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Showing results for tags 'Communication'.
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News Article
Betsi Cadwaladr did not discuss resuscitation decision with family
Patient Safety Learning posted a news article in News
A health board has apologised to the family of a patient after medical staff failed to consult with them over a decision not to resuscitate her. While the decision was clinically justified, the public services ombudsman for Wales said Betsi Cadwaladr health board did not discuss it with the patient and her family. The ombudsman, Michelle Morris, also upheld a complaint by the patient's daughter, identified only as Miss A, that her mother's discharge from Ysbyty Gwynedd in Bangor was "inappropriate" and that insufficient steps were taken to ensure her needs could be safely met at home. The final complaint, which was also upheld, was that medics failed to communicate with the family about the deteriorating condition of the patient, identified as Mrs B, which meant a family visit was not arranged before she died. In her report she said the Covid pandemic had contributed to the failings, but added "this was a serious injustice to the family". As well as apologising to the family, she asked that all medical staff at Ysbyty Gwynedd and Ysbyty Penrhos Stanley be reminded of the importance of following the proper procedure when deciding when a patient should not be resuscitated. Read full story Source: BBC News, 6 February 2023 -
News Article
North East ambulance staff lacked critical medicines, CQC finds
Patient Safety Learning posted a news article in News
Ambulance crews in the North East frequently responded to emergencies without access to life-saving drugs, a damning inspection report has found. The study of North East Ambulance Service NHS Trust (NEAS) concluded patients were potentially put at risk by the poor management of medicines. The Care Quality Commission (CQC) found a deterioration of services and rated NEAS's urgent care as "inadequate". In response, NEAS said it had faced a year of "unprecedented pressures". The damaging assessment follows the launch of a full independent NHS review into numerous "tragic failings" involving patients. Announcing the review, the then health secretary Sajid Javid said he was "deeply concerned" about claims NEAS had covered up mistakes. Whistleblowers have told Newsnight multiple deaths were not investigated properly because information was not always provided to coroners and families. Read full story Source: BBC News, 1 February 2023 -
News Article
"Doctors discuss my daughter like she's nothing"
Patient Safety Learning posted a news article in News
A doctor in Cambridge is spearheading a project to help to reform "blunt" medical language that patients and their families can find upsetting. Ethicist Zoe Fritz said language that "casts doubt, belittles or blames patients" was long overdue for change. Sixteen-year-old Josselin Tilley from Wiltshire has charge syndrome that reduces her life expectancy. Her mother Karen said Josselin's death was often referred to in correspondence "like she's not a person. "It's not person-centred at all, it's like she's just nothing." The example she gave was an extract from a typical letter in November that she was copied in to by a community paediatrician addressed to colleagues. "Death below 35: On discussion with Josselin's mum early death has been discussed with her, and there is plan, discussed with Josselin's mother about a wishes document being done." Mrs Tilley, from Westbury, said she objected to the use of language that "very bluntly discusses Josselin's death like she's something going off in the fridge". Doctor Fritz said the reason she and doctor Caitriona Cox were running the campaign at Cambridge University was because they recognised language regularly used by clinicians was often problematic for anyone outside of medical practice. "Even just (the term) presenting [a] complaint. Patients coming into hospital with whatever's bothering them we [doctors] talk about as a complaint and I think that infantilises the patient. They're not complaining when telling us what's going on." Read full story Source: BBC News, 17 January 2023 Further reading on the hub: Presenting complaint: use of language that disempowers patients -
News Article
Pandemic care home death: Family to sue over mother's end-of-life consent
Patient Safety Learning posted a news article in News
