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1.
Br J Nurs ; 29(5): 324-325, 2020 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-32167818

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses two patient safety reports, which stress the importance of taking proper action when patient safety incidents occur.


Asunto(s)
Seguridad del Paciente , Calidad de la Atención de Salud , Medicina Estatal , Humanos , Medicina Estatal/normas , Reino Unido
2.
BMJ ; 368: m517, 2020 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-32205307

RESUMEN

The studyPowell J, Atherton H, Williams V, et al. Using online patient feedback to improve NHS services: the INQUIRE multimethod study. Health Serv Deliv Res 2019;7:38.This project was funded by the NIHR Health Services and Delivery Research programme (project number HS&DR 14/04/48).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000861/online-patient-feedback-is-mostly-positive-but-is-not-being-used-effectively.


Asunto(s)
Retroalimentación , Satisfacción del Paciente , Medicina Estatal , Participación de la Comunidad , Humanos , Medicina Estatal/normas , Reino Unido
3.
Br J Nurs ; 29(6): 378-379, 2020 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-32207641

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent patient safety publications from the World Health Organization and the Care Quality Commission.


Asunto(s)
Seguridad del Paciente/normas , Garantía de la Calidad de Atención de Salud/normas , Medicina Estatal/normas , Inglaterra , Hospitales Públicos/organización & administración , Hospitales Públicos/normas , Hospitales Universitarios/normas , Humanos , Medición de Riesgo , Medicina Estatal/organización & administración , Organización Mundial de la Salud
5.
Br J Nurs ; 29(4): 250-251, 2020 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-32105535

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent patient reports and crisis events.


Asunto(s)
Informes Anuales como Asunto , Seguridad del Paciente , Medicina Estatal/legislación & jurisprudencia , Comités Consultivos , Femenino , Humanos , Servicios de Salud Materna/normas , Embarazo , Calidad de la Atención de Salud , Medicina Estatal/normas , Reino Unido
6.
Br J Nurs ; 29(3): 174-175, 2020 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-32053432

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses a Healthwatch report showing that improvements need to take place in the way the NHS reports on patient complaints.


Asunto(s)
Satisfacción del Paciente , Medicina Estatal/organización & administración , Humanos , Cultura Organizacional , Seguridad del Paciente , Calidad de la Atención de Salud , Medicina Estatal/normas , Reino Unido
8.
Br J Nurs ; 29(1): 75, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31917946

RESUMEN

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the need for nurse leaders to champion progress in digital technology and information-sharing with the aim of providing better care.


Asunto(s)
Registros Electrónicos de Salud/organización & administración , Enfermeras Administradoras/psicología , Medicina Estatal/normas , Inglaterra , Humanos
11.
Int J Med Inform ; 134: 104030, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31864097

RESUMEN

BACKGROUND: A recent review of primary care serious incidents suggests that diagnosis and assessment problems, underpinned by communication failures, involving the UK telephone triage service, NHS 111, may contribute to patient harm. METHODS: The present study utilised conversation analysis to address the lack of evaluative research examining the NHS 111 system and in particular interactions between system components (call handler, computerized decision support system, patients/caller). RESULTS: Analysis of audio recorded call interactions revealed interactional misalignment across four mapped call phases (eliciting caller details, establishing reason for call, completing the Pathways assessment, and agreeing the outcome). This misalignment has the capacity to increase the risk of system failure, particularly in relation to assessment problems and issues related to the accurate transfer of care advice. Our analysis suggests that efforts to enhance the NHS 111 system, similar telehealth services, and patient safety management more generally, should shift their focus from a limited set of individual components towards a system-specific interactionist perspective encompassing all elements. CONCLUSIONS: Further evaluative research is required in order to build a comprehensive evidence-base concerning the multiple interacting factors influencing patient safety in the NHS 111 system.


