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Found 982 results
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Content ArticleFew previous studies evaluating the benefits of diagnostic decision support systems have simultaneously measured changes in diagnostic quality and clinical management prompted by use of the system. This report describes a reliable and valid scoring technique to measure the quality of clinical decision plans in an acute medical setting, where diagnostic decision support tools might prove most useful.
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Content ArticleSuicide is a leading cause of maternal death during the perinatal period, which includes pregnancy and the year after birth. While maternal suicide is a relatively rare event with a prevalence of 3.84 per 100,000 live births in the UK, the impact of maternal suicide is profound and long-lasting. Many more women will attempt suicide during the perinatal period, with a worldwide estimated prevalence of 680 per 100,000 in pregnancy and 210 per 100,000 in the year after birth. This qualitative study aimed to explore the experiences of women and birthing people who had a perinatal suicide attempt and to understand the context and contributing factors surrounding their perinatal suicide attempt. The researchers spoke to women with lived experience of perinatal mental illness. Their results highlighted three key themes: Trauma and Adversities which captures the traumatic events and life adversities with which participants started their pregnancy journeys. Disillusionment with Motherhood which brings together a range of sub-themes highlighting various challenges related to pregnancy, birth and motherhood resulting in a decline in women’s mental health. Entrapment and Despair which presents a range of factors that lead to a significant deterioration of women’s mental health, marked by feelings of failure, hopelessness and losing control. The authors called for further research into these factors which could lead to earlier detection of suicide risk, improving care and potentially prevent future maternal suicides.
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Content ArticleAlzheimer’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.
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News Article
Almost half of antidepressant users could quit with GP support, study finds
Patient Safety Learning posted a news article in News
Almost half of long-term antidepressant users could stop taking the medication with GP support and access to internet or telephone helplines, a study suggests. Scientists said more than 40% of people involved in the research who were well and not at risk of relapse managed to come off the drugs with advice from their doctors. They also discovered that patients who could access online support and psychologists by phone had lower rates of depression, fewer withdrawal symptoms and reported better mental wellbeing. Prof Tony Kendrick, of Southampton University, who was the lead author of the research, said the findings were significant because they showed high numbers of patients withdrawing from the drugs without the need for costly intense therapy sessions. He said: “This approach could eliminate the risk of serious side-effects for patients using antidepressants for long periods who have concerns about withdrawal. “Offering patients internet and psychologist telephone support is also cost-effective for the NHS. Our findings show that support not only improves patient outcomes but also tends to reduce the burden on primary healthcare while people taper off antidepressants.” Read full story Source: The Guardian, 26 June 2024 -
Content ArticleIn healthcare, 'speaking up' refers to when healthcare workers raise concerns regarding patient safety through questions, sharing information, or expressing their opinion to prevent harmful incidents and ensure patient safety. Conversely, withholding voice is an act of not raising concerns, which could be beneficial in certain situations. Factors associated with speaking up and withholding voices are not fully understood, especially in strong authoritarian societies, such as Malaysia. This study aimed to examine the factors associated with speaking up and withholding the voices of healthcare workers in Malaysia, thus providing suggestions that can be used in other countries facing similar patient safety challenges.
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Content Article
In this blog, patient advocate and healthcare communications consultant, Tambre Leighn, summarises her poster, Ask Me! Transforming Patient Communication to Improve Enrolment & Adherence in Clinical Trials and Cancer Care, presented at this year's American Association of Cancer Researchers conference. Tambre discusses how effective communication is essential for ensuring patient safety in clinical trials and cancer care, and why poor communication can lead to negative outcomes. She shares her strategies to improve patient safety through communication. -
Content ArticleImplementing levels of maternal care is one strategy proposed to reduce maternal morbidity and mortality. The levels of maternal care framework outline individual medical and obstetrical comorbidities, along with hospital resources required for individuals with these different comorbidities to deliver safely. The overall goal is to match individuals to hospitals so that all birthing people get appropriate resources and personnel during delivery to reduce maternal morbidity. This study examined the association between delivery in a hospital with an inappropriate level of maternal care and the risk of experiencing severe maternal morbidity.
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Content ArticleFalls are reported by more than 14 million US adults aged 65 years or older annually and can result in substantial morbidity, mortality, and health care expenditures. This study reviewed interventions to reduce falls.
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Content ArticleInfections due to multidrug-resistant organisms (MDROs) are associated with increased morbidity, mortality, length of hospitalisation, and health care costs. Regional interventions may be advantageous in mitigating MDROs and associated infections. This study evaluated whether implementation of a decolonisation collaborative is associated with reduced regional MDRO prevalence, incident clinical cultures, infection-related hospitalisations, costs, and deaths. It found a regional collaborative involving universal decolonisation in long-term care facilities and targeted decolonisation among hospital patients in contact precautions was associated with lower MDRO carriage, infections, hospitalisations, costs, and deaths.
