Category: Medical Quality

Wooden figurine of a person leans against a wood wall clock

Patient Satisfaction in the NHS in England with the Emergency Room

John Tingle Leave a comment

By John Tingle

The Accident and Emergency (A&E), the Emergency Room, is the bellwether NHS speciality from which all the other clinical specialities appear to be judged. Long reported delays and missed targets in the A&E (Emergency Room) lead to a public, media clamoring that the NHS is a failing public service. The independent regulator of health and social care in England, the CQC (Care Quality Commission) recently published findings from a national survey of more than 50,000 people who received urgent and emergency care from 132 NHS trusts (hospitals).The survey looked at people’s experiences, from decision to attend, to leave, using Type 1 (major A&E) and Type 3 (urgent care centers, minor injury units, urgent treatment centers) urgent and emergency care services.

Survey Results

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Senior female woman patient in wheelchair sitting in hospital corridor with nurses and doctor

Care Quality Commission Annual Assessment of Health and Social Care

John Tingle Leave a comment

By John Tingle

The independent regulator for health and social care in England, the Quality Care Commission (CQC) has recently published its annual report on the real-time state of health and social care in England. It analyses trends, shares examples of outstanding, good, and poor health care care practices. It provides a true, unabashed account of issues facing the National Health Service (NHS) and health care delivery.

A Health System Stretched

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Black silhouette of a woman looking down

The FDA’s NEST Initiative and Women’s Health

Alexandra Slessarev Leave a comment

The history of medical device regulation in the United States has been shaped by the prominent failure of individual devices, many of which were indicated for women.

The Dalkon Shield intrauterine device infamously ushered in the 1976 amendments to the Federal Food, Drug, and Cosmetics Act, establishing the first pre-market notification and approval process for medical devices in the United States. Similarly, a series of failures among devices designed for women’s health—including the power morcellator, the Essure System, and pelvic mesh—has recently invigorated the FDA’s focus on its post-market regime. Read More

Image of the head of a baby on a lap

Report: Maternal Mental Health Must be a Top Priority

Rebecca Friedman Leave a comment

The U.S. Preventive Services Task Force (USPSTF), published recommendations recently urging clinicians to refer pregnant and postpartum women to counseling if they are at risk of depression.

The recommendations respond to the prevalence of perinatal depression, which is considered to be the most common pregnancy complication. Perinatal depression, affects up to one in seven women and can develop at any time after a woman becomes pregnant, immediately following the brith of a child, or even up to a year after.

Among the many concerning potential consequences of maternal depression are premature births and low birth weights, as well as neglect and inattentiveness from mothers after the baby is born, which can subject infants to risk of additional problems, according to Karina Davidson, a USPSTF member who helped write the recent recommendations. Read More

NHS logo on the side of a building

Update on the Future Direction of Patient Safety in the National Health Service

John Tingle Leave a comment

Matt Hancock, the Secretary of State for Health and Social Care on February 6 gave a wide-ranging speech on the future direction of patient safety in the NHS. The speech is important as it gives key insights into government priorities for patient safety policy development in the NHS.He stated that we all trust nurses and doctors more than any other profession. He spoke about the importance of a “just culture” in the NHS and openness, honesty, and trustworthiness. Read More

Image of a pile of gold coins on top of a map showing African continent

Repayment for Training as an Optimal Solution to Medical Brain Drain

Mark Satta Leave a comment

In an earlier post I offered two arguments for why wealthy nations have a moral obligation to address medical professional brain drain from resource-scarce developing nations. But once one acknowledges that wealthy nations have this obligation, a question remains as to what the best way to fulfill that obligation is.

Some have suggested that the solution is for wealthy nations to train an ample amount of doctors in their home countries so that they no longer need to take talent from developing nations to make up for the gap. This idea has intuitive appeal. After all, it allows more medical doctors to be trained in wealthy nations like the U.S. and results in more doctors being trained overall (assuming that developing nations would continue to train the same amount of doctors under such a model). Read More

Robot hand placing metal cylinder into appropriate hole on a wooden block

Machine Learning in Medicine: Addressing Ethical Challenges

Alex Pearlman Leave a comment

Machine learning in medicine is accelerating at an incredible rate, bringing a new era of ethical and regulatory challenges to the clinic.

In a new paper published in PLOS Medicine, Effy Vayena, Alessandro Blasimme, and I. Glenn Cohen spell out these ethical challenges and offer suggestions for how Institutional Review Boards (IRBs), medical practitioners, and developers can ethically deploy machine learning in medicine (MLm). Read More

group of nurses walking in hospital hallway

Burnout and Moral Distress in Nurses: Can Staffing Numbers Increase Patient Safety?

Paul C. McLean 3 Comments

I know Nurse X only by her failures the night a young woman with asthma died gasping for breath just steps from the emergency entrance of Somerville Hospital. The preventable nature of the woman’s death, and the discovery of that hard truth by her husband, are described thoroughly and compellingly in Sunday’s Boston Globe magazine.

This death was the result of medical error, estimated to be the third leading cause of death behind heart disease and cancer.

But the blurry image of Nurse X, standing in the ER doorway and failing to see the dying woman in the shadows steps away, is for me a snapshot of burnout. I’ll carry it with me to the voting booth on Tuesday when I stare at Question 1, the ballot measure in Massachusetts that could determine and lock into place nurse-to-patient staffing levels. Read More

health secretary matt hancock leaves 10 downing street

No room for complacency in patient safety in the NHS

John Tingle Leave a comment

Matt Hancock, the recently appointed Government, Health and Social Care Secretary, made a keynote speech on patient safety in London recently. The speech spelled out the future direction of NHS (National Health Service) patient safety policy development in England and also contained some very useful observations and policy which have relevance to patient safety policy developers globally, as well as in England.

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millennial man at home sick with scarf and thermometer talking on the phone

The Millennial Need for Speed in Healthcare

Rebecca Friedman 1 Comment

According to a recent Kaiser Family Foundation (KFF) poll, shockingly large swaths of Americans have reported that they don’t have a primary care provider.

The July 2018 report found that 45 percent of 18-29 year olds, as well as 28 and 18 percent of 30-49 and 50-64 year olds, respectively, also lack designated primary care.

Kaiser Health News (KHN) explained that the price transparency, convenience, and speed of alternatives to office-based primary care physician (PCP) visits appear to be some of the preferences driving these patterns. Retail clinics, urgent care centers, and telemedicine websites satisfy many of these preferences, and are therefore appealing alternatives to scheduled appointments with a PCP. For example, extended hours and shorter wait times at increasingly widespread retail clinics have attracted young patients who want to avoid the hassle and wait times involved in scheduling and attending a traditional doctors office.

A 2015 PNC Healthcare survey similarly found that millennials saw their PCP significantly less (61 percent) than baby boomers and seniors (80 and 85 percent, respectively). The study emphasized the effects of technology on millennials’ trends in healthcare acquisition, such as higher utilization of online reviews to shop for doctors (such as Yelp). It also found that millennials are much more likely to prefer retail and acute care clinics, and are more likely to postpone treatment due to high costs than older generations.

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