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Found 29 results
  1. News Article
    The waiting lists for diagnostic tests, including cancer scans, is at a record high in NHS England, with doctors warning of a “staggering shortfall” of clinical radiologists. Figures published on Thursday reveal the diagnostic waiting list stands at 1,658,221 – twice what it was 10 years ago. Nearly 500,000 patients are waiting for CT scans and MRIs. The figures show the scale of the task facing the new health secretary, Wes Streeting, who has ordered a review into the NHS. Labour pledged in its manifesto to double the number of scanners, but doctors warn there is an urgent need for more staff to operate them and read the resulting scans. “The NHS is broken,” a spokesperson for the Department of Health and Social Care said in response to the figures. “Waiting lists are too high and patients have not been able to access the care they desperately need. “The longer patients wait for tests and scans, the worse their outcomes will be. We’ve got to get patients diagnosed much earlier.” Read full story Source: The Guardian, 14 July 2024
  2. Content Article
    The incidence of early-onset colorectal cancer has increased significantly over the past decade. Although there has been research on the relationship between outcomes and socioeconomic status in older adults, data on socioeconomic and racial disparities in younger adults is lacking. This US study in Surgery aimed to fill this gap by investigating factors affecting screening, treatment and outcomes for adults under 50 years at the time of diagnosis. The authors found that socioeconomic and racial disparities in early-onset colorectal cancer affect diagnosis, treatment and survival. They call for interventions to boost early diagnosis and access to surgery among minorities and patients living in neighbourhoods with low socioeconomic status.
  3. Content Article
    In this blog, consultant rheumatologist and RCP Digital Health Clinical Lead Anne Kinderlerer looks at how digital solutions could improve patient care and safety in outpatients. She highlights that existing triage systems make it difficult to manage risk across pathways and outlines how digital tools might enable patients to access the right support at the time when they most need it. She also describes why increasing interoperability and sharing of data between primary and secondary care will be vital to improving how the health service predicts and manages risk, reducing health inequalities and preventing patients getting 'lost in the system'.
  4. Content Article
    Diagnostic error is largely discovered and evaluated through self-reporting and manual review, which is costly and not suitable for real-time intervention. AI presents new opportunities to use electronic health record data for automated detection of potential misdiagnosis, executed at scale and generalised across diseases. The authors of this study propose a new, automated approach to identifying diagnostic divergence considering both diagnosis and risk of mortality. The aim of this study was to identify cases of misdiagnosis of infectious disease in the emergency department by measuring the difference between predicted diagnosis and documented diagnosis, weighted by mortality. Two machine learning models were trained for prediction of infectious disease and mortality using the first 24 hours of data. Charts were manually reviewed by clinicians to determine whether there could have been a more correct or timely diagnosis.
  5. Content Article
    Alzheimer’s Society estimates that there are currently around 900,000 people living with dementia in the UK. Unlike other major conditions, there is no national clinical pathway for dementia, and despite there being a national target, there is wide variation in dementia diagnosis rates across England.  Alzheimer’s Society commissioned The King’s Fund to explore the development of Integrated Care Systems (ICSs) through the lens of dementia diagnosis—to consider what opportunities ICSs present to approach dementia differently and to improve diagnosis rates by doing so. The research team explored enablers and barriers to improving dementia diagnosis through interviews with stakeholders and people affected by dementia in three case study ICSs.
  6. Content Article
    Although diagnostic errors are estimated to affect about 12 million Americans each year in ambulatory care settings alone, the conceptual and pragmatic scientific foundations for their measurement are under-developed. Further progress towards reducing diagnostic errors will rely on our ability to overcome measurement-related challenges. This article in BMJ Quality & Safety outlines a multifaceted framework to advance the science of measuring diagnostic errors (The Safer Dx framework). The authors describe how Safer DX serves as a conceptual foundation for system-wide safety measurement, monitoring and improvement of diagnostic error. They believe it lays robust groundwork for measurement and monitoring techniques to ensure diagnostic safety.
