patient voice is better heard.
  5. Event
    Facilitate effective communication and manage quality efforts across your organisation with a platform that promotes staff engagement and encourages proactive risk mitigation. Learn how Safety Huddles can help your organisation prevent potential harm from happening in the first place. Empower staff to share ideas for improvement and speak up about patient safety concerns. Configure your huddle format to collect the information that matters most. Capture customised quick notes, reference pertinent files or patients and create targeted tasks. Measure huddle performance and effectiveness with robust dashboards and reports. Register
  6. Event
    until
    The Patient Information Forum's sell-out writing training course has been redeveloped for online delivery, maintaining the element of classroom style teaching with direct interaction with tutors and group work with practical exercises. The course features practical exercises, group work and feedback from tutors. The course is ideal for anyone starting out in health information and for those wishing to improve and refresh their skills. It is also ideal for staff planning to return from furlough who may have lost confidence while away from work. The course will be delivered via Zoom and will be held over three consecutive mornings with a maximum of 30 delegates. Register
  7. Event
    until
    A webinar to mark the launch of the Patient Information Forum's updated 'Producing Health Information for Children and Young People' guide. The guide has been reviewed and updated for 2020 by an expert panel and will be published in November. The guide retains much of its core content but reflects new priorities including using digital tools, mental health, violence reduction and working with CYP from seldom heard groups, including looked after children and young carers. Registration
  8. Content Article
    Many working age adults in the UK lack skills to understand and use information on health and wellbeing. Health literacy skills are lacking in 43% of the population and numeracy skills in 61%. This gap between skills and the complexity of health information leaves millions excluded from making informed decisions about their health, compounding existing health inequalities. COVID-19 accelerated the digital ambition of the NHS Long Term Plan. In the four weeks to 12 April 2020, 71% of routine GP consultations were delivered remotely, according to the Office for National Statistics (ONS). Secretary of State for Health Matt Hancock has said he wants this trend to continue and it is likely remote consultations will be part of the new normal. However, nine million people lack digital skills, 8% are not connected and 66% with online access do not use the internet or digital tools to support their health. In 2019 there was already concern that people with low health literacy and those without access, skills or motivation to use digital tools would be left behind in a digital first NHS. Late in 2019 the Patient Information Forum (PIF) ran a survey of its membership about their action on health and digital literacy. Its findings and recommendations have been made more urgent by the inequalities exposed by the pandemic.
  9. Content Article
    In this Patient Safety Movement Foundation webinar, Dr Donna Prosser, Chief Clinical Officer at the Patient Safety Movement Foundation, is joined by a multidisciplinary group of patient advocacy experts and clinicians to understand the various meanings of the term 'patient advocacy' and to evaluate how an empowered patient can improve healthcare delivery, experience, and outcomes for all involved. The group discuss the history and current state of patient advocacy, and propose recommendations regarding the extent to which various healthcare disciplines and patients and their families can improve patient advocacy.
  10. Content Article
    The Comprehensive Unit-based Safety Program (CUSP) is a method that can help clinical teams make care safer by combining improved teamwork, clinical best practices, and the science of safety. The Core CUSP toolkit gives clinical teams the training resources and tools to apply the CUSP method and build their capacity to address safety issues. A number of toolkits are available to help clinical teams adopt the CUSP method to make care safer. Most teams will want to start with the Core CUSP Toolkit to learn key principles of the CUSP method. Once you’ve learned the basics, additional toolkits can help you target certain safety issues in specific settings of care. Created for clinicians by clinicians, the Core CUSP toolkit is modular and modifiable to meet individual unit needs. Each module includes teaching tools and resources to support change at the unit level, presented through facilitator notes that take you step by step through the module, presentation slides, tools, and videos.
  11. Content Article
    The US National Quality Forum (NQF) convened a multistakeholder committee to identify recommendations for the practical application of the Diagnostic Process and Outcomes domain of the 2017 Diagnostic Quality and Safety Measurement Framework, measuring and reducing diagnostic error, and measuring and improving patient safety. This report outlines the recommendations through a series of four Use Cases – missed subtle clinical findings (Use Case 1), communication failures (Use Case 2), information overload (Use Case 3), and dismissed patients (Use Case 4) – that depict resolutions to specific types of diagnostic errors, and broad-scope, comprehensive recommendations with applications to multiple populations and settings.
  12. Content Article
    This is a book written to celebrate the humanity of people, and to share experiences of what brilliant care and support can look like for families with learning disabled or autistic children and adults. Sara Ryan steers clear of jargon and 'doublespeak' to conjure authentic experiences of families. Speaking with families and professionals, she conveys the love, laughter and joy which binds families and the harsh realities many face; of separation from loved ones, substandard care and frustration and helplessness in the face of inflexible services. From their experiences, Sara looks to capture those pockets of brilliance that families have encountered, and which outstanding practitioners have pioneered, for us all to learn from. We know so much about what support and services should look like in order to enable flourishing lives - this book aims to help families and professionals to achieve it, together.
  13. Content Article
    In his latest blog, Steven Shorrock explores what humanistic values and human decency means in management and organisational behaviour. Steven Shorrock is an interdisciplinary humanistic, systems and design practitioner interested in human work from multiple perspectives.
  14. Content Article
    In this blog, Patient Safety Learning sets out its response to NHS England and NHS Improvement’s draft Framework for involving patients in patient safety. We commend the intention and share thoughts on our perspective on this important patient safety issue. We make proposals for how to strengthen patient engagement and co-production.