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Content ArticlePatient advocate and healthcare communications consultant, Tambre Leighn, shares her poster, Ask Me!: Transforming Patient Communication to Improve Enrollment & Adherence in Clinical Trials and Cancer Care, presented at the American Association of Cancer Researchers conference.
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Content ArticleIn this JAMA Internal Medicine article, doctors Jessica Holtzman and Rita Redberg argue that for decades, women have been inadequately represented in clinical trials of drugs and devices evaluated by the US Food and Drug Administration (FDA). Looking at existing evidence on the issue, they identify barriers and improvements to women's representation in trials. They argue that the FDA needs to take action by declining to review medical devices and drugs if the representation of women does not reflect the intended use population.
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Content ArticleCancer Research UK has published a manifesto that sets out the measures and commitments the next government can make to help prevent 20,000 cancer deaths every year by 2040.
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Content ArticleHospital-acquired pressure injuries (HAPIs) pose significant challenges in healthcare and cause increased patient suffering, longer hospital stays and higher healthcare costs. Children in hospital face unique risks, but evidence about this remains scarce. This study in the Journal of Advanced Nursing aimed to identify and describe HAPI admission incidence and severity predictors in a large Australian children's hospital. The authors found that HAPI injuries in paediatric patients are unacceptably high. They argue that prevention should be prioritised and the quality of care improved globally. They also call for further research to develop targeted prevention strategies for these vulnerable populations.
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Content ArticlePatient safety policies increasingly encourage carer (i.e., family or friends) involvement in reducing health care–associated harm in hospital. Despite this, carer involvement in patient safety in practice is not well understood—especially from the carers’ perspective. The purpose of this article is to understand how carers of adult patients perceived and experienced their patient safety contributions in hospital. Constructivist grounded theory informed the data collection and analysis of in-depth interviews with 32 carers who had patient safety concerns in Australian hospitals. Results demonstrated carers engaged in the process of “patient-safety caring.” Patient-safety caring included three levels of intensity: low (“contributing without concern”), moderate (“being proactive about safety”), and high (“wrestling for control”). Carers who engaged at high intensity provided the patient with greater protection, but typically experienced negative consequences for themselves. Carers’ experiences of negative consequences from safety involvement need to be mitigated by practice approaches that value their contributions.
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Content ArticlePeople who have used health services are often invited to offer their expertise through research, service evaluation, giving patient experience talks or other forms of feedback. This is often referred to as Patient and Public Involvement (PPI). This guidance by Imperial College London and the National Institute for Health and Care Research (NIHR) is intended for healthcare professionals, staff who work in patient experience roles, healthcare organisations, researchers and others who interact with service users and their relatives who are giving insight and feedback through a PPI process. It has evolved from the lead author’s observations when contributing to PPI activities, and the recognition that more needs to be done to create a safe psychological environment to enable people to feel comfortable when contributing and to be involved without harm.
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Content ArticleInvolving patients is a key premise of national and international policies on patient safety, which requires understanding how patients or carers want to be involved and developing resources to support this. This paper examines patients' and carers' views of being involved in patient safety in primary care and their views of potentially using a co-designed patient safety guide for primary care (PSG-PC) to foster both involvement and their safety. It found that involving patients and carers in patient safety needs a tailored and personalised approach that enables patients and carers to use resources like the PSG-PC routinely and helps challenge assumptions about their willingness and ability to be involved in patient safety. Doing so would raise awareness of opportunities to be involved in safety in line with personal preference.
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Content ArticleThe relentless increase in administrative responsibilities, amplified by electronic health record (EHR) systems, has diverted clinician attention from direct patient care, fuelling burnout. In response, large language models (LLMs) are being adopted to streamline clinical and administrative tasks. Notably, Epic is currently leveraging OpenAI's ChatGPT models, including GPT-4, for electronic messaging via online portals. The volume of patient portal messaging has escalated in the past 5–10 years, and general-purpose LLMs are being deployed to manage this burden. Their use in drafting responses to patient messages is one of the earliest applications of LLMs in EHRs. Previous works have evaluated the quality of LLMs responses to biomedical and clinical knowledge questions; however, the ability of LLMs to improve efficiency and reduce cognitive burden has not been established, and the effect of LLMs on clinical decision making is unknown. To begin to bridge this knowledge gap, the authors of this study, published in the Lancet, carried out a proof-of-concept end-user study assessing the effect and safety of LLM-assisted patient messaging.
