Learning from the report of the independent medicines and medical devices safety review: “first do no harm”

2022 ◽  
pp. 003693302110584
Author(s):  
Priyanka H Krishnaswamy ◽  
Marie-Anne Ledingham ◽  
Veenu Tyagi ◽  
Karen Lesley Guerrero
Keyword(s):  
Healthcare System ◽  
Medical Devices ◽  
Current Response ◽  
Missed Opportunities ◽  
Safety Review ◽  
Anti Epileptic Drug ◽  
Do No Harm ◽  
Clinical Scenarios ◽  
Health And Social Care ◽  
Learning Points

This is a review of the learning points from the Independent Medicines and Medical Devices Safety Review, 1 chaired by Baroness Julia Cumberlege CBE DL. This system-wide review was initiated by the then Secretary of State for Health and Social Care, following patient-led campaigns. It looked at how the “healthcare system reacted as a whole, and how that response can be made more robust, speedy and appropriate”. We aim to highlight the learning points for doctors in Obstetrics and Gynaecology as these are relevant to our current practice and future changes in our healthcare system. These are: Aims of the review: why it was initiated and how it was conducted Overarching themes and missed opportunities to prevent avoidable harm Three clinical scenarios: their histories, issues and adverse events associated with their use and the current response in Scotland The hormone pregnancy test - Primodos The anti-epileptic drug - sodium valproate Surgical mesh for prolapse & incontinence The recommendations made by the review and implementation guidance Responses to the review, such as apologies issued by BSUG 2 /BAUS 3 /RCOG, 4 and compensations schemes such as the Scottish scheme as recommended by the review

Trend of Parental Refusal or Delay of Childhood Vaccinations

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Meagan Marie Daoust
Keyword(s):  
Public Health ◽  
Social Media ◽  
Healthcare System ◽  
Educational Context ◽  
Health Consequences ◽  
Missed Opportunities ◽  
The Public ◽  
Health Related ◽  
Parental Refusal

The healthcare trend of parental refusal or delay of childhood vaccinations will be investigated through a complex Cynefin Framework component in an economic and educational context, allowing patterns to emerge that suggest recommendations of change for the RN role and healthcare system. As a major contributing factor adding complexity to this trend, social media is heavily used for health related knowledge, making it is difficult to determine which information is most trustworthy. Missed opportunities for immunization can result, leading to economic and health consequences for the healthcare system and population. Through analysis of the powerful impact social media has on this evolving trend and public health, an upstream recommendation for RNs to respond with is to utilize reliable social media to the parents’ advantage within practice. The healthcare system should focus on incorporating vaccine-related education into existing programs and classes offered to parents, and implementing new vaccine classes for the public.

What initiatives do healthcare leaders agree are needed for healthcare system improvement? Results of a modified-Delphi study

2018 ◽  
Vol 32 (8) ◽  
pp. 1002-1012
Author(s):  
Stuart Barson ◽  
Robin Gauld ◽  
Jonathon Gray ◽  
Goran Henriks ◽  
Christina Krause ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Healthcare System ◽  
Professional Training ◽  
Delphi Process ◽  
Content Type ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Health And Social Care ◽  
System Leaders ◽  
Practical Implications

Purpose The purpose of this paper is to identify five quality improvement initiatives for healthcare system leaders, produced by such leaders themselves, and to provide some guidance on how these could be implemented. Design/methodology/approach A multi-stage modified-Delphi process was used, blending the Delphi approach of iterative information collection, analysis and feedback, with the option for participants to revise their judgments. Findings The process reached consensus on five initiatives: change information privacy laws; overhaul professional training and work in the workplace; use co-design methods; contract for value and outcomes across health and social care; and use data from across the public and private sectors to improve equity for vulnerable populations and the sickest people. Research limitations/implications Information could not be gathered from all participants at each stage of the modified-Delphi process, and the participants did not include patients and families, potentially limiting the scope and nature of input. Practical implications The practical implications are a set of findings based on what leaders would bring to a decision-making table in an ideal world if given broad scope and capacity to make policy and organisational changes to improve healthcare systems. Originality/value This study adds to the literature a suite of recommendations for healthcare quality improvement, produced by a group of experienced healthcare system leaders from a range of contexts.

Why do patients attend and what do they want from the consultation?