  15. Content Article
    Some personal reflections on how the varieties of human work as summarised by Steven Shorrock apply to healthcare and personal experiences within the NHS. I offer some considerations of how this type of thinking should inform the activity of those working in patient safety oversight roles where they are not in close and regular contact with staff delivering frontline services.
  16. Content Article
    The World Health Organization (WHO) is actively exploring the role of compassion in quality health care. This Global Health Compassion Rounds (GHCR) highlighted the compelling evidence around compassion and quality care—not only for patients, but also for providers and health care organisations. Respondents offered their views of the implications of this evidence at national, district, and community levels of care. 
  17. News Article
    A mother of a young boy with Down's syndrome is helping to teach people about appropriate language, after being hurt by words people often used. Becca, from Cornwall, uses flashcards to make sure people are aware to say things like saying someone "has Down's syndrome", rather than "suffers with Down's syndrome". The campaign is being rolled out in hospitals for midwives and other healthcare workers to use, with many in the profession talking about it on social media. A children's clothing company has offered to run it, with her son Arthur as the model, and she has been asked to translate it into other languages. Source: BBC News, 15 October 2020
  18. Content Article
    "Healthcare systems need to act in equal measures to both enable the recovery of patients and families it has harmed, and to protect future patients.... Yet providing what is set out in the Duty of Candour to harmed patients has not been framed as providing care to make sick or injured people better and/or to minimise their pain and suffering." In this blog, Jo Hughes explains why we need to reframe the Duty of Candour and explores what needs to change.
  19. Content Article
    In September, Patient Safety Learning worked with Gill Phillips, Director of Nutshell Communications Ltd, to host an online workshop with staff and patients on the subject of staff safety, the theme of this year's World Patient Safety Day. Known as Whose Shoes?®, the workshop was an an intimate, highly participative event, giving participants the chance to talk openly about their personal experiences around key issues in staff safety and how they impact patient safety. 
  20. Content Article
    Physicians and patients have concerns associated with a shift toward virtual medicine. This interview with a Dr Paul Hyman, a primary care physician, highlights how the loss of physical touch and in-person communication could negatively affect care and the patient/physician relationship. 
  21. Content Article
    The safety huddle has become an important way for hospitals to surface safety concerns affecting patients and the workforce. The best huddles are multidisciplinary, highly structured, brief (15 minutes or less), take place early in the morning and focus on incidents from the day before and risks to safety in the day ahead. Is the safety huddle effective? Have organisations grown lax with the process over time? Some participants have observed that, over time, safety huddles tend to become "just another meeting" or "another box to check off." Dr. James Reinertsen, who has spent decades coaching clinical leaders and staff about safety, says too many huddles allow department leads to report "no safety issues today." That's impossible, says Reinertsen. Every department has safety risks; it's a matter of being proactive and looking for them. In this podcast, Ronette Wiley shares the story of the turnaround with the safety huddle and the tools they use at Bassett Medical Center in upstate New York, USA, and Dr Helen Mackie educates us about the safety huddle at Hairmyres Hospital in Scotland where issues are flagged daily in a rigorous process known as The Onion. 
  22. Content Article
    Parents know better than anyone if their child is not behaving as they usually do or seem different in some way. Studies have shown that caregivers are often the first people to spot changes in the health of their child, even when in a clinical environment. You should feel able to raise any concerns if you think something is ‘just not right’ with your child. Great Ormond Street Hospital has produced guidance on what to look out for and how to raise a concern if you are worried about your child when in hospital.
  23. Content Article
    The health literacy field has evolved over several decades. Its initial focus was on individuals who had poor literacy skills. Now there is a broad recognition that everyone—not just those with limited literacy—face challenges in understanding health information and navigating the healthcare system. Acknowledging that the healthcare system is overly complex, healthcare organisations have started to take responsibility to ensure that everyone, especially the vulnerable, is able to find, understand, and use health information and services. The Agency for Healthcare Research Quality (AHRQ) provides national health literacy leadership. AHRQ’s health literacy work spans from developing improvement tools, to designing professional training and education, to funding and synthesising health literacy research. You can find health literacy improvement tools, educational and training, and publications on the AHRQ Health Literacy website.
  24. Content Article
    What Your Patient Is Thinking (WYPIT) is a BMJ series led and edited by patients and carers. The articles are written by patients and carers and are a key part of The BMJ’s campaign to increase partnership with patients and public in healthcare. They contain messages that are thought provoking, and challenging for clinical readers of The BMJ, who mainly consist of doctors from across the world. Articles can be about any aspect of patient or carer experiences. This might include what it is like for you to live with your condition or as a carer or your experience of an appointment or procedure. This might be in relation to a single healthcare appointment to those from a lifetime of managing a long term health condition. It is important for the piece to include lessons for doctors. They can focus on a particular aspect of care or treatment, offer a new angle on a familiar situation, or ask controversial questions from the patient or carer's perspective. They can be triggered by good or bad experiences but all of them should give healthcare professionals and, or policy makers practical things that they can do differently tomorrow as a result of reading the article. The BMJ patient and clinical editors will work with you to develop your piece and to suggest specific questions to prompt reflection and action from the readership, that follow from the key points of your article. Guidance if you would like to contribute to the "What Your Patient is Thinking" series.
  25. Content Article
    In this study, Avery et al. estimated the incidence of avoidable significant harm in primary care in England, and describe and classify the associated patient safety incidents and generate suggestions to mitigate risks of ameliorable factors contributing to the incidents. The study found there is likely to be a substantial burden of avoidable significant harm attributable to primary care in England with diagnostic error accounting for most harms. Based on the contributory factors we found, improvements could be made through more effective implementation of existing information technology, enhanced team coordination and communication, and greater personal and informational continuity of care.
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