How do I get more involved in my patient safety?

1 Feb

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We have been working together with patients, carers, members of the public, GPs and pharmacists to design a PSTRC patient safety guide for patients and carers. This will be a useful resource to help answer key questions about primary care patient safety and to identify points where patients and carers can make their own care safer.

The guide consists of a short booklet, website and cue card prompts which people can use flexibly:

  • to plan for a consultation
  • as a memory aid
  • to help make the most of the time a person has with a healthcare professional
  • to support their own care at home.

As part of this project, the PSTRC has held co-design events which have brought together members of the public, patients, carers, GPs and pharmacists to discuss how everyone can work together to make care safer. Discussions have focused on key points in the care pathway and actions that each person could identify to improve their patient safety with the priorities that were identified for their own care. These discussions were then used to develop and refine the guide.

Since completing the initial development stage of the patient safety guide, work has been taking place with key national stakeholders to further refine the guide and the centre will continue to co-develop the project and the testing of it with patients, carers and healthcare professionals.

If you’re interested in hearing more about the guide, or to find out more about future co-design events, please contact Rebecca Morris at rebecca.morris@manchester.ac.uk.

New Theme Overview: Safer Care Systems and Transitions

1 Feb

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The research for this new theme will take place at the Universities of Nottingham (lead: Justin Waring) and Manchester (lead: Stephen Campbell) and sites of study include hospitals, mental health services, community pharmacy and primary care.

A patient’s journey through different parts of the health service is called a “pathway,” and it is already known that patients can be put at particular risk when they move along their pathway and receive care from different organisations. Concerns for patients might include: “Has all the relevant information been passed from my GP to my hospital consultant (or the other way round)? Am I getting the same advice from different health professionals about my health problems or are people giving me contradictory advice?” Patient transfers, i.e. when people are in between different services and perhaps reliant on self-care or support from family members, can bring additional risks.

In this theme, these issues will be explored in four main topics:

  • ‘mental health’ (also in collaboration with the Marginalised Groups theme)
  • ‘information storage and transfer systems’ and ‘patient-held care records’ (both in collaboration with the Safety Informatics theme)
  • ‘governance and regulation’ (in collaboration with the Medication Safety theme)

Specific research projects being worked up include threats to safety in mental health transitions, and the potential role of patient-held care records in improving safety across the patient pathway. Through this programme of work, the key factors in transitional safety will be identified, followed by the development and testing of new systems of routine data collection and analysis to measure them.

Past PhD Fellows: Where are they now? Christian Jones

1 Feb

In this new series, we catch up with past Greater Manchester PSTRC PhD Fellows to see what they are doing now and how their PhD projects affected patient safety. Our first past PhD Fellow is Christian Jones.

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What did you learn during your PhD project?

My PhD project focused on how and why community pharmacy staff deviate from or bypass procedures. Although the idea of not following the rules might sound sinister, my project highlighted that staff use their professional judgement daily to tailor care to patient’s individual needs.

My PhD project also taught me many personal skills. I learnt about the importance of being passionate about your work and the importance of being determined, focused and tenacious in order to reach a goal. I’m so grateful for the PhD experience and for the support that I received from my supervisors and colleagues – definitely some of the best years of my life so far!

How has your PhD changed the patient safety landscape?  

My PhD has illuminated how procedures are viewed and followed in practice by both pharmacists and pharmacy support staff. As well as exploring the types of violations that occur in this setting and why, I was also the first to explore the impact of motivation, opportunity and capability on the frequency of violations in this setting.

What you are doing now and where you see yourself going in your future career?

I now work as a senior project manager for the community pharmacy commissioning team at NHS England. So far, it has been fascinating to understand how policies are created and implemented on a national scale. I am also an honorary lecturer at the University of Manchester, which means a great deal as I adore teaching and I am passionate about patient safety research.

For the future, I would love to continue building a career in community pharmacy policy and research alongside my own blog on mindfulness.

Building on success: Medication Safety

1 Feb

 

Meds Safety

Plans for the Medication Safety theme will extend the work programme carried out by the 2012-2017 NIHR Greater Manchester PSTRC on improving medication safety surveillance and interventions to reduce adverse drug events and make prescribing safer. This focus aligns directly with the recent World Health Organization’s (WHO) Third Global Patient Challenge “Medication Without Harm”.