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News Article
Landmark study compares risks of water births to births out of water
Patient Safety Learning posted a news article in News
A landmark study has compared the risk of complications of water births. The results could have implications for thousands of women each year who use birthing pools as a form of pain relief during labour, researchers said. It concluded having a water birth does not increase the risk of complications for mother or baby. The Pool study analysed 73,229 records from low-risk pregnant women who used a pool during labour across 26 NHS organisations in England and Wales between 2015 and 2022. The team explored the rate of severe tears suffered by women during childbirth, as well as the number of babies who needed antibiotics or help with breathing on a neonatal unit after birth. They also looked at the number of babies that died. According to researchers, risks “were no higher among waterbirths compared with births out of water”. Read full story Source: The Independent, 11 June 2024 -
Content ArticleReducing social inequalities in health and health determinants, including physical activity (PA), is a major challenge for public health. PA-promoting interventions are increasingly implemented. Little is known, however, about the impact of these interventions on social inequalities. For prioritising interventions most likely to be effective in reducing inequalities, studies of PA interventions need to conduct equity impact assessments. The aim of this article is to describe the development of a logic model framework for equity impact assessments of interventions to promote PA. The framework was developed within the prevention research network AEQUIPA—Physical activity and health equity: primary prevention for healthy ageing, informed by an equity-focused systematic review, expert interviews, exploratory literature searches, and joint discussions within the network. The framework comprises a general equity-focused logic model to be adapted to specific interventions. The intervention-specific equity-focused logic models illustrate the key elements relevant for assessing social inequalities in study participation, compliance with and acceptance of interventions, as well as the efficacy of interventions. Equity impact assessments are beneficial for prioritising interventions most likely to be effective in reducing health inequalities.
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Content ArticlePatient feedback on diagnostic errors may improve the quality and safety of care. This analysis examined patient feedback on what went well with the diagnostic process. Results mirrored those of studies on diagnostic errors, stating feeling heard, appreciated, and timely communication contributed to a good diagnostic process.
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Content ArticleThe NHS is the world’s largest publicly funded health service. It is also the world’s largest repository of healthcare data, but these data are fragmented and underutilised. Making them accessible in one place would improve health and deliver wealth for the nation. This report by the Tony Blair Institute for Global Change proposes the creation of a National Data Trust (NDT)—an organisation which would be majority-owned and controlled by the government and the NHS, together with investment from industry partners. It would aim to connect NHS data, attract private investment in new medical discoveries and bring the economic benefits of health innovation to citizens. The authors believe the NDT would accelerate the NHS’s development of cutting-edge innovations, provide quicker access to these advancements at reduced costs and generate a new funding source for the healthcare system.
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Content ArticleUncontrolled sensory stimuli can hinder healthcare delivery quality in trauma rooms. High noise and temperature levels can increase staff stress and discomfort as well as patient discomfort. Conversely, proper lighting can decrease staff stress levels and reduce burnout. Sensory overload in trauma rooms is a crucial concern, but no studies have been conducted on this issue.
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Content ArticleDiagnostic management teams (DMT), which are comprised of experts in specialised fields, review patient cases and produce reports with diagnostic interpretations and recommendations for future testing or treatments. This pre/post study evaluates the effectiveness of a coagulation DMT at one hospital. Cases reviewed by the DMT were twice as likely to have a diagnostic conclusion (i.e., ruled in or ruled out coagulopathy) than cases without DMT.
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Content ArticleIncivility or rudeness is a form of interpersonal aggression. Studies suggest that up to 90% of healthcare staff encounter incivility at work with it being considered ‘part of the job’. Interviews were undertaken between June and December 2019. Four themes were identified: paramedics reported a lack of respect displayed both verbally and non-verbally from other professional groups. The general public and interdisciplinary colleagues alike have unrealistic expectations of the role of a paramedic. In order to deal with incivility paramedics often reported taking the path of least resistance which impacts on ways of working and shapes subsequent clinical decision-making, potentially threatening best practice. Finally paramedics report using coping strategies to support well-being at work. They report that a single episode of incivility is easier to deal with but subsequent episodes compound the first. This study highlights the effect incivility can have on operational paramedics. Incivility from the general public and other health professionals alike can have a cumulative effect impacting on well-being and clinical decision-making.
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Content ArticleAmbulance handover delays arise when emergency departments become overcrowded as patients waiting prolonged periods for admission occupy clinical cubicles designed to facilitate the assessment and treatment of emergency arrivals. In response, many organisations become reliant on temporarily lodging acutely unwell patients awaiting admission in undesignated areas for care such as corridors, to provide additional space. This results in a significant risk of avoidable harm, indignity and psychological trauma for patients and has a negative effect on the well-being of healthcare professionals, since unacceptable standards of care become normalised.
