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Showing results for tags 'Safe staffing'.
Found 246 results
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Content Article
Safety is a core dimension of health care quality, and measurement of patient safety culture in Organisation for Economic Co-operation and Development (OECD) countries is increasingly conducted as part of efforts to monitor patient safety and to contribute to health system performance assessment. This Health Working Paper looks at the findings of the second OECD pilot on patient safety culture. This occurred in 2022-2023 and in total took data from 648,209 health care providers from 14 countries. -
News Article
Maternity staff faced racism from colleagues
Patient Safety Learning posted a news article in News
Maternity staff at an NHS trust faced racism from their own colleagues, a Care Quality Commission (CQC) report said. The problem was identified at both the Luton and Dunstable (L&D) and Bedford hospitals during an inspection. Some ethnic minority overseas staff told the CQC discrimination had become "normalised". The regulator was alerted to concerns around the safety, culture, and management of the service by whistleblowers. On the first day of the inspection, last November, the Luton and Dunstable Hospital's maternity unit was at full capacity and the trust had to divert new arrivals. Low staffing levels also meant women and babies were not always kept safe. The trust was issued with a warning to improve and maternity services at both hospitals have now both been rated as 'inadequate'. At the L&D some staff told the inspectors they did not feel able to report instances of racism. Management acknowledged some parts of the unit had a "challenging culture". There were concerns racist incidents being reported to the trust would not be investigated in line with the trust’s values. Read full story Source: BBC News, 5 July 2024 -
News Article
'We desperately need safety-critical nurse-to-patient ratios enshrined in law'
Patient Safety Learning posted a news article in News
The latest release of data from the Royal College of Nursing's Last Shift Survey shows the urgent need for investment in the nursing workforce and safety-critical nurse-to-patient ratios enshrined in law. New analysis finds more than 11,000 members reveals just a third of shifts had enough registered nurses. Chronic staff shortages mean individual nurses are often caring for 10, 12, 15 or more patients at a time. The RCN are now calling for safety-critical limits on the maximum number of patients a single nurse can be responsible for. Our survey found that 1 in 3 hospital shifts were missing at least a quarter of the registered nurses they needed. In A&E settings, significant numbers of nurses reported having more than 51 patients to care for. Across all settings, 80% of respondents said there aren't sufficient nurses to meet the needs of patients safely. RCN Acting General Secretary and Chief Executive Professor Nicola Ranger said: “Without safety-critical limits on the maximum number of patients they can care for, nurses are being made responsible for dozens at a time, often with complex needs. It is dangerous to patients and demoralising for nursing staff. “When patients can’t access safe care in the community, conditions worsen, and they end up in hospital where workforce shortages are just as severe. This vicious cycle fails staff and patients – it can’t go on. “We desperately need urgent investment in the nursing workforce but also to see safety-critical nurse-to-patient ratios enshrined in law. That is how we improve care and stop patients coming to harm.” Read full story Source: RCN, 1 July 2024 -
Content Article
Should hospital nurses be working 12-hour shifts? (12 May 2022)
Patient-Safety-Learning posted an article in Nurses
Increasingly, some nursing leaders say it’s time to move away from the 12-hour nursing shifts used by many hospitals. They say that health systems must develop other scheduling options to accommodate the changing needs of nurses as they progress in their careers. This article by Ron Southwick looks at the arguments for moving away from the 12-hour shift, including the risks that the current system poses to patient safety. -
Content ArticleThis US cross-sectional study in JAMA Network Open aimed to find out whether there is a difference in reported inappropriate antipsychotic medication use between severely and less severely deprived neighbourhoods, and whether this difference is modified by greater total nurse staffing hours. The study included 10,966 nursing homes and found that nursing homes that fell below critical levels of staffing (less than three hours of nurse staffing per resident-day), were associated with higher inappropriate antipsychotic medication use among nursing homes in severely deprived neighbourhoods (19.2%) compared with nursing homes in less deprived neighbourhoods (17.1%). These findings suggest that addressing staffing deficiencies in nursing homes, particularly those located in severely deprived neighbourhoods, is crucial in mitigating inappropriate antipsychotic medication use.
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Content ArticleThe last two decades have seen substantial advancement in the practice of team-based, safe care delivery. In parallel, burnout has been recognised as prevalent among US doctors and influenced by workplace structure and experiences. This study assessed US doctors’ perceptions of team-based care delivery and safety climate within their institutions and how these domains were associated with burnout.
