Photograph of memorial to victims of the El Paso, TX mass shooting

Pervasive Health Effects of Anti-Immigrant Rhetoric at the U.S.-Mexican Border

By Lilo Blank

The current xenophobic, racist, and anti-immigrant climate in the United States and its detrimental impact on immigrant communities and their health cannot be ignored. This month, gunmen have executed a series of mass shootings, including one specifically in El Paso, Texas, in which the gunman killed 22 people. The FBI is currently investigating the shooting as a suspected hate crime against immigrants. Terroristic acts of violence such as this are enough to incite fear in anyone, but especially in Hispanic communities on the border, who are facing additional forms of structural violence.

“Stigma is fundamentally about alienation and exclusion,” said stigma expert Dr. Daniel Goldberg, Associate Professor at the University of Colorado Anschutz Medical Campus’s Center for Bioethics and Humanities, in a recent interview. “Even when you control for access, people who are stigmatized get sicker and die quicker. And of course, we are social creatures. If stigma exists persistently and longitudinally, the more likely you are to be socially isolated, and social isolation is one of the most powerful predictors of mortality.”

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Nurse holding a patient's hand

Toward a Just and Learning Culture in the NHS

By John Tingle

NHS Resolution has several functions in the NHS (National Health Service) in England which include managing legal claims brought against NHS hospitals and other health organisations, as well as important patient safety responsibilities. They have recently published guidance on supporting a just and learning culture for staff, patients, and caregivers following incidents in the NHS.

The guidance is wide ranging and includes examples of just and learning culture development practices. Example one is a just and learning charter that NHS hospitals and other health organisations can adapt or adopt. The NHS charter provides in the first paragraph a sample introductory pledge:

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Monthly Round-Up: What to Read on Pharma Law and Policy

By Ameet Sarpatwari, Frazer Tessema, and Aaron S. Kesselheim

Each month, members of the Program On Regulation, Therapeutics, And Law (PORTAL) review the peer-reviewed medical literature to identify interesting empirical studies, policy analyses, and editorials on health law and policy issues relevant to current or potential future work in the Division.

Below are the abstracts/summaries for papers identified from the month of June. The selections feature topics ranging from premarket development times for biologics versus small-molecule drugs, to the characteristics of trials and regulatory pathways leading to U.S. approval of innovative vs. non-innovative drugs, to generic and brand-name thyroid hormone drug use among commercially insured and Medicaid beneficiaries. A full posting of abstracts/summaries of these articles may be found on our website.

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The NHS in England Launches a New Patient Safety Strategy

On July 2, 2019 a new National Health Service (NHS) patient safety strategy was launched in England. The strategy promises many things and lays out the future trajectory of NHS patient safety policy making.

Aidan Fowler, the NHS National Director of Patient Safety highlights the scale of the NHS patient safety problem in the foreword to the strategy:

 Too often in healthcare we have sought to blame individuals, and individuals have not felt safe to admit errors and learn from them or act to prevent recurrence…The opportunity is huge. Hogan et al’s research from 2015 suggests we may fail to save around 11,000 lives a year due to safety concerns, with older patients the most affected. The extra treatment needed following incidents may cost at least £1 billion (p3).

 

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A white hospital hallway

The Latest in the Continuing Cycle of NHS Patient Safety Inquiries

There does not seem to be a week that goes by without an NHS (National Health Service) patient safety crisis hitting the headlines and this has been the case for many years. Major public inquiry reports into patient safety and health quality failings are published. Recommendations are made, and then another crisis event follows soon afterwards spawning yet other reports, broadly saying the same thing.

The NHS has built up a huge back catalogue of inquiry reports into patient safety crisis’s, spanning decades containing a lot of deep thinking, useful analysis and valuable recommendations. Analysing present and past patient safety crisis inquiry reports is a very useful educational exercise and can help inform future policy development in the area. Some of the seemingly intractable, stubbornly persistent patient safety problems that beset the NHS, both past and present are identified and discussed. Revisiting reports and analysis can also refresh our perspective on patient safety issues and provides an information bedrock on which we can base change.

Patient safety inquiry reports also provide a momentum for change through their recommendations which the government of the day can accept or reject. Read More

NHS logo on the side of a building

Testing the Temperature of Patient Safety in the NHS

In terms of transparency and accountability the National Health Service ( NHS) in England is excellent at producing insightful, well-produced reports on health quality and patient safety. It does this on a regular basis and one of the great difficulties faced by NHS nurses and doctors today is the sheer volume of reports published. It’s an impossible task for nurses and doctors to keep up to date with all the reports published and to maintain heavy workloads in resource constrained environments. It’s also hard for health care staff to know which reports to prioritize and which are authoritative.

There is an urgent need for the NHS to create a one stop, patient safety information hub which collects reports from all NHS sites and other important global sites, putting everything into one accessible place. Some recent reports on written patient complaints have been published which are helpful in assessing, testing patient safety and health quality in the NHS. Read More

A group of surgeons perform an operation in a hospital operating theatre.

Keeping up to Date with Global Patient Safety

One of the great difficulties in patient safety and health quality is keeping up to date with all the material that is produced. A myriad number of patient safety and health resources exist globally. By sharing good quality resources, we can help advance the global patient safety agenda.

NHS Resolution (the operating name of the National Health Service Litigation Authority) has excellent patient safety and clinical negligence resources, learning materials and should be viewed as a priority global information source.

NHS Resolution is a Special Health Authority and is a not-for-profit arm’s length body of the Department of Health and Social Care.It is a part of the NHS and has several functions including handling negligence claims on behalf of NHS organizations and independent sector providers of NHS care in England who are members of the NHS Resolution indemnity schemes. Read More

Patient Safety: The Urgent Need for Global Information Sharing and Learning

Patient harm is the 14th leading contributor to the global disease burden, according to a new report by WHO, OECD, and the World Bank.

In resource-constrained health care environments, it is important not to reinvent the wheel and waste money when existing, proven patient safety solutions already exist in other countries. Global patient safety knowledge sharing, and learning helps all countries, regardless of income level and this needs to be encouraged. Read More

Two senior women jogging in a park

What Should We Ask About Age-Based Criteria in Healthcare?

In the American health care system, age shapes patients’ options. Most people over age 65 are eligible for Medicare, which is inaccessible to almost everyone under 65.

But many providers limit older patients’ access to certain interventions—like in-vitro fertilization or organ transplants. Some clinical research studies also exclude older patients, while others stratify populations by age. And insurers in the Affordable Care Act’s individual marketplaces can legally charge older patients up to three times as much as younger patients, which has motivated calls to let people below 65 buy into the Medicare program (although these proposals use age 55 as an eligibility criterion). Many of these uses of age have generated debate in the past, and are likely to continue to generate debate in the future. Read More

Suicide Prevention and Patient Safety

Suicide prevention needs to be taken more seriously globally by governments, health systems as an urgent public health concern.

WHO (World Health Organisation) states that close to 800,000 people die due to suicide every year, which translates to one person dying every 40 seconds. For each adult who died by suicide there may have been more than 20 others attempting suicide. Suicide is the second leading cause of death among 15 to 29-year-olds globally, and occurs throughout the lifespan. Read More