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Content ArticleFrimley Health has launched a new service for members of the public to independently raise concerns if they believe a patient’s clinical condition is deteriorating. The Call 4 Concern programme enables friends, relatives – and the patients themselves - to make a direct referral if their concerns have not been alleviated by first speaking to the medical team. The Trust’s critical care outreach practitioners will then review the patient, liaise with the medical team and take any appropriate action. At Frimley Park Hospital, call 07717 303231. At Wexham Park Hospital call 07909 930728. The Call 4 Concern programme is available 24 hours a day, seven days a week and has previously been successfully implemented by several other NHS organisations.
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Content Article
HealthIT.Gov: SAFER guides (USA)
Patient Safety Learning posted an article in Health records and plans
The SAFER Guides consist of nine guides organiaed into three broad groups. These guides enable healthcare organisations to address electronic health record (EHR) safety in a variety of areas. Most organisations will want to start with the Foundational Guides, and proceed from there to address their areas of greatest interest or concern. -
Content ArticleNHS England have released statistics on referral to treatment (RTT) waiting times for consultant-led elective care. The statistics include patients waiting to start treatment at the end of July 2022 and patients who were treated during July 2022.
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Content ArticleThe purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) was to consider the management and care of preterm labour and birth of twins. Preterm birth—defined as babies born alive before the completion of 37 weeks of pregnancy—is one of the main causes of death, long-term conditions and disability in under-fives worldwide, and 60% of twin pregnancies result in premature birth. The reference event for this investigation was the case of Sarah, who was pregnant with twins and was overseen by an obstetrician during her pregnancy. Sarah was assessed as having a higher-risk pregnancy as she had had previous medical intervention on her cervix and was pregnant with twins. Shortly after having been discharged from a hospital with a specialist neonatal unit following suspected early labour, she went to her local maternity unit at 29+2 weeks with further episodes of abdominal tightening. Her labour did not progress as expected and a caesarean section was required to deliver the babies at 29+6 weeks. The twin girls were born well, but 23 days after their birth a scan revealed brain injury in both babies. The investigation identified several findings to explain the experience of the mother in the reference event, including the lack of scientific evidence or specific guidelines and the uncertainty associated with the clinical decision making in this scenario. This highlighted the need for further research into preterm labour as a recognised risk factor for twin pregnancies. As part of the investigation, HSIB identified that since 2019 a large volume of national work and research in the area of twin pregnancy and preterm birth has been undertaken. The investigation report sets out the work currently in progress and seeks to understand if it will address gaps in knowledge.
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Content ArticleVideo and telephone consultations have, through the course of the pandemic, become a central of daily operations across the NHS. In this blog, Ben Gadd and Amanda Nash of University Hospitals Plymouth NHS Trust share their experiences about how they are being received and the potential lessons we can learn.
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Content ArticleA Treatment Escalation Plan (TEP) is a communication tool designed to improve quality of care in hospital, particularly if patients deteriorate. TEPs aim to reduce variation caused by discontinuity of care, avoid harms caused by inappropriate treatment and promote patients’ priorities and preferences. This article in the Journal of the Royal College of Physicians of Edinburgh examines the key components of a TEP, how and why TEPs should be implemented and the outcome-related evidence to support their use.
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Content ArticleCompensation claims are a useful source of information on patient safety research. This study in The Journal of Patient Safety aimed to determine the main causes of surgical compensation claims and their financial impact on the health system. The authors analysed the frequency, causes, consequences, locations and surgical settings of compensation claims brought against the surgical area of the Murcia Health System between 2002 and 2018. The study found that the most frequent causes for claims were surgical error (42.4%) and treatment error (30.9%), and that the main surgical settings involved were orthopaedic surgery and traumatology (27.4%), gynaecology and obstetrics (25.7%) and “general surgery” (17.2%).