A man plans to sue a nursing home because, he says, during the pandemic his mother was put on end-of-life care without her family being told. Antonia Stowell, 87, did not have the mental capacity to consent because she had dementia, say the family's lawyers. Her son, Tony Stowell, said if end-of-life care had been discussed, he would not have agreed to it. Rose Villa nursing home in Hull says all proper process in Mrs Stowell's care was followed with precision. As a prelude to legal action, Mr Stowell's lawyers have obtained his mother's hospital records which, they say, show she was diagnosed with suspected pneumonia while living in the home. End-of-life drugs were then prescribed and ordered by medical professionals. In a statement, Rose Villa said: "We believe that our dedicated and professional team provided Antonia with the very best care under the direction of her GP and medical team, and all proper process in the delivery of this care was followed with precision." Mr Stowell's lawyers, Gulbenkian Andonian solicitors, said his mother's hospital records reveal the decision to put her on end-of-life care was made two days before the family was told. In their letter to the home announcing the planned legal action, they said Mrs Stowell could have had "48 additional hours on a ventilator with treatment… with the necessary implication that Antonia Stowell could still be with us today or at least survived". The lawyer dealing with the case, Fadi Farhat, told the BBC: "As a matter of law, there is a presumption in favour of treatment which would preserve life and prolong life, irrespective of one's age or condition. "Therefore to deviate from that presumption means a patient, or family members, should be consulted as soon as that decision is made or contemplated." He adds: "What is particularly concerning for me is this case occurred at the height of the pandemic. That should worry everybody because it demonstrates that rights can be suspended in times of crisis, when the very purpose of legal rights is to protect us during times of crisis." Read full story Source: BBC News, 9 January 2023 -
News Article
'Keep mums and babies safe by improving digital medical records'
Patient Safety Learning posted a news article in News
With the distressing spate of news reports about mums and babies who weren’t kept safe in hospital, an initiative in the Midlands to improve patient safety in maternal and acute care settings comes as a relief. The newly announced Midlands Patient Safety Research Collaboration will bring together NHS trusts, universities and private business to evaluate how digital tools can help clinical decision making and reduce danger for patients. Problems can arise if communication is poor between medics when patients move between departments. Professor Alice Turner of Birmingham University said: “The power of new technology available to us means that we can address one of the ongoing areas of risk for patients, which is effective communication and clinical decision making. “The new collaboration will be looking at how digital tools can make a real difference to reduce risks and support patient safety in the areas of acute medicine and maternal health.” Digital decision-making tools could improve prescribing and personalised management for patients needing emergency care. Importantly, these tools should provide a smoother flow of information between healthcare professionals in acute care between hospitals, doctors and the West Midlands Ambulance Service, and hopefully reduce risks of patient harm at key points during acute care. Read full story Source: The Mirror, 18 December 2022 -
News Article
How chatbots are helping doctors be more human and empathetic
Patient Safety Learning posted a news article in News
Despite the drawbacks of turning to artificial intelligence in medicine, some US physicians find that ChatGPT improves their ability to communicate with patients. Last year, Microsoft and OpenAI released the first free version of ChatGPT. Within 72 hours, doctors were using the artificial intelligence-powered chatbot. Experts expected that ChatGPT and other A.I.-driven large language models could take over mundane tasks that eat up hours of doctors’ time and contribute to burnout, like writing appeals to health insurers or summarising patient notes. However, they found that doctors were asking ChatGPT to help them communicate with patients in a more compassionate way. Dr Michael Pignone, the chairman of the department of internal medicine at the University of Texas at Austin, has no qualms about the help he and other doctors on his staff got from ChatGPT to communicate regularly with patients. However, skeptics like Dr Dev Dash, who is part of the data science team at Stanford Health Care, are so far underwhelmed about the prospect of large language models like ChatGPT helping doctors. In tests performed by Dr Dash and his colleagues, they received replies that occasionally were wrong but, he said, more often were not useful or were inconsistent. If a doctor is using a chatbot to help communicate with a patient, errors could make a difficult situation worse. Read full story (paywalled) Source: New York Times, 12 June 2023 -
News Article
FDA proposes revamping medication guides that come with prescriptions
Patient Safety Learning posted a news article in News
