Quality improvement resource pack

New resource to introduce and improve situation awareness in hospitals is now available on the Royal College of Paediatrics and Child Health’s website.

This free, online resource pack aims to improve communication, build a safety-based culture and deliver better health outcomes for children and young people.

It includes informative presentations and useful tools with worked examples in six areas.

  • Quality improvement
  • Patient safety culture
  • Structured communication
  • Recognising deterioration
  • The ‘huddle’
  • Evaluation and spread

The resource pack has been developed as part of the final phase of the College’s flagship quality improvement programme, Situation Awareness for Everyone (S.A.F.E).

Access the S.A.F.E resource pack

Find out more about the S.A.F.E programme

Video introducing key concepts:

Drug company is suspended from UK industry body after “deception on a grand scale”

O’Dowd, A. BMJ. 2016. 353:i3574

Image source: Wikipedia // CC BY-SA 3.0

The UK subsidiary of a prominent Japanese drug firm has had its membership of the United Kingdom’s industry representative body suspended after what has been described as “deception on a grand scale.”

The Association of the British Pharmaceutical Industry’s one year suspension of Astellas UK, from 24 June, was made because of serious breaches of the association’s code of practice that related to covert attempts to market prostate cancer drugs to doctors.

The decision came after a complaint about an advisory board meeting that was held in Milan in February 2014 and was ruled to be in breach of the code, including of clause 2, which deals with actions likely to bring discredit on, or reduce confidence in, the drug industry.

An anonymous health professional who complained said that he or she had been invited by Astellas, along with colleagues, to what was described as an “educational event” meeting in Milan where they could obtain advice about prostate cancer and share their expertise.

More than 100 other clinicians attended this meeting, and Astellas presented the benefits of its prostate cancer drug enzalutamide (Xtandi) for what was at the time an unlicensed indication. The complainant alleged that Astellas was not truthful in explaining why delegates had been invited to the meeting, and that the company promoted something it should not have done.

Read the full article here

Working together to prevent maternal mortality

Royal College of Physicians and Surgeons of Glasgow / Royal College of Obstetricians and Gynaecologists, June 2016

It’s better to ask: working together to prevent maternal mortality

image source: rcpsg.ac.uk/

The RCPSG and the RCOG have produced an animated video to help doctors assess unwell pregnant or postpartum women, which aims to help reduce the number of maternal deaths in the UK. It is accompanied by a poster, which highlights the main causes of maternal death and provides midwives and doctors with advice for assessing pregnant and postpartum women who are feeling unwell.

More information available from the Royal College of Midwives here

Patients’ experiences of deep brain stimulation for Parkinson’s disease

Mathers, J. et al. BMJ Open. 2016. 6:e011525

Image source: Andreashorn – Wikipedia // CC BY-SA 4.0

Objective: To review and synthesise qualitative research studies that have explored patients’ experience of deep brain stimulation (DBS) in advanced Parkinson’s disease (PD).

Design: Systematic review and meta-synthesis of 7 original papers, using metaethnography.

Setting: Studies conducted in Denmark, France and Sweden.

Participants 116 patients who had undergone DBS and 9 spouses of patients.

Results: Prior to surgery, the experience of advancing PD is one of considerable loss and a feeling of loss of control. There are significant hopes for what DBS can bring. Following surgery, a sense of euphoria is described by many, although this does not persist and there is a need for significant transitions following this. We suggest that normality as a concept is core to the experience of DBS and that a sense of control may be a key condition for normality. Experience of DBS for patients and spouses, and of the transitions that they must undertake, is influenced by their hopes of what surgery will enable them to achieve, or regain (ie, a new normality).

Conclusions: There is a need for further qualitative research to understand the nature of these transitions to inform how best patients and their spouses can be supported by healthcare professionals before, during and after DBS. In assessing the outcomes of DBS and other treatments in advanced PD, we should consider how to capture holistic concepts such as normality and control. Studies that examine the outcomes of DBS require longer term follow-up.

Read the full article here

Related video: How does DBS work?

What makes a good leader in today’s NHS?

Johnson, S. The Guardian. Published online: 22 June 2016

Image source: Tranductrung2009 – Wikimedia Commons// CC BY-SA 4.0

Good leadership is often credited with being able to save the NHS. For individuals willing to take on leadership roles, the rewards can be great. However, with a general feeling of demoralisation in the workforce and services facing unprecedented demand, the challenges are even greater.

Marcus Powell, director of leadership and organisational development at The King’s Fund, recognises that leaders get “buffeted in all sorts of situations” and that they must have the ability to absorb problems and make sure their team feels safe.

He says that interference from the government and national bodies holds leaders back from fulfilling their potential: “The politics of healthcare gets in the way of the job people need to do … the interference is a drag on people’s resilience.”

Powell says that every member of staff working in the NHS should demonstrate leadership qualities. He says leaders should foster a culture whereby employees feel able to speak out if standards slip in order to improve care.

People should explore their responsibilities as a leader and learn how to listen, empathise and create conditions where people feel cared for – it’s impossible to lead a complex organisation as a cut-throat, coercive or bullying leader, he says.

Read the full article here

Study addresses safety concerns for older adults with diagnosed/undiagnosed dementia

ScienceDaily. Published online: 23 June 2016

B0005919 The criminal mind
Image source: Rowena Dugdale – Wellcome Images // CC BY-NC-ND 4.0

Dementia currently affects some 5 million people in the U.S., and that number is expected to triple by 2050. Having dementia affects the way you think, act, and make decisions.

In a study published in the Journal of the American Geriatrics Society, researchers examined how often older adults who have diagnosed and undiagnosed dementia engage in potentially unsafe activities.

The researchers examined 7,609 Medicare beneficiaries aged 65 to more than 90-years-old. Based on various cognitive tests, the researchers determined that 1,038 of the people they observed had probable dementia. Of that group, 457 had been diagnosed with dementia and 581 had not been diagnosed with dementia.

Nearly 1,000 participants tested as having “possible” dementia and 5,575 did not have dementia. Of the older adults with probable dementia, the researchers learned that:

  • 23 percent were still driving
  • 31 percent prepared hot meals
  • 22 percent managed their own finances
  • 37 percent managed their own medications
  • 21 percent attended doctors’ appointments alone

Read the full commentary here

Read the original research abstract here

Ban fast food deliveries to schools

RSPH. Published online: 23rd June 2016

Image source: RSPH

A new report, published by RSPH, the Youth Health Movement and Slimming World, is calling for a ban on fast food takeaway deliveries to schools and the introduction of new initiatives such as film-style classifications on unhealthy food and a loyalty card to reward healthy food choices, as part of a raft of ideas put forward by young people to tackle the childhood obesity epidemic.

The move to ban deliveries to school is backed by three quarters of UK parents. In the report, young people point the finger at the temptation of fast food takeaways and unclear food labelling for the childhood obesity epidemic. Key findings from the research, which was developed from a roundtable workshop involving 19 young people aged 13-18 and a follow-up survey of more than 500 children, include:

rsph child2
Image source: RSPH
  • Almost half of young people (49%) blame fast food takeaways as the companies or brands most at fault for childhood obesity
  • A quarter (25%) of young people have ordered a takeaway to their school; half of young people (50%) have ordered a takeaway via their smartphone
  • More than four in five (82%) think food manufacturers are misleading people when they provide fat, salt and sugar for single servings rather than for the entire product
  • More than two in five (42%) can walk from their school to somewhere selling unhealthy food in under two minutes

Read the full report here