  7. Event
    until
    Join Patients for Patient Safety US for 3 days of events centred around World Patient Safety Day (WPSD) 2024. PFPS US urges Americans impacted by missed or delayed diagnoses, bias or medical error to convene in Washington, DC for a Summit held September 15-17, 2024. The World Health Organization designates 17 September 17 as World Patient Safety Day, and WPSD 2024’s theme is Improving Diagnosis for Patient Safety. Find the full Summit event list at https://www.pfps.us/wpsd-2024, including: Sunday 15 September: Welcome reception and dinner at Johns Hopkins University Bloomberg Center to launch Project PIVOT, a national project identifying patient-prioritized outcomes and experiences and collaboration with patient organizations, US Department of Health and Human Services, Johns Hopkins University, Harvard Medical School and others. Monday 16 September: Participants visit Capitol Hill to urge Congressional leaders to ACT Now for patient safety, diagnostic safety and health equity solutions. ACT Now is PFPS US’s urgent request to leaders for Accountability, Coordination, and Transparency in health care. Later, PFPS US and AcademyHealth co-host a film premiere of The Pitch: The Next Generation of Patient Safety. From immersive tech to AI machine learning, innovations are finally making waves in medicine with the goal of safer health care. The Pitch gives a unique look at the American health care system’s ongoing challenge to embrace the next generation of patient safety. Tuesday 17 September, World Patient Safety Day: The March for Patient Safety begins at Freedom Plaza and ends with a ceremony on the US Capitol Lawn, where marchers will remember those whose lives have been lost to or impacted by preventable harm. Afterwards, PFPS US and the Bloomberg Center co-host a World Patient Safety Day Leadership Briefing with government leaders. Further information and to sign up
  8. Content Article
    During the diagnostic process, clinicians may make assumptions, prematurely judge or diagnose patients based on their appearance, their speech or how they are portrayed by other clinicians. Such judgements can be a major source of diagnostic error and are often linked to unconscious cognitive biases - faulty quick-fire thinking patterns that impact clinical reasoning. Patient safety is profoundly influenced by cognitive bias and language, i.e. how information is presented or gathered, and then synthesised by clinicians to form and communicate diagnostic decisions. Here, authors discuss the intricate links between interpersonal communication, cognitive bias, and diagnostic error from a patient's, a linguist's and clinician's perspective. They propose that through patient engagement and applied health communication research, we can enhance our understanding of how the interplay of communication behaviours, biases and errors can impact upon the patient experience and diagnostic error. In doing so, they provide new avenues for collaborative diagnostic error research striving towards healthcare improvements and safer diagnosis.
  9. Content Article
    Persistent physical symptoms (PPS) are distressing physical complaints lasting several months or more without a clear cause. They are very common—but complex—and can be overwhelming for patients and healthcare professionals. PPS can have a devastating effect on mental health and cause distress for patients when they are not believed. This Lancet editorial looks at the increasing knowledge we have of the risk factors and mechanisms involved in PPS and what this means for patient care. It looks at recent research studies and models of care designed specifically for dealing with PSS.
  10. News Article
    A simple blood test using artificial intelligence to predict Parkinson's disease years before symptoms begin has been developed by researchers. They hope it can lead to a cheap, finger-prick test providing early diagnoses - and help find treatments to slow down the disease. Charity Parkinson's UK said it was "a major step forward" in the search for a non-invasive patient-friendly test, but larger trials are needed to prove its accuracy. “At present we are shutting the stable door after the horse has bolted," senior author Prof Kevin Mills, from UCL's Great Ormond Street Institute of Child Health, said. "We need to start experimental treatments before patients develop symptoms." Co-author Dr Jenny Hällqvist, from UCL, said: "People are diagnosed when neurons are already lost. "We need to protect those neurons, not wait till they are gone." Read full story Source: BBC News, 18 June 2024
  11. News Article
    A woman is battling a terminal cervical cancer diagnosis after an NHS trust misdiagnosed her test results as constipation several times. Sarah Roch, a 43-year-old mother of two from Plymouth, faced nine years of missed opportunities from 2010 by Derriford Hospital and only discovered she had cervical cancer after a voluntary hysterectomy in 2019. By the time she was diagnosed - which occurred by accident following her hysterectomy - Ms Roch was told she had late-stage cervical cancer. Ms Roch, who worked at the same hospital which misdiagnosed her, has had to give up her job to have chemotherapy three times a week. She is now calling for greater awareness of cervical cancer symptoms and has urged women to seek a second opinion if they feel something isn’t right. Read full story Source: The Independent, 17 June 2024
  12. Community Post
    Have you or someone you know been affected by a: delayed diagnosis incorrect diagnosis missed diagnosis? Errors can happen at every stage of the diagnostic process and can happen in all healthcare settings. In some circumstances the impact is life-changing. If you have insights to share around diagnostic error and the impact on patient safety, please comment below (sign up first here, for free). Or you can contact us directly at content@pslhub.org.
  13. Content Article
    This report from National Voices called People’s experiences of diagnosis, brings together insights from people with lived experience and our members on the entire process of diagnosis – from trying to get an appointment for a diagnostic referral, to undergoing tests, and experiences post-diagnosis. The report covers the themes of challenges in diagnosis, inequalities in diagnosis, and new innovation in diagnosis, before concluding with nine recommendations for improving patient experience of diagnosis. These nine recommendations include:  Adjustments and adaptations to enable access  Provide better support while waiting  Listen to the patient  Better communication around diagnosis  Make sure people have a plan  Provide access to support groups  Collect better data to understand the driver of diagnostic health inequalities, and act on it rapidly  Upskill, coordinate and ultimately increase the workforce  Have health equity embedded into new innovations the start.