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Content Article
Saving Babies’ Lives 2024: A report on progress (May 2024)
Patient-Safety-Learning posted an article in Maternity
This is the second ‘saving babies’ lives’ progress report from the Joint Policy Unit. When the first report was published in May 2023, the Unit committed to reassessing progress each year. Through this process it aims to hold government and decisionmakers to account, helping to ensure that saving babies’ lives and tackling inequalities in pregnancy and baby loss are the political priorities they deserve to be. This years report highlights that maternity services need a much more transformative approach from government, that matches the scale and impact of the issue. Maternity services are not on course to meet government ambitions to reduce rates of stillbirth, neonatal death or preterm birth, and there continue to be stark and persistent inequalities in rates of pregnancy and baby loss by ethnicity and deprivation. View a summary version of the report -
News Article
Nurse wins staff shortages whistleblowing case
Patient-Safety-Learning posted a news article in News
An NHS trust has lost an employment tribunal case against a nurse who had his shifts cancelled after whistleblowing when a patient was put in seclusion because of staff shortages. A judgment published last week found that Mark Temperton, a mental health nurse, was “subjected to detriment” after having made a “protected disclosure” during his agency shift at Greater Manchester Mental Health Foundation Trust’s (GMMH) Atherleigh Park Hospital. Mr Temperton, who is also employed by the Priory Group as a regulatory inspector as well as doing ad-hoc work for the Care Quality Commission, worked as an agency mental health nurse for Blackstone Recruitment and was booked to work a night shift in a psychiatric intensive care unit (Priestners Unit) at Atherleigh Park on 14 October 2022. He raised concerns after a patient, brought in by the police, was put “immediately” into seclusion because of staff shortages. Mr Temperton subsequently raised it with the nurse in charge and with a locum consultant psychiatrist but the patient was kept in seclusion. According to the Mental Health Act’s Code of Practice, seclusion “should not be used as a punishment or a threat, or because of a shortage of staff”. Serious concerns were also raised about the trust’s Edenfield Centre in September 2022 by BBC Panorama, one of them being use of inappropriate seclusion. Paul Lewis-Grundy, associate director of corporate governance at GMMH, said: “It is absolutely vital that staff feel confident and safe to speak up, with no detrimental impact to themselves or their career and prospects. Over the past two years, we have invested significantly, and taken a number of steps, to support this across GMMH.” Read full story (paywalled) Source: HSJ, 15 May 2024 -
News Article
Staff shortages stop 1.4 million NHS operations each year, top doctors warn
Patient-Safety-Learning posted a news article in News
Hospitals in the UK are facing shortages of almost 2,000 anaesthetists, leading the NHS to miss 1.4 million operations a year, doctors have warned. The government has been urged to increase funding for the number of newly qualified doctors who can train as anaesthetists as more than 2,000 miss out on places each year. The Royal College of Anaesthetists has said the NHS will not be able to tackle waiting lists without more of these specialist doctors. Their warning comes amid fears hospitals are substituting doctors for staff without sufficient training, called anaesthesia associates. This week the NHS will publish new waiting list figures. They stood at 7.6 million in March. Dr Fiona Donald, president of the Royal College of Anaesthetists warned: “The shortage of anaesthetists has reached crisis levels and is preventing patients from getting the operations they so desperately need. During the election campaign, I’m sure we’ll see all parties pledge to reduce NHS waiting lists but unless their policies include plans for more anaesthetists they will have limited impact.” According to the college, each year 2,600 doctors apply for anaesthetist training however only 550 places are funded. For more advanced training there are around 650 applicants a year yet only 400 are funded. Read full story Source: Independent, 8 May 2024 -
News Article
Staff ‘belittled’ for contacting senior doctors, NHSE finds
Patient-Safety-Learning posted a news article in News
The safety of a teaching hospital’s out-of-hours supervision has been questioned, including reports trainees were told not to ask for help “unless your patient is dying”. The General Medical Council put University Hospital Southampton Foundation Trust’s general surgery training under enhanced monitoring at the end of 2023 following a referral and quality management visit by NHS England South East, Workforce Training and Education – Wessex. The NHSE team’s visit and subsequent report said doctors in training had claimed senior staff were “not contactable” out of hours and there was “difficulty” in securing senior clinical advice, particularly on Sundays. The report added foundation year doctors were “discouraged” from contacting senior staff out of hours by “inappropriate” and “belittling” comments and behaviours, such as being told not to ask for help “unless your patient is dying”. Foundation doctors also reported starting rotation on call and conducting ward rounds without appropriate supervision. While the GMC open case is centred on patient safety concerns relating to supervising trainee doctors, the workforce and training directorate report also raised concerns about bullying, inappropriate sexual comments made by consultants, and a feeling that foundation doctors were unable to speak up. Read full story (paywalled) Source: HSJ, 1 May 2024 -