2020 ◽  
pp. 14-19
Author(s):  
Des Spence
Keyword(s):  
Clinical Practice ◽  
Healthcare System ◽  
Healthcare Professionals ◽  
Medical Profession ◽  
Education And Training ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Do No Harm ◽  
Developed World ◽  
And Training

Contrary to traditional thinking and teaching, it is not illness that dictates the health-seeking behaviour of a population but the healthcare system itself, and—most importantly—our actions as healthcare professionals. A scourge affecting clinical practice in the developed world today is the medicalization of all interactions, accompanied by overinvestigation, overdiagnosis, and overtreatment. The medical profession retains its traditional duty, wherever possible, to diagnose disease and treat or cure illness appropriately, also to comfort the sick, irrespective of the ability to cure. At the same time, a long-held principle of medicine at all levels is to do no harm, while at the same time supporting the maintenance of health and protecting those who are well. This chapter explains how maintaining the balance between these apparent conflicting precepts is a scarce skill that needs to be taught by example during the education and training of the modern doctor.

scholarly journals “What Bothers Me Most Is the Disparity between the Choices that People Have or Don’t Have”: A Qualitative Study on the Health Systems Responsiveness to Implementing the Assisted Decision-Making (Capacity) Act in Ireland

2020 ◽  
Vol 17 (9) ◽  
pp. 3294 ◽  
Author(s):  
Éidín Ní Shé ◽  
Deirdre O’Donnell ◽  
Sarah Donnelly ◽  
Carmel Davies ◽  
Francesco Fattori ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Healthcare System ◽  
Health Systems ◽  
Critical Incident ◽  
Family Carers ◽  
Acute Setting ◽  
Face To Face ◽  
Health And Social Care ◽  
Diagnosis Of Dementia

Objective: The Assisted Decision-Making (ADM) (Capacity) Act was enacted in 2015 in Ireland and will be commenced in 2021. This paper is focused on this pre-implementation stage within the acute setting and uses a health systems responsiveness framework. Methods: We conducted face-to-face interviews using a critical incident technique. We interviewed older people including those with a diagnosis of dementia (n = 8), family carers (n = 5) and health and social care professionals (HSCPs) working in the acute setting (n = 26). Results: The interviewees reflected upon a healthcare system that is currently under significant pressures. HSCPs are doing their best, but they are often halted from delivering on the will and preference of their patients. Many older people and family carers feel that they must be very assertive to have their preferences considered. All expressed concern about the strain on the healthcare system. There are significant environmental barriers that are hindering ADM practice. Conclusions: The commencement of ADM provides an opportunity to redefine the provision, practices, and priorities of healthcare in Ireland to enable improved patient-centred care. To facilitate implementation of ADM, it is therefore critical to identify and provide adequate resources and work towards solutions to ensure a seamless commencement of the legislation.

Challenging Concepts in Respiratory Medicine

2017 ◽  
Keyword(s):  
Learning Process ◽  
Management Strategies ◽  
Evidence Base ◽  
Respiratory Medicine ◽  
Clinical Scenarios ◽  
Expert Commentary ◽  
Learning Points ◽  
Case Based

Challenging Concepts in Respiratory Medicine is a case-based guide to difficult scenarios in the field, covering many of the major subspecialty areas. Consisting of contemporary clinical scenarios with expert commentary, chapters are interspersed with the most up-to-date evidence, management strategies, guidelines, and controversies in management. Using handy ‘Clinical tips’, ‘Learning points’, and ‘Evidence base’ to enhance the learning process, Challenging Concepts in Respiratory Medicine includes valuable ‘Expert Comment’ written by a nationally or internationally renowned expert to provide a unique inside track on how the experts approach these types of challenging cases. Covering a range of respiratory and related conditions, including allergy, tuberculosis, asthma, and narcolepsy, this title is specifically designed for those preparing for their specialist exams.

scholarly journals SOME ADDITIONAL THOUGHTS ON FORTHCOMING AMENDMENTS TO HTA IN POLAND

2017 ◽  
Vol 33 (3) ◽  
pp. 358-359
Author(s):  
Anna Zawada
Keyword(s):  
Health Technology Assessment ◽  
Healthcare System ◽  
Medical Devices ◽  
Technology Assessment ◽  
Health Technology ◽  
Additional Information

In reference to the article A Decade of Health Technology Assessment in Poland by I. Lipska et al. (1), I would like to provide you with some comments and additional information on the changes in reimbursement policies in the Polish healthcare system currently taking place, which is likely to lead to increased number of health technology assessments (HTAs) of medical devices (MDs).

scholarly journals Multimaterial 3D Printing for the Fabrication of Functional Stethoscopes

2019 ◽  
Author(s):  
Rachel Popkin ◽  
Fluvio Lobo ◽  
Jack Stubbs
Keyword(s):  
3D Printing ◽  
Healthcare System ◽  
Medical Devices ◽  
Financial Burden ◽  
Cross Contamination ◽  
On Demand ◽  
The World ◽  
Single Use ◽  
The Cost ◽  
Developed World