Asunto(s)
Comunicación , Prestación de Atención de Salud/organización & administración , Accesibilidad a los Servicios de Salud/normas , Necesidades y Demandas de Servicios de Salud/normas , Medicina Estatal/normas , Teléfono/normas , Triaje/normas , Humanos , Atención Primaria de Salud/normas , Teléfono/estadística & datos numéricos , Triaje/métodos , Reino Unido
13.
Br J Nurs ; 28(22): 1492-1493, 2019 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-31835946

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent patient safety crises, litigation claims and a new patient safety publication from NHS Resolution.


Asunto(s)
Seguridad del Paciente/normas , Medicina Estatal/normas , Salud Global , Humanos , Liderazgo , Mala Praxis/legislación & jurisprudencia , Medicina Estatal/legislación & jurisprudencia , Reino Unido
14.
Br J Nurs ; 28(20): 1340-1341, 2019 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-31714833

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses the Care Quality Commission's annual assessment of health care and social care in England.


Asunto(s)
Seguridad del Paciente , Calidad de la Atención de Salud , Medicina Estatal/normas , Informes Anuales como Asunto , Inglaterra , Humanos
16.
BMJ ; 367: l6090, 2019 11 13.
Artículo en Inglés | MEDLINE | ID: mdl-31722875

RESUMEN

OBJECTIVES: To quantify post-colonoscopy colorectal cancer (PCCRC) rates in England by using recent World Endoscopy Organisation guidelines, compare incidence among colonoscopy providers, and explore associated factors that could benefit from quality improvement initiatives. DESIGN: Population based cohort study. SETTING: National Health Service in England between 2005 and 2013. POPULATION: All people undergoing colonoscopy and subsequently diagnosed as having colorectal cancer up to three years after their investigation (PCCRC-3yr). MAIN OUTCOME MEASURES: National trends in incidence of PCCRC (within 6-36 months of colonoscopy), univariable and multivariable analyses to explore factors associated with occurrence, and funnel plots to measure variation among providers. RESULTS: The overall unadjusted PCCRC-3yr rate was 7.4% (9317/126 152), which decreased from 9.0% in 2005 to 6.5% in 2013 (P<0.01). Rates were lower for colonoscopies performed under the NHS bowel cancer screening programme (593/16 640, 3.6%), while they were higher for those conducted by non-NHS providers (187/2009, 9.3%). Rates were higher in women, in older age groups, and in people with inflammatory bowel disease or diverticular disease, in those with higher comorbidity scores, and in people with previous cancers. Substantial variation in rates among colonoscopy providers remained after adjustment for case mix. CONCLUSIONS: Wide variation exists in PCCRC-3yr rates across NHS colonoscopy providers in England. The lowest incidence was seen in colonoscopies performed under the NHS bowel cancer screening programme. Quality improvement initiatives are needed to address this variation in rates and prevent colorectal cancer by enabling earlier diagnosis, removing premalignant polyps, and therefore improving outcomes.


Asunto(s)
Colonoscopía/métodos , Neoplasias Colorrectales , Detección Precoz del Cáncer , Anciano , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/epidemiología , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/normas , Detección Precoz del Cáncer/estadística & datos numéricos , Inglaterra/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Mejoramiento de la Calidad/organización & administración , Factores de Riesgo , Medicina Estatal/normas
17.
BMJ ; 367: l5205, 2019 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-31578187

RESUMEN

OBJECTIVES: To determine how clinicians vary in their response to new guidance on existing or new interventions, by measuring the timing and magnitude of change at healthcare institutions. DESIGN: Automated change detection in longitudinal prescribing data. SETTING: Prescribing data in English primary care. PARTICIPANTS: English general practices. MAIN OUTCOME MEASURES: In each practice the following were measured: the timing of the largest changes, steepness of the change slope (change in proportion per month), and magnitude of the change for two example time series (expiry of the Cerazette patent in 2012, leading to cheaper generic desogestrel alternatives becoming available; and a change in antibiotic prescribing guidelines after 2014, favouring nitrofurantoin over trimethoprim for uncomplicated urinary tract infection (UTI)). RESULTS: Substantial heterogeneity was found between institutions in both timing and steepness of change. The range of time delay before a change was implemented was large (interquartile range 2-14 months (median 8) for Cerazette, and 5-29 months (18) for UTI). Substantial heterogeneity was also seen in slope following a detected change (interquartile range 2-28% absolute reduction per month (median 9%) for Cerazette, and 1-8% (2%) for UTI). When changes were implemented, the magnitude of change showed substantially less heterogeneity (interquartile range 44-85% (median 66%) for Cerazette and 28-47% (38%) for UTI). CONCLUSIONS: Substantial variation was observed in the speed with which individual NHS general practices responded to warranted changes in clinical practice. Changes in prescribing behaviour were detected automatically and robustly. Detection of structural breaks using indicator saturation methods opens up new opportunities to improve patient care through audit and feedback by moving away from cross sectional analyses, and automatically identifying institutions that respond rapidly, or slowly, to warranted changes in clinical practice.


