A short film produced by Health Education England to support healthcare professionals in training and staff at all levels to report and respond to concerns about patient safety.
Toward a high-performance management system in health care, part 4: Using high-performance work practices to prevent central line-associated blood stream infections-a comparative case study
An observational study from the USA which examined the impact of high-performance work practices on interventions to reduce central line associated bloodstream infections.
Produced by the Canadian Patient Safety Institute, this report includes a literature review on effective teamwork and communication in healthcare, a needs assessment of Canadian healthcare organisations, a review of teamwork and communication training programmes, and a consultation with national and international experts in teamwork and communication.
An interview with Dr Kim Holt, Consultant Paediatrician who ‘blew the whistle’ on the Baby P case in Haringey. She also founded Patients First, which is a support group for whistle-blowers.
She discusses her experience and those of other health professionals who have been “whistle-blowers”.
She discusses the need to change the system so that clinical staff feel empowered to speak up.
This moving film recounts the harrowing experiences of the Titcombe family during their son, Joshua’s, tragically short life. The film is based on the testimony of James Titcombe, Joshua’s father and now a National Advisor on Safety for the Care Quality Commission.
This film tells the powerful and hard-hitting story of a tragic incident, in which a simple human and procedural mistake had catastrophic consequences at Doncaster and Bassetlaw Hospitals NHS Foundation Trust.
This website provides a broad range of resources relating to the effective use of emergency manuals to enhance patient safety. Emergency manuals are increasingly being used in a wide range of clinical settings, along with other forms of ‘cognitive aid’ such as checklists.
This slideset from a Patient Safety workshop coordinated by Biomedea gives an introduction to the role of human factors and engineering in medical device malfunction and patient safety. Although some of the technologies mentioned as examples are dated, the principles remain up to date and are well outlined and communicated in this presentation.
An educational approach to improve outcomes in acute kidney injury (AKI): report of a quality improvement project
This project, published in BMJ Quality Improvement Reports, utilises a multifaceted educational intervention to improve awareness of AKI as demonstrated by changes in the clinician's self-reported management of patients with AKI.