  14. Content Article
    Recognising the profound impact of aortic dissection on loved ones and healthcare professionals, the team at Hull Royal Infirmary identified a critical need for improvement. As a result, the team has enhanced the diagnostic detection of aortic dissection by integrating Human Factors insights and leveraging the experiences of patients, earning them the 2023 Health Services Journal Patient Safety Award. Hull Royal Infirmary's innovative approach has significantly improved aortic dissection diagnosis, reducing missed cases and enhancing patient outcomes.
  15. Content Article
    This study, published in Human Factors in Healthcare, applied a human factors approach through the Systems Engineering Initiative for Patient Safety (SEIPS) model to inform the design of community cardiac diagnostic services, focusing on workforce design and the potential role of cardiac physiologists. The study setting was a cardiology department at a community hospital. Data were collected through observations, interviews and focus groups. Data were analysed using SEIPS and Thematic Analysis.The analysis revealed three overarching design considerations: (1) Promoting professional growth and autonomy for the cardiac workforce in the community. (2) Focusing on the needs of patients in the community, including accessibility and communication. (3) Facilitating communication across organisational boundaries, particularly between CDCs and General Practitioners (GPs).
  16. Content Article
    This report commissioned by the US Agency for Healthcare Research and Quality aims to identify major themes related to the current state of diagnostic safety and highlight key gaps in knowledge. Through a rapid narrative review methodology to evaluate multiple resources in the literature and interviews with experts, it presents several findings that have implications for future resource investments to reduce harm from diagnostic errors. The report looks at the following key themes: Incidence and Contributing Factors Measurement: Data and Methods Cognitive Processes Culture, Workflow, and Work System Issues Disparities Health Information Technology Patients and Families Testing Interventions Implementation
  17. Content Article
    In this blog, Kristy Widdicombe-Dutch shares her decades-long experience of harmful healthcare that has left her with a complete loss of trust in the system. She describes how, starting in her 20s, she has experienced disbelief, gaslighting and poor care in relation to her vascular issues, which has left her with long-term physical harm and psychological trauma.
  18. Content Article
    Despite growing awareness of diagnostic error, most healthcare systems do not track or record diagnostic quality, and many diagnostic safety events are not recognised. Without methods to identify, measure, investigate and analyse events, healthcare organisations cannot understand causes of diagnostic errors, identify contributing factors or create solutions. One of the best ways to collect information about diagnostic errors is through self-reporting by patients and healthcare professionals. This issue brief from the Agency for Healthcare Research and Quality looks at how to foster psychological safety and organisational safety culture in order to reduce harm from diagnostic error. 
  19. Content Article
    Kerri Mothersole was a 44 year old woman who had a past medical history of asthma, labyrinthitis, depression and back pain. In May 2020 she was seen with symptoms of possible early menopause and blood tests requested. In October 2020 she was noted to be suffering from tiredness and had irregular periods and again blood tests were requested. Blood tests taken in January 2021 noted a low haemoglobin and ferritin so iron was prescribed as well as follow up in two months. In March 2021 she complained of having per vaginal bleeding for six weeks and she was referred for an ultrasound. Due to her underlying ill health, she had difficulty in attending appointments and missed a number of different appointments. She was seen in the surgery on 21 June 2021 by her General Practitioner who noted abdominal tenderness and weight loss and he again referred her for an ultrasound. An ultrasound was undertaken by a private firm HEM Clinical Ultrasound on 28 June 2021 but the report was never sent to her General Practitioner. A second ultrasound on the 1 July 2021suggested a diagnosis of adenomyosis but noting that serious pathology could not be ruled out. Only the second report was sent to the General Practitioner which led to a routine gynaecology referral, she had however already been referred to the colorectal team on the urgent two week wait pathway. Had the earlier scan report been seen this would have led to an urgent referral to gynaecology. There were a number of missed appointments and a colonoscopy took place on 20 October 2021. The procedure was negative but the endoscopist thought he could feel something in the pelvis and a CT scan was arranged. The CT scan on 28 October 2021 demonstrated a large pelvic mass and she was referred to the gynaecology team in early December and a multidisciplinary team meeting discussion on 17 December 2021 led to a request for an MRI scan. Appointments were made for 31 December 2021, 25 January 2022 and again in February but not attended and she eventually underwent an MRI on 1 May 2022 which revealed a large mass. She was again discussed at the multidisciplinary team meeting on 6 May 2022 and referred to the gynae-oncology surgeons at Maidstone hospital. She was seen on 1 June 2022 and booked for surgery on 27 June 2022. She was, however, far too unwell for surgery on 27 June 2022 and further investigations revealed brain metastases. She was admitted to hospital and treated with steroids and referred to the Oncologists as surgery was deemed no longer appropriate. She was prescribed hormone treatment but she was, by now, too unwell to receive even palliative radiotherapy. She was taken to Medway Maritime hospital on 19 August 2022 and was struggling as she had been so unwell at home. Whilst plans were being made to provide some care at home she remained overnight but sadly died on 20 August 2022 as she was so unwell she could not return home.
