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9.
BMC Public Health ; 20(1): 1100, 2020 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-32660533

RESUMO

BACKGROUND: Responsibility for public health in England transferred from the National Health Service to local authorities in 2013, representing a different decision-making environment. Systematic reviews are considered the gold standard of evidence for clinical decision-making but little is known about their use in local government public health. This study aimed to explore the extent to which public health decision-makers in local authorities engage with systematic reviews and how they do so. METHODS: Semi-structured interviews were conducted with senior public health practitioners (n = 14) in Yorkshire and the Humber local authorities. Sampling was purposive and involved contacting Directors of Public Health directly and snowballing through key contacts. Face-to-face or telephone interviews were digitally recorded, transcribed verbatim and analysed using the Framework Method. RESULTS: Public health practitioners described using systematic reviews directly in decision-making and engaging with them more widely in a range of ways, often through a personal commitment to professional development. They saw themselves as having a role to advocate for the use of rigorous evidence, including systematic reviews, in the wider local authority. Systematic reviews were highly valued in principle and public health practitioners had relevant skills to find and appraise them. However, the extent of use varied by individual and local authority and was limited by the complexity of decision-making and various barriers. Barriers included that there were a limited number of systematic reviews available on certain public health topics, such as the wider determinants of health, and that the narrow focus of reviews was not reflective of complex public health decisions facing local authorities. Reviews were used alongside a range of other evidence types, including grey literature. The source of evidence was often considered an indicator of quality, with specific organisations, such as Public Health England, NICE and Cochrane, particularly trusted. CONCLUSIONS: Research use varies and should be considered within the specific decision-making and political context. There is a need for systematic reviews to be more reflective of the decisions facing local authority public health teams.


Assuntos
Prática Clínica Baseada em Evidências/organização & administração , Administração em Saúde Pública/métodos , Medicina Estatal/organização & administração , Revisões Sistemáticas como Assunto , Tomada de Decisão Clínica , Inglaterra , Prática Clínica Baseada em Evidências/normas , Humanos , Entrevistas como Assunto , Governo Local , Pesquisa Qualitativa , Medicina Estatal/normas
16.
Br J Nurs ; 29(10): 582-583, 2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-32463752

RESUMO

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent patient safety reports, revealing that patient safety concerns continue during the current pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias , Segurança do Paciente , Pneumonia Viral/epidemiologia , Medicina Estatal/legislação & jurisprudência , Feminino , Humanos , Serviços de Saúde Materna/normas , Gravidez , Medicina Estatal/normas , Reino Unido/epidemiologia
17.
Br J Nurs ; 29(5): 324-325, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32167818

RESUMO

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.


Assuntos
Segurança do Paciente , Qualidade da Assistência à Saúde , Medicina Estatal , Humanos , Medicina Estatal/normas , Reino Unido
18.
Arch Dis Child ; 105(8): 731-737, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32144091

RESUMO

PURPOSE: Patient safety failures are recognised as a global threat to public health, yet remain a leading cause of death internationally. Vulnerable children are inversely more in need of high-quality primary health and social-care but little is known about the quality of care received. Using national patient safety data, this study aimed to characterise primary care-related safety incidents among vulnerable children. METHODS: This was a cross-sectional mixed methods study of a national database of patient safety incident reports occurring in primary care settings. Free-text incident reports were coded to describe incident types, contributory factors, harm severity and incident outcomes. Subsequent thematic analyses of a purposive sample of reports was undertaken to understand factors underpinning problem areas. RESULTS: Of 1183 reports identified, 572 (48%) described harm to vulnerable children. Sociodemographic analysis showed that included children had child protection-related (517, 44%); social (353, 30%); psychological (189, 16%) or physical (124, 11%) vulnerabilities. Priority safety issues included: poor recognition of needs and subsequent provision of adequate care; insufficient provider access to accurate information about vulnerable children, and delayed referrals between providers. CONCLUSION: This is the first national study using incident report data to explore unsafe care amongst vulnerable children. Several system failures affecting vulnerable children are highlighted, many of which pose internationally recognised challenges to providers aiming to deliver safe care to this at-risk cohort. We encourage healthcare organisations globally to build on our findings and explore the safety and reliability of their healthcare systems, in order to sustainably mitigate harm to vulnerable children.


Assuntos
Serviços de Saúde da Criança/normas , Bem-Estar da Criança/estatística & dados numéricos , Erros Médicos/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Atenção Primária à Saúde/normas , Serviço Social/normas , Populações Vulneráveis , Adolescente , Criança , Saúde da Criança , Serviços de Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Erros Médicos/prevenção & controle , Segurança do Paciente/normas , Atenção Primária à Saúde/estatística & dados numéricos , Serviço Social/estatística & dados numéricos , Medicina Estatal/normas , Medicina Estatal/estatística & dados numéricos , Reino Unido
19.
BMJ ; 368: m517, 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32205307

RESUMO

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.


Assuntos
Retroalimentação , Satisfação do Paciente , Medicina Estatal , Participação da Comunidade , Humanos , Medicina Estatal/normas , Reino Unido
20.
Br J Nurs ; 29(6): 378-379, 2020 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-32207641

RESUMO

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.


Assuntos
Segurança do Paciente/normas , Garantia da Qualidade dos Cuidados de Saúde/normas , Medicina Estatal/normas , Inglaterra , Hospitais Públicos/organização & administração , Hospitais Públicos/normas , Hospitais Universitários/normas , Humanos , Medição de Risco , Medicina Estatal/organização & administração , Organização Mundial da Saúde
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