Asunto(s)
Prescripciones de Medicamentos/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Indicadores de Calidad de la Atención de Salud/estadística & datos numéricos , Medicina Estatal/estadística & datos numéricos , Antiinfecciosos/uso terapéutico , Conjuntos de Datos como Asunto , Sustitución de Medicamentos/estadística & datos numéricos , Medicamentos Genéricos/uso terapéutico , Inglaterra , Medicina General/organización & administración , Medicina General/normas , Medicina General/estadística & datos numéricos , Humanos , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina/normas , Medicina Estatal/normas , Factores de Tiempo , Infecciones Urinarias/tratamiento farmacológico
18.
Br J Nurs ; 28(17): 1152-1153, 2019 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-31556735

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses the Annual Report and Accounts 2018-2019 of the health and social care regulator.


Asunto(s)
Comités Consultivos , Informes Anuales como Asunto , Garantía de la Calidad de Atención de Salud/organización & administración , Inglaterra , Humanos , Medicina Estatal/normas
19.
Ann R Coll Surg Engl ; 101(8): 584-588, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31537105

RESUMEN

INTRODUCTION: The National Institute for Health and Care Excellence published a draft consultation update on abdominal aortic aneurysm, which was expected to be published on 7 November 2018. This article analyses the readiness of NHS hospitals and their workforce to embrace the proposed guidelines. METHODS: The trust and individual surgeon-level anonymised data in the public domain for elective, rupture and complex abdominal aortic aneurysm cases were collected and analysed for all the acute care trusts providing these services from the Vascular Society of Great Briton and Ireland's prospective National Vascular Registry database. RESULTS: Of the 95 acute care trusts providing the service for the year 2017, the annual volume of infrarenal abdominal aortic aneurysm (both endovascular and open repairs) ranged between 0 and 137. Of these, 64 (67.36%) trusts had an annual volume of fewer than 60 cases. A total of 366 (approximately 75% of 490) vascular surgeons have performed 10 or fewer open abdominal aortic aneurysm repairs in three years (2014-2016) with a mean operating volume of 1.452 procedures per surgeon per three years (n = 254, median 0, interquartile range, IQR, 0-3, 0.484 procedures per surgeon per year) and about 51% of the vascular surgeons have only performed five or fewer procedures in those three years with a mean operating volume of 3.455 per surgeon per three years (n = 367, median 3, IQR 0-3, 1.151 per surgeon per year). CONCLUSION: The observations show that most UK acute hospitals lack the optimum case volume necessary to embrace the proposed change in the guideline.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Guías de Práctica Clínica como Asunto , Procedimientos Quirúrgicos Vasculares/normas , Aneurisma de la Aorta Abdominal/epidemiología , Rotura de la Aorta/epidemiología , Rotura de la Aorta/cirugía , Bases de Datos Factuales , Procedimientos Quirúrgicos Electivos/normas , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Urgencias Médicas , Medicina Basada en la Evidencia/métodos , Adhesión a Directriz/estadística & datos numéricos , Humanos , Irlanda/epidemiología , Sistema de Registros , Medicina Estatal/normas , Medicina Estatal/estadística & datos numéricos , Reino Unido/epidemiología , Procedimientos Quirúrgicos Vasculares/métodos , Procedimientos Quirúrgicos Vasculares/estadística & datos numéricos , Carga de Trabajo/estadística & datos numéricos
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