System learning from major incidents is essential for enhancing preparedness for responding to future adverse events. Sharing learning not only stimulates further improvements, preventing the repetition of mistakes, but may also promote collaboration and the adoption of evidenced-based best practises. As part of a qualitative interview study designed to explore lessons learned, this paper describes the experiences and perspectives of 30 staff from the public health agency responsible for the national COVID-19 response in the United Kingdom.
View Article and Find Full Text PDFSimulation plays a pivotal role in addressing universal healthcare challenges, reducing education inequities, and improving mortality, morbidity and patient experiences. It enhances healthcare processes and systems, contributing significantly to the development of a safety culture within organizations. It has proven to be cost-effective and successful in enhancing team performance, fostering workforce resilience and improving patient outcomes.
View Article and Find Full Text PDFThe simulation community has effectively responded to calls for a more direct contribution by simulation to healthcare quality and safety, and clearer alignment with health service priorities, but the conceptual framing of this contribution has been vague. The term 'translational simulation' was proposed in 2017 as a "functional term for how simulation may be connected directly with health service priorities and patient outcomes, through interventional and diagnostic functions" (Brazil V. Adv Simul.
View Article and Find Full Text PDFThe effectiveness of healthcare depends on successful teamwork. Current understanding of teamwork in healthcare is limited due to the complexity of the context, variety of team structures, and unique demands of healthcare work. This qualitative study aimed to identify different types of healthcare teams based on their structure, membership, and function.
View Article and Find Full Text PDFBackground: Communication is a core element of dietetic practice, and although communication skills are a prominent feature of dietetic curricula, research suggests a need for more consistent approaches. The evidence on how communication skills are taught and assessed in dietetics has not been synthesised leaving uncertainty about best practice. This scoping review aimed to examine and map the research literature relating to the teaching and assessment of communication skills in dietetics.
View Article and Find Full Text PDFBackground: Communication skills are a cornerstone of practice for dietitians. The field of dietetics is evolving and there is a need to synthesize the available literature on communication skills to improve the effectiveness of patient consultations and inform practitioner development.
Objective: This scoping review aimed to identify the research literature relating to communication skills used in dietetics practice and perceptions and experiences of dietetics students, dietitians, and patients regarding communication skills.
Background: Providing optimal care for critically ill patients is an extremely important but also highly demanding task, both emotionally and physically. The "ICU Support" team meeting concept aims to support intensive care unit (ICU) teams by promoting interprofessional communication, peer support, and patient safety by providing a structure for daily team meetings. This protocol describes a study to explore the effectiveness of "ICU Support" for patient- and staff-centered outcomes.
View Article and Find Full Text PDFStatement: There continues to be a lack of detailed understanding of how debriefing works and how it enables learning. To further our understanding and simultaneously illuminate current knowledge, a metaethnographic qualitative synthesis was undertaken to address the research question: how are interactions in simulation debriefing related to participant learning? Ten databases were searched (up to November 2020) and 17 articles were selected for inclusion. Initial interpretive synthesis generated 37 new concepts that were further synthesized to produce a new theoretical framework.
View Article and Find Full Text PDFBackground: Resilient Healthcare research centres on understanding and improving quality and safety in healthcare. The Concepts for Applying Resilience Engineering (CARE) model highlights the relationships between demand, capacity, work-as-done, work-as-imagined, and outcomes, all of which are central aspects of Resilient Healthcare theory. However, detailed descriptions of the nature of misalignments and the mechanisms used to adapt to them are still unknown.
View Article and Find Full Text PDFBackground: The coronavirus pandemic continues to shake the embedded structures of traditional in-person education across all learning levels and across the globe. In healthcare simulation, the pandemic tested the innovative and technological capabilities of simulation programs, educators, operations staff, and administration. This study aimed to answer the question: What is the state of distance simulation practice in 2021?
Methods: This was an IRB-approved, 34-item open survey for any profession involved in healthcare simulation disseminated widely and internationally in seven languages from January 14, 2021, to March 3, 2021.
Healthcare workers must balance competing priorities to deliver high-quality patient care. Rasmussen's Dynamic Safety Model proposed three factors that organisations must balance to maintain acceptable performance, but there has been little empirical exploration of these ideas, and little is known about the risk trade-offs workers make