The theme focuses on developing safety management systems and exploring how the prescribing, dispensing and administration of medicines within, and between, healthcare organisations can be further improved and made safer. Medicines are the most commonly used clinical intervention in healthcare, and errors can lead to significant patient harm and hospitalisation. A number of new interventions will be developed and tested, working with the Safety Informatics theme, to address these major safety challenges.

Specific projects will include the following:

  • Examining the impact of electronic audit and feedback on prescribing safety of general practice trainees
  • Enhancing and evaluating the Medication Safety Surveillance system using electronic health records to develop a library of prescribing safety indicators that can be used across the NHS
  • Building on the success of the Patient Safety Toolkit for general practice, work will continue with the Greater Manchester Community Pharmacy Patient Safety Collaborative to develop and test a patient safety and improvement toolkit for community pharmacies
  • Evaluating the impact of an electronic Refer-to-Pharmacy scheme, examining the extent to which this could improve medication safety on discharge from hospital.

Keep up to date with the work of the Medication Safety theme on its dedicated webpage.

PhD Studentship: Effective Legal and Regulatory Responses to Patient Safety Incidents at Transitions of Care

1 Feb

Sarah Devaney (School of Law) and Gavin Daker-White (School of Health Sciences) will be supervising this a PhD studentship on ‘Effective Legal and Regulatory Responses to Patient Safety Incidents at Transitions of Care’ as part of the Safer Care Systems and Transitions research theme. To date, most transitions research has been conducted around hospital discharge (and back to GP led care).

There is very little legal and regulatory research existing in this area. The legal and regulatory response (e.g. to safety failures) tends to focus on individual services, clinical teams or individuals. However, a recent UK Government Bill proposes more of a whole systems approach, drawing on lessons learned in the aviation industry.

This study will generate information in an under-researched field as well as comprising the first collaboration between the Greater Manchester PSTRC and the University of Manchester’s School of Law. It extends the research interests of the centre to include issues such as medical ethics, informed consent and the regulatory responses to medical error or professional malpractice.

NAPCRG 45th annual meeting

1 Feb

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Sally Giles, Penny Lewis, Sarah Rodgers and Patient and Public Involvement (PPI) representative Antony Chuter presented a workshop at the recent Annual Meeting of the North American Primary Care Research Group (NAPCRG) in Montreal. The objectives of the workshop were to provide an overview of examples of current research into medication safety in primary care, discuss the challenges to medication safety and some of the tools that can be used in practice to improve medication safety.

Sarah highlighted the work of the ‘PINCER’ prescribing intervention and workshop participants worked through clinical scenarios using the PINCER indicators. Antony discussed his role as a PPI member in various medication safety research projects. This stimulated discussion around patient involvement in healthcare research, as this is a relatively new concept in North America.

Penny and Sally discussed patient involvement in medication safety and the development of the Manchester Patient Safety Framework (MaPSaF) with workshop participants engaging in discussions about how they currently involve patients in the prevention of safety incidents. The workshop was well attended by a mixture of primary care physicians, pharmacists and healthcare researchers and the topic fitted well with the patient-centred care theme of the conference.

Sally also presented her work on the primary care patient measure of safety (PC_PMOS) in a well-attended oral session. Sally’s work stimulated interest in the audience with US researchers hoping to carry out similar work in this area.

Drug Utilisation Research Group (Euro DURG)

1 Feb

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Stephen Campbell attended the European Drug Utilisation Research Group (Euro DURG) Conference 2017, in Glasgow in November 2017 to present at a workshop on the “Quality of quality indicators”. Healthcare and medication use are changing and the field of drug utilisation research is evolving in a digital world.

Drug utilisation is an eclectic scientific discipline that includes many methods for the “quantification, understanding and evaluation of the processes of prescribing, dispensing and consumption of medicines and for the testing of interventions to enhance the quality of these processes”.  It has overlap with the PSTRC focus on medication safety, transitional care for those with multimorbidity and safety informatics but is linked also to the broader field of pharmacoepidemiology (the study of the uses and effects of drugs in defined populations) and health outcomes research and health economics.

The overall aim is to improve the safe and efficient use of medicines in populations to shape health policy and clinical practice.  The economic and health consequences of inappropriate drug use are substantial and patients are the end users of medicines. Those in marginalised groups can experience more inconsistent outcomes due to medication. The conference emphasised the need for a partnership between researchers, policy-makers and patients.