  20. Content Article
    Diagnostic errors are associated with patient harm and suboptimal outcomes. However, despite efforts to advance definition, measurement and interventions for diagnostic error, diagnosis in mental health is not well represented in this ongoing work. The authors of this article, published in BMJ Safety & Quality, summarise the current state of research on diagnostic errors in mental health and identify opportunities to align future research with the emerging science of diagnostic safety.
  21. News Article
    Dementia could cost the UK almost £91bn a year by 2040, as the number of people affected rises inexorably, a study has found. The “colossal” costs of the disease are likely to more than double from an already “staggering” £42.5bn today to £90.6bn, according to research undertaken for the Alzheimer’s Society. That projected rise will happen in line with an expected increase in the number of diagnosed cases from 981,575 to 1,402,010, related to an ageing and growing population. Read full story Source: Guardian, 13 May 2024
  22. Content Article
    It’s well known that diagnosis at an early stage of cancer dramatically increases chances of survival. Current NHS policy is focused on diagnosing cancer at an earlier stage and improving the speed with which patients receive a definitive diagnosis. This article from the Nuffield Trust and The Health Foundation presents graphical data illustrating that the NHS is seriously off course in achieving these aims. It examines the reasons for delays to diagnosis including difficulties patients face in getting their concerns and symptoms taken seriously, the role of deprivation in increasing diagnostic inequalities and pressures due to increasing numbers of referrals. It also looks at the role screening has to play in achieving earlier diagnosis and highlights issues with patients understanding the information they are given.
  23. News Article
    Increased reliance on imaging for diagnosis and efficient patient care mixed with higher volumes of patients has left US hospitals scrambling to meet demand with the few radiologists they have. There are over 1,400 vacant radiologist positions posted on the American College of Radiology's job board, according to a bulletin posted on its website. The total number of active radiology and diagnostic radiology physicians has dropped by 1% between 2007 and 2021, but the number of people in the U.S. per active physician in radiology grew nearly 10%, according to the Association of American Medical Colleges. An increase in the Medicare population and a declining number of people with health insurance adds to the problem. "Demand for imaging services is increasing across the country, creating longer worklists for radiology staff at the same time the healthcare system is experiencing a workforce shortage in radiology," Michigan Hospital Association CEO Brian Peters told The Detroit News in an April 28 report. "The combination of vacancies and increased demand can force imaging delays measured from days to upwards of two weeks." CMS also cut fees for both diagnostic (3%) and interventional radiology (4%) this year, according to an article published on healthcare technology company XiFin's website. This leaves many hospitals having to use external groups to stay on top of demand. Mr. Peters told Detroit News, "Hospitals and health systems are also competing with practices offering remote-only positions, which allows Michigan radiologists to work for out-of-state providers at higher rates." Read full story Source: Becker's Hospital Review, 29 April 2024
  24. Content Article
    This article tells the story of 61 year-old Susannah Constantine who was diagnosed with a rare neurological condition after her MRI was not looked at by her GP surgery for over a year. Susannah decided to have a private MRI when doctors couldn't diagnose why she’d been suffering from tinnitus and pins and needles in the fingers of her left hand. The results were sent to her GP, and Susannah heard no more, so struggled on for another year—she gradually became weaker and her muscles atrophied. She called her GP surgery to check if the MRI held any clues and learnt no one there had ever looked at the results—they had just been sat there for a year. She was told she needed to see a neurosurgeon immediately and was diagnosed with arteriovenous malformation (AVM), a rare neurological condition that disrupts the flow of blood and oxygen to the brain. If not spotted and treated in good time there is a one in three chance of suffering a brain haemorrhage, paralysis or stroke.
  25. Content Article
    On 17 and 18 April 2024, government ministers, high-level representatives and health experts from all over the world gathered in Santiago, Chile for the Sixth Global Ministerial Summit on Patient Safety. In this long-read article, Patient Safety Learning’s Chief Executive Helen Hughes reflects on the key themes and issues discussed at the event.
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