News Article
Hospitals grapple with radiologist shortage
Patient-Safety-Learning posted a news article in News
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 -
News ArticleFears over patient safety have been raised after it was revealed that 600 jobs will be lost at hospitals in parts of Essex to save money. Mid and South Essex NHS Foundation Trust - which runs Southend, Basildon, Broomfield, St Peter's in Maldon and Braintree hospitals - is facing a £91m pound black hole in it's budget and said that "reducing headcount" would be necessary. The trust is one of the largest acute trusts in the country and employs 16,000 members of staff. It has a budget of around £1bn each year. Bosses said in a letter to staff that "all posts" must be reviewed, "including clinical roles". All current vacancies are being reviewed and no vacancies will be approved until that process is complete, they add. The news has been criticised by campaign groups and union bosses, who say that patients could be put at risk. UNISON Eastern regional organiser Sam Older said: "This vacancy freeze will ring alarm bells for already overworked staff. These 600 posts weren't created for the hell of it - they are there to provide healthcare to 1.2 million people in Essex. The trust was already struggling with rising demand. Slashing staff numbers, cancelling bank shifts and long waits to fill vacancies is only going to make this worse. And there's a clear risk that cutbacks will pose a threat to patient safety if staffing levels fall too low." Read full story Source: ITV, 27 April 2024
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News Article
Biden administration imposes first-ever staff minimum for nursing homes
Patient-Safety-Learning posted a news article in News
The Biden administration set a first-ever minimum staffing rule for nursing homes Monday, making good on the president’s promise more than two years ago to seek improvements in care for the nation’s 1.2 million nursing home residents. The final rule, proposed in September, requires a registered nurse to be on-site in every skilled nursing facility for 24 hours a day, seven days a week. It mandates enough staff to provide every resident with at least 3.48 hours of care each day. And it beefs up rules for assessing the care needs of every resident, which will boost staff numbers above the minimum to care for sicker residents. For a facility with 100 residents, it translates to a minimum of two or three registered nurses and at least 10 or 11 nurse aides per shift, as well as two additional staffers who could be nurses or aides per shift, according to the administration’s interpretation of its new formula. Set to phase in over the next few years, the mandate will replace the current vague standard that gives operators wide latitude on how to staff their facilities. While the administration has said the rule will improve care, industry lobbyists have said it’s unworkable, with staffing goals that will be impossible to achieve because of a shortage of workers. The administration received 47,000 public comments on the rule since it was proposed last September. They included observations of people lying in their own filth for hours, not being fed appropriately and being left on the floor too long after falling, Secretary of Health and Human Services Xavier Becerra said in an interview Monday. Read full story Source: Washington Post, 22 April 2024 -
Community PostPhysician associates are healthcare professionals who work as part of a multidisciplinary team with supervision from a named senior doctor, providing care to patients in primary, secondary and community care environments. First introduced in 2003, PAs have become increasingly talked about in healthcare and in the media, with many discussions focused on the safety of the current approach. We want to hear from patients and carers. Have you, or someone you care for, got an experience of being seen by a PA that you would like to share? Do you feel more information about the PA role would be useful for patients? Do you have any other comments, concerns or perspectives you would like to add? Please comment below (you'll need to sign up first, for free) or contact the team at content@pslhub.org
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Content Article
Panorama investigates a private hospital chain being used to help clear the NHS waiting list. With more than six million people in England alone waiting for an operation on the NHS, Monika Plaha investigates the safety record of one of the UK's biggest private healthcare providers. -
Content ArticleThis is an official NHS letter sent to:all general practicesall primary care network clinical directorsintegrated care board CEOsNHS England regional directors.The letter highlights guidance and actions to support the practices that employ physician associates on the implementation of roles as part of the delivery of the NHS Long Term Workforce Plan.