The US Food and Drug Administration has proposed to add to what you get with your prescription drugs. The proposed rule would require the prescriptions you get to come with a new kind of single-page medication guide with an easy-to-use set of directions and easy-to-understand safety information, a goal the FDA has been working toward for years. One study found that nearly 75% of Americans have had trouble taking their medicine as directed. A lot of that is due to cost – people might not be able to afford their medicine, so they don’t take it – but some is due to confusion. They might get more than one kind of written information with their prescription, or the information they receive can be conflicting, incomplete or repetitive, the FDA said. When people are confused or misinformed about their prescription, there is a good chance they will not take it or will stop taking it, and that can directly hurt their health. “Research suggests that medication nonadherence can contribute to nearly 25% of hospital admissions, 50% of treatment failures, and approximately 125,000 deaths in our country each year,” the FDA says. The agency said the new proposal is also meant to help fight the “nation’s crisis with health care misinformation and disinformation.” Read full story Source: CNN, 30 May 2023 -
News Article
Northern Ireland: No shows to health appointments costing thousands
Patient Safety Learning posted a news article in News
Patients who fail to turn up for surgical day case procedures are costing the health service thousands of pounds. It is a problem across Northern Ireland's five health trusts. Over a 10-month period in the South Eastern area 14,000 patients did not attend or cancelled review appointments on the day they were due to turn up. Assistant Director of Elective Surgery at the South Eastern Trust Christine Allam said it was "frustrating". The South Eastern trust review showed between April 2022 and January 2023, 7,755 people did not attend or cancelled new outpatient appointments on the day. During the same period, 14,003 or 10% of patients didn't show for review appointments. Ms Allam said the situation was "frustrating for those patients who are waiting to be seen". "Those slots where people don't turn up are lost capacity because we haven't been given notice - and this only lengthens the waiting lists," she added. It is a problem that all health trusts are experiencing. Read full story Source: BBC News, 24 May 2023 -
News Article
Call for national guidelines on discussing past trauma in maternity appointments
Patient Safety Learning posted a news article in News
National guidelines are needed to help maternity care professionals navigate discussions with pregnant women about past traumas, experts have said. Their study, published in the journal Plos One, also found that while talking about previously experienced traumas can be valuable, they can also trigger painful memories if not approached sensitively. The authors also raised concerns about the support available for professionals who may not feel equipped to explore challenging topics such as domestic or sexual abuse, childhood trauma and birth trauma without adequate guidelines or referral pathways. Joanne Cull, a midwife and PhD student at the University of Central Lancashire’s School of Community Health and Midwifery, who is corresponding author on the study, said: “As awareness of the long-term effects of trauma on health and wellbeing has grown, there has been a move toward asking pregnant women about previous trauma, usually at the first appointment. “No national guidance on this has been published in the UK so NHS Trusts have implemented this on a piecemeal approach.” Read full story Source: The Independent, 17 May 2023 -
News ArticleBlind people are being put “at risk” when the NHS provides them with “inaccessible” information about their health, a charity has warned. People with sight loss have missed appointments, cancer screenings or been unable to use home test kits because of a lack of clear instructions in an accessible format, according to the sight loss charity RNIB. It warned that denying people access to their information can also “cause embarrassment and loss of dignity”. Linda Hansen, from Bradford, who is severely sight-impaired, said that she needed to get her daughter to read her the results of a medical exam which was sent to her in print format. Ms Hansen, 62, said: “I can get my bank statement or a gas bill in accessible formats, but yet I still receive health information that I can’t read. What could be more personal than your health status?” A new RNIB campaign – My Info My Way – has been launched calling for all blind and partially sighted people to be given accessible information. The charity said that a failure to provide information in an accessible format is putting blind and partially sighted people “at risk”. Read full story Source: The Independent, 16 May 2023
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News Article
What the NHS is learning from Brazil
Patient Safety Learning posted a news article in News