Stethoscopes are ubiquitous across the healthcare system. For the most part, stethoscopes do not represent a financial burden, mostly throughout the developed world. Further reducing the cost of stethoscopes has both humanitarian and prophylactic goals. The Glia project pioneered the concept of 3D printing stethoscopes for war or poverty-stricken regions of the world. Cross-contamination concerns have led researchers and manufacturers to develop single-use stethoscopes. Our aim is to develop a fully printed, multi-material, functional stethoscope to alleviate these concerns. Our team also seeks to establish a framework for the on-demand manufacturing of medical devices to reduce costs associated with shipping, distribution, and inventory.

scholarly journals New organizational model to foster good practice. Central venous access management in cancer patients

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Mastrandrea ◽  
F Cangialosi ◽  
P Notarangelo ◽  
G Chetta ◽  
E A Graps
Keyword(s):  
Integrated Care ◽  
Cancer Patients ◽  
Medical Devices ◽  
Remote Monitoring ◽  
Central Venous Access ◽  
Venous Access ◽  
Access Management ◽  
Central Venous ◽  
Management Procedures ◽  
Health And Social Care

Abstract Issue Central Venous Access positioning is a common practice in cancer patients, however improper devices' management lead to complications and multiple accesses to hospital services, increasing costs. Assessment and certification of Central Venous Access insertion site at hospital so as proper dressing at home, are required; patient empowerment in management of complex technologies is desirable to improve outcomes. Problem Description To tackle the abovementioned issues, PICC project was drawn up in joint action between the Strategic Health and Social care Agency and the Research Institute on Cancer in Puglia. The aim is to pilot an organisational model for central venous access positioning and remote monitoring barely technology driven and based on safe storage of outcomes pictures, patient/care-givers empowerment, integrated care approach. A sistematic review of good practices for Central Venous Access management was conducted in june 2019; besides an analysis of medical devices public procurement procedures was performed at national scale; a survey was edited to probe the existence of diverse organisational models to insert and manage Central Venous Access. Results Very preliminary data are avalaible. Procurement analysis showed: around 15 companies of Central Venous Access and related medical devices' producers; a spread of Central Venous Access location medical devices/supply of services based on few firms (including consumables). The analysis helps to identify the “least common multiple” in technologic equipment to support Central Venous Access management to develop a standard and applicable model, not driven by a conditioning “starting choice” (catheter selection, tip location, dressings). Lessons A standard Central Venous Access management certification procedure can be realized regardless of potential technology driven approach. A Central Venous Access remote monitoring model based on images and empowered patients can allow daily review fostering integrated care. Key messages Patients’ proper training, even in complex technologies usage, can increase self awareness and empowerment and promote compliance to innovative organizational models. Collaboration among patients – caregivers and professionals, set up of a dynamic pictures store to record Central Venous Access management procedures can improve oucomes avoiding added costs.

The Role of Health Inequalities and Assessing Impacts on Population Health

2015 ◽  
Vol 5 (1) ◽  
pp. 68-74
Author(s):  
Shahid Muhammad
Keyword(s):  
Population Health ◽  
Health Inequalities ◽  
Social Care ◽  
Health In All Policies ◽  
Missed Opportunities ◽  
Department Of Health ◽  
Health And Social Care ◽  
Average Health ◽  
Missed Opportunity

In ‘today's' world, technology advances are pacing and surrounding all areas of health and social care. Whilst the ‘age of technology' has its certainties, health professionals are still identifying missed opportunities in diagnosis for specific diseases and this has its own burden and impact on over budgeting and healthcare. There now seems to be charade in allocating the appropriate funds in those sectors that require more man-power than technology. In turn health has now become more about through-put then compassion (Barnett et al. 2012; Department of Health 2012; Luxford and Sutton 2014; Muhammad et al. 2015). Here, the author briefly explores the role of average health status – Health Inequalities (or Panayotov Matrix) for Assessing Impacts on Population Health and Health in All Policies (HiAP) in the ‘age of technology' and missed opportunity in diagnoses, providing a Chronic Kidney Disease (CKD) example.

The importance of timely diagnosis and replacement of medical equipment in healthcare institutions

2022 ◽  
pp. 6-14
Author(s):  
I.P. Abysheva ◽  
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Healthcare System ◽  
Medical Devices ◽  
Medical Equipment ◽  
Review Article ◽  
Limited Resources ◽  
High Quality ◽  
The World ◽  
Provision Of Services

The health care system around the world, both in developed and developing countries, is struggling with the problem of managing the provision of health care in conditions of limited resources. The availability and use of various medical equipment at all levels of the healthcare system were emphasized for the efficient and high-quality provision of services. The main purpose of this review article is to assess the availability and use of medical devices and identify the registered causes affecting the availability and use of medical devices in healthcare institutions.

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