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Content Article
BMJ - Scan first, ask questions later? (18 August 2022)
Patient-Safety-Learning posted an article in Diagnosis
In this opinion piece in The BMJ, consultant radiologist Giles Maskell examines changes to the ways in which medical imaging is used in the health service. He states that imaging used to be ordered, when necessary, at the end of a diagnostic process, whereas now many doctors are asking for scans before they will see a patient for the first time. The article highlights some of the implications of this shift in practice, including on screening service capacity and on the interpretation of test results. -
Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Soojin talks to us about how her personal experience of harm motivated her to work in healthcare and campaign for patient safety, the power of collaboration in improving healthcare safety and how healthcare workers can take steps to improve their own patient interactions. -
Content Article
NHS Scotland waiting times
Patient Safety Learning posted an article in Dashboards and presentations of data
Information on waiting times for local health boards and specialties in Scotland. This site shows information on waiting times for planned (elective) care. This site does not show information for emergency (unscheduled) care. The statistics shown here relate only to any treatment as an inpatient or day case covered by the Treatment Time Guarantee (TTG). A small number of specialist treatments are not covered by the TTG. -
Content ArticleOnline patient feedback is becoming increasingly prevalent on an international scale. However, limited research has explored how healthcare organisations implement such feedback. This research from Baines et al. sought to explore how an acute hospital, recently placed into ‘special measures’ by a regulatory body implemented online feedback to support its improvement journey.
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Content ArticleSafety reporting systems are widely used in healthcare to identify risks to patient safety. But, their effectiveness is undermined if staff do not notice or report incidents. Patients, however, might observe and report these overlooked incidents because they experience the consequences, are highly motivated, and independent of the organsation. Online patient feedback may be especially valuable because it is a channel of reporting that allows patients to report without fear of consequence (e.g., anonymously). Harnessing this potential is challenging because online feedback is unstructured and lacks demonstrable validity and added value.
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Content ArticleSuccessful adoption of novel noncontact physiological measurement and physical monitoring requires analysis of how they support patient care. Lloyd-Jukes et al. review available technologies and present their vision-based patient monitoring and management system, supported by a framework enabling its integration within clinical workflows. The framework links tasks such as assessing patients to elements of the patient journey (eg, risk factors and early warning signs). The system enabled insights from patient activity reports and noncontact vital sign measurements. It supports staff in ensuring patients' health follows desired trajectories, avoiding adverse events, making observations without disrupting patients' rest, intervening proactively, and learning from incidents.
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Content ArticleThe US's response to monkeypox fails to put patients and their care at its centre, writes Eric Kutscher in the BMJ opinion article. As a primary care and addiction medicine physician, Kutscher has been dismayed by the number of patients he has treated over the past few weeks who’ve been infected with the vaccine-preventable monkeypox virus. Most have been in considerable pain and required strong analgesics, with some unable to even sit because of their skin lesions. Yet for many, the most agonising and scarring aspect of their infection is not their physical symptoms, but the complete removal of their humanity by the medical response to monkeypox. As a medical and public health community, we are exhausted after Covid-19, and our compassion fatigue is showing in our policies and procedures for monkeypox. The spread of the virus to previously non-endemic countries was only recently declared a public health emergency of international concern by the World Health Organization. Unlike with Covid-19, this is not a novel virus—we have the appropriate diagnostic testing, treatment, and even vaccines that we need. Yet, just as we have failed to deploy these tools to assist in outbreaks in African nations, we are now also failing our patients from a sexual minority—patients who are already underserved and justifiably mistrusting of a medical system.
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Content ArticleThis article explores political barriers to integrated care, arguing that improving the US healthcare system requires the pursuit of three aims: improving the experience of care, improving the health of populations and reducing per capita costs of health care.
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Content ArticleThis blog on the NHS England website looks at how Written Medicine, a service that provides bilingual medication information, is helping to reduce healthcare inequalities and medical errors in London. Written Medicine’s software allows pharmacies and hospitals to translate and print medication information, instructions and warnings. Drawn from a dataset of 3,500 phrases, printed labels are available in fifteen different languages. The bilingual labels help patients take ownership of their treatment, giving them a better understanding of how to take their prescribed medication. The solution is helping to reduce errors, improve medication adherence and enhance patient safety and experience. The blog also looks at the experience of London North West University Healthcare NHS Trust (LNWH) using Written Medicine. A 2019 audit showed that the service was valued by patients and highly successful in increasing medication adherence through empowering patients.