Knocking on doors to check on people's health and catch problems before they escalate is common practice across Brazil. But could that approach work in the UK? Comfort and Nahima are two out of four door-knockers on round Churchill Gardens, a council estate in the Pimlico neighbourhood of London, visiting residents as part of a proactive community healthcare pilot. They can help with anything from housing issues which impact health, such as overcrowding, or pick up the early signs of diabetes by chatting informally to residents about their lifestyle. These community health workers are partly funded by the local authority and partly by the NHS so they can co-ordinate between the local GP surgery and other social services. Local GP Dr Connie Junghans-Minton says the proactive approach had led to fewer requests for appointments The National Institute for Health Research helped crunch the data from the pilot. Households which had been visited regularly were 47% more likely to have received immunisations and 82% more likely to have taken up cancer screening, compared to other areas. The idea to import this model to the UK came from Dr Matthew Harris, a public health expert at Imperial College London who worked as a GP in Brazil for four years. There, community health workers have been credited with achieving a drop of 34% in cardiovascular deaths. "In Brazil they have scaled this role to such degree that they have 270,000 community health workers across the whole country, each of which looks after 150 households, visiting them at least once a month," Dr Harris said. "They've seen extraordinary outcomes in terms of population health in the last two or three decades. We think we've got a lot to learn from that." Read full story Source: BBC News, 9 May 2023 -
News Article
Medical leaders call for arbitration to resolve junior doctors’ dispute
Patient Safety Learning posted a news article in News
Medical leaders have called for third-party arbitration to break the impasse on a pay dispute between junior doctors and the government after hundreds of thousands of procedures and appointments were cancelled as a result of last week’s strike in England. The “colossal impact” of the four-day stoppage compounded by a health service already stretched by the coronavirus pandemic and facing workplace shortages has led the Academy of Medical Royal Colleges (AoMRC) to intervene and urge both parties to engage with an independent organisation. The AoMRC, the membership body for the UK and Ireland’s 24 medical royal colleges and faculties, said in a statement it was “concerned that a solution has not yet been reached and about the anticipated impact on NHS services and patients that will potentially follow any future action”. It added: “Both parties need to rapidly engage with an independent organisation to work out how the deadlock can be broken for the sake of patients and the wider NHS.” Read full story Source: The Guardian, 20 April 2023 -
News ArticleNHS England has launched a “very aggressive campaign” to ensure all acute trusts give patients the ability to make appointments and receive messages online. Details of the new “national requirement” which must be met by the end of 2023-24 were sent by NHS England to acute trust chief information officers on Friday. NHSE wants all trust portals to integrate with the NHS App to enable patients to manage outpatient appointments and respond to messages through a single channel. Under NHSE’s requirements, the portals must: Enable patients to view their outpatient appointments; Enable the trust to send a waiting list validation questionnaire to patients; Provide patients with a single point of access to contact the provider, for example to cancel appointments; and Enable patients to access their correspondence from the trust. Read full story (paywalled) Source: HSJ, 31 March 2023
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Content ArticleIn this blog, US family doctor Lisa Baron highlights the role that social media has played in exposing how patients, particularly women, are dismissed and gaslighted by healthcare professionals, resulting in delayed diagnosis, deterioration and trauma. She talks about her own experience of having her symptoms and concerns dismissed by her GP, which led to a two-year delay in being diagnosed with coeliac disease, rheumatoid arthritis and Sjogren's syndrome. She goes on to talk about her experience of Long Covid and how her symptoms were dismissed and not taken seriously in spite of the life-limiting nature of her condition. She raises concerns that Long Covid patients are turning to unqualified practitioners offering untested, ineffective and expensive treatments as they are not being taken seriously by mainstream healthcare systems.
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Content Article
Julie Smith, Topic Leader for the hub and Content Director at EIDO Healthcare, takes a look at how patient information can be used to help improve outcomes for those on long surgical waiting lists. -
Content ArticleStorytelling gives a voice to patients and staff as well as providing an opportunity for others to understand the importance of patient safety from the perspectives of those that access services or work within them. This toolkit was developed by the National Quality and Patient Safety Directorate in Ireland which works in partnership with health services, patient representatives and other partners to improve patient safety and quality of care. It provides a step by step guide to creating patient and staff stories.
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Content ArticleIn this article for the Byline Times, Consultant David Oliver analyses claims by media and political commentators about spending, waste and inefficiency in healthcare and proposes a ten point plan to restore services to their 2010 level.