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Content ArticleIn this Guardian article, Theopi Skarlatos explains how she was making a documentary about the UK’s midwife crisis when she lost her baby. By then she had heard time and again about understaffing, depression, burnout …
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News ArticleNHS England’s workforce ambitions are based on ‘significant’ substitution of fully qualified GPs with trainees and specialist and associate specialist (SAS) doctors, the public spending watchdog has revealed. In a new assessment of the NHS long-term workforce plan, the National Audit Office (NAO) found that NHS England’s modelling of the future workforce had ‘significant weaknesses’ and that some of its ‘assumptions’ may have been ‘optimistic’. Last year, the national commissioner committed to doubling medical school places to 15,000 and increasing GP training places to 6,000 by 2031. This was based on modelling which predicted that, without these changes, the NHS could face a staffing shortfall of 360,000 and a GP shortfall of 15,000 by 2036. The NAO’s report has examined the robustness of NHS England’s predictions, and made a number of recommendations which could influence the refreshed projections NHSE has committed to publishing every two years. The long-term workforce plan (LTWP) projected only a 4% increase in fully-qualified GPs between 2021 and 2036, compared to a 49% growth in consultants. "The total supply of doctors in primary care is projected to increase substantially over the modelled period but the total number of fully qualified GPs is not," the report said. It found that NHSE’s projected supply growth in general practice "consists mainly of trainee GPs", who accounted for 93%, as well as "making increased use of specialist and associate specialist (SAS) doctors in primary care". Read full story Source: Pulse, 22 March 2024
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News Article
Mental health trust failed to heed safety warnings, campaigners say
Patient Safety Learning posted a news article in News
A mental health trust linked to thousands of unexpected patient deaths repeatedly failed to act on coroners' safety warnings, campaigners say. BBC News has been given exclusive access to new evidence from coroners' reports gathered by a campaign group. It wants a criminal investigation into why so many patients died at Norfolk and Suffolk NHS Foundation Trust - and has sent police the evidence. Campaigners, including patients and bereaved families, claim it is failing to make vital safety improvements despite promising to do so. Last summer, a report found more than 8,000 mental-health patients had died unexpectedly in Norfolk and Suffolk between 2019 and 2022. This is defined as the death of a patient who has not been identified as critically ill or whose death is not expected by the clinical team. The new evidence, based on 38 coroners' prevention of future death (PFD) reports since 2013, suggests there were repeated warnings more patients could die unless safety issues were addressed, including: dangerously poor record-keeping and communication family concerns being ignored unsafe levels of staffing at the trust. And campaigners say the trust's failure to improve safety has led to more deaths. Read full story Source: BBC News, 12 March 2024 -
Content Article
This month marks two years of the hub's Patient Safety Spotlight interview series. Patient Safety Learning's Content and Engagement Manager Lotty Tizzard reflects on the value of sharing personal insights and identifies the key patient safety themes that interviewees have highlighted over the past two years. -
Content ArticleIn this interview, Professor Martin Marshall, former GP and Chair of the Royal College of General Practitioners, shares his concerns for the future of general practice in the UK. He outlines the danger that more of the workforce will turn to private practice due to current pressures facing NHS GPs.
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Content ArticleThe adrenal glands are found in the fatty tissue at the back of the abdomen above each kidney, and produce steroid and adrenaline hormones. Surgery on tumours of the adrenal gland is uncommon compared with surgery for other tumours such as those of the breast, bowel, kidney and lung. Research has shown that the more adrenal operations a surgeon undertakes per year, the better the overall outcomes for patients undergoing that type of surgery. In this study, the outcomes from adrenal operations recorded over 18 years in the national adrenal surgical registry were analysed. The results confirmed previous findings showing that postoperative complications and length of hospital stay were reduced for patients operated by surgeons who did more adrenal operations per year. Operations done by keyhole surgery had better outcomes. Operations done either in older patients, or for the rare adrenal cancer tumours had worse outcomes, as did operations in which both adrenal glands were removed. The authors recommended that all surgeons performing adrenal surgery should monitor the outcomes of their operations, ideally in a national registry, and discuss these with patients before surgery; and undertake a minimum of six adrenal operations per year, but a minimum of 12 per year if doing surgery for adrenal cancer or surgery to remove both adrenal glands.
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Content ArticleThe press has all been full of headlines about staffing levels in the NHS, but this is probably a problem across healthcare around the country. What this does is provide the perfect patient safety quandary, how do we keep all the areas safe. This often results in the redeployment of nursing staff to different areas, but does this provide the required levels of safety. It appears that having several areas in an “amber” staffing level is preferable than one red area. It is simple logic, but does this create an unrealistic expectation on staff that means the safety is better but only at a barely satisfactory level? Do we think that any of these decisions influences the efficiency of a ward? Is the ward safe and effective? In this blog, Chris Elston explores these issues and uses a Safety Engineering Initiative for Patient Safety (SEIPS) to show some of the lesser appreciated risks to redeploying staff and consider some ways to reduce the risks.
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Content Article
APIC staffing calculator
Patient-Safety-Learning posted an article in Safe staffing levels
This staffing calculator has been developed by the US Association for Professionals in Infection Control and Epidemiology (APIC). The tool is in beta version and uses input from individual healthcare facilities to provide recommendations to assist with infection prevention staffing decisions. There are three separate calculators: Acute care hospital calculator Long-term care calculator Ambulatory clinic calculator As the tool is currently in development, the data collected from participating organisations will be used to update the calculators and provide the most accurate staffing recommendations. -
Content ArticleIn the USA, Accreditation Council for Graduate Medical Education (ACGME) work-hour restrictions (WHRs) are intended to improve patient safety by reducing resident doctor fatigue. However, compliance with ACGME WHRs is not universal. This study aimed to identify factors that influence resident doctors' decisions to take a post-call day (PCD) off in line with ACGME WHRs. The authors concluded that as most important influencer of residents’ decisions to take a PCD off was related to feedback from their supervisors, compliance with WHRs can be improved by focusing on the residency program’s safety culture.