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Content Article
PRSB - 111 referral standard (August 2022)
Patient-Safety-Learning posted an article in Processes
The Professional Record Standards Body (PRSB) has published the final draft standard for 111 referral, which defines the information that should be shared from 111 or 999 services when a person is referred on to another service. The standard applies to: all 111 and 999 service referrals to wherever the person goes next. referrals through 111 online, call handler or clinical assessment services and 999 services, and is not specific to any triage system. all age groups including children. The standard is UK-wide and was developed in consultation with a wide range of professionals from all four nations, including from 111 services, receiving services, IT suppliers and people who use services. It does not apply to transfers between 111 services (e.g. across a country border) or between 111 and 999 services. -
Content ArticleIn the 2017 Health Survey for England, 34% of adults reported experiencing chronic pain. The survey found that 5.5 million people (12%) are affected by high-impact pain that prevents them from enjoying social, family and recreational activities, and from working, including carrying out household tasks. This document sets out what the Arthritis and Musculoskeletal Alliance (ARMA) believes should be available in every area for people living with long term pain. It covers four areas: Underpinning framework Treatment for underlying conditions Services for people living with chronic pain Prevention and inequalities
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Content ArticleIn this letter to the Secretary of State for Health and Social Care, Rachel Power, Chief Executive of the Patients Association, calls on Steve Barclay to ask the Government to develop a long-term workforce strategy for the NHS. She also requests that the government urgently fund social care and calls on Steve Barclay to take action to remedy the threat to patient safety caused by staff shortages.
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Content ArticleCOVID-19 has been associated with new-onset cardiovascular disease (CVD) and diabetes mellitus (DM), but it is not known whether COVID-19 has long-term impacts on cardiometabolic outcomes. This study from Rezell-Potts et al. aimed to determine whether the incidence of new DM and CVDs are increased over 12 months after COVID-19 compared with matched controls. The study found that CVD was increased early after COVID-19 mainly from pulmonary embolism, atrial arrhythmias, and venous thromboses. DM incidence remained elevated for at least 12 weeks following COVID-19 before declining. People without preexisting CVD or DM who suffer from COVID-19 do not appear to have a long-term increase in incidence of these conditions.
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Content ArticleMoral injury is a specific kind of trauma that can happen when when people face situations that deeply violate their conscience or threaten their core values. This blog for Scientific American looks at the experience of ER doctor Torree McGowan when the Delta wave of Covid-19 hit the central Oregon region where she works. It examines the impact that moral injury has had on her mental health and her relationship with patients. The author looks at how Covid-19 hugely increased the incidence of moral injury as people in frontline roles faced ethically wrenching dilemmas every day. The growing realisation that moral injury is a separate diagnosis to other conditions such as PTSD and depression is resulting in a wider range of treatments and trauma therapies. Many of these treatments encourage people to face moral conflicts head-on rather than blotting them out or explaining them away, and they emphasize the importance of community support in long-term recovery.
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Content ArticleThis report sets out the impact the Point of Care Foundation’s programmes have had on people who use and deliver health and care services, in its mission to humanise healthcare.
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Content Article
Long Covid by Geraint Jones
Patient Safety Learning posted an article in Patient recovery
Geraint Jones, a healthcare worker at a hospital in Wales, shares his experiences of Long Covid. Geraint tested positive for COVID-19 in April 2020, whilst working on the COVID-positive wards in a district general hospital. This long-lasting illness is still little understood, but new research is uncovering some of the recurring symptoms that many patients experience and suggesting better options for treatment for adults and children. -
Content ArticleEmer Joyce is a Cardiologist at Mater University Hospital in Dublin who developed myocarditis as a result of a Covid-19 infection. This article by Professor Joyce in the European Journal of Heart Failure aims to "give a birds-eye view of the physician as patient, the sub-specialist as sub-specialist condition sufferer, the one on the far side of the bed as the one in the bed." She also looks at the pattern of previously healthy, highly active healthcare professionals developing serious long-term health issues as a result of Covid-19.
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Content ArticleThis framework produced by the Royal College of Paediatrics and Child Health (RCPCH) aims to improve how healthcare organisations recognise and respond to children at risk of deterioration. A safer system can work in partnership with families and patients, develop a patient safety culture and support ongoing learning. The framework covers: Patient safety culture Partnership with families Recognising deterioration Responding to deterioriation Open and consistent learning Education and training