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Content ArticleThis download A4 Easy Read booklet from Jo's Cervical Cancer Trust uses simple language and pictures to talk about smear tests. It explains what a smear test is and has tips to make it better for you. It also has a list of words you might hear. Please note this edition of the Easy Read booklet has not been updated with HPV primary screening, but the information and tips about cervical screening are correct.
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Content ArticleMany people see their GP with symptoms that could either get better without treatment, or be a sign of serious illness; their diagnosis is uncertain. Research has explored how GPs and patients can work together to develop follow-up plans (a process known as safety-netting). New recommendations could help GPs manage uncertain diagnoses. To avoid unnecessary referrals, GPs may adopt a ‘watch and wait’ strategy when someone has an uncertain diagnosis. This strategy should come with a clear follow-up plan so that people understand the possible causes of their symptoms, how to look after themselves and what to do if symptoms persist. This is good safety-netting. Without good safety-netting, watch and wait carries risks. For example, late cancer diagnoses have been linked to poor safety-netting. However, professional guidance on safety-netting is lacking. This is a knowledge and practice gap. A study from Friedemann Smith explored the best ways to deliver safety-netting advice. It suggests that people are more likely to follow advice if they are involved in developing the follow-up plan. They need to understand: why they are receiving this advice what actions are required, and by whom. The lack of time within primary care consultations is well known. This may need to be addressed for clinicians to have long enough to develop a safety-netting plan. Professionals may also need training to develop the appropriate communication skills.
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Content Article
The words used in healthcare to communicate to patients, either in person or in writing, can significantly impact patient safety. From the barriers created by jargon to phrases that dismiss, offend or stem from bias, the case for health information to be clear, accessible and inclusive has been made time and again. In this blog, we've picked out seven resources that have been shared on the hub, to highlight just a few ways language can affect a patient's journey, and ultimately their safety. -
Content ArticleNHS England have developed a review tool to support NHS organisations in reducing inequalities in patient safety.
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Content ArticleSarah Woolf shares the impact her cancer treatment had on her mental health and describes why it is important to see each patient as a whole person, understanding that their body has meaning for them
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Content ArticleHealthcare professionals are encouraged to use feedback from their patients to inform service and quality improvement. This study in the journal Sociology of Health and Illness aimed to understand how three NHS Trusts in England were interacting with patient feedback through online channels. The authors found that organisations demonstrated varying levels of ‘preparedness to perform’ online, from invisibility through to engaging in public conversation with patients within a wider mission for transparency. Engagement varied between the Trusts; one organisation employed restrictive ‘cast lists’ of staff able to respond to patients, while another devolved responding responsibility amongst a wide array of multidisciplinary staff.
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Content ArticleIn this post, Amber Clour, author of the Diabetes Daily Grind blog, talks about her experience of managing her type 1 diabetes while attending the emergency room for suspected appendicitis. She describes the steps she took to make sure her blood sugar levels were managed safely and with her consent, including communicating clearly with all healthcare professionals, ensuring her continuous glucose monitor (CGM) was not removed and bringing her own supply of glucose tablets to manage hypoglycaemia. Further reading Blog - “I felt lucky to get out alive”: why we must improve hospital safety for people with diabetes
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Content ArticleThis blog by Brita Lundberg of Lundberg Health Advocates looks at how healthcare providers can sometimes blame the patient for their condition, errors in treatment and communication issues. She looks at the role that language used in medical settings and historical views of the medical profession have on the tendency to blame patients, and highlights how the issue is also present in wider society. She offers three potential steps to help tackle patient-blaming: Recognise the problem, as it is difficult if not impossible to solve a problem until one recognises that it exists. Families, friends and clinicians should start with the assumption that the patient is correct and question others, particularly any in authority. All of us can be much too quick to dismiss patients’ concerns and to reassure them. It’s a bad habit. Instead–it is prudent never to eliminate any diagnosis, particularly one suggested by the patient, until all the supporting and contradictory evidence for each is carefully considered. Listen–that terribly overused and so little practiced—word. Listening instead of interrupting right away not only helps preserve the flow of the narrative but also gives us time to think about what is being said, and time to formulate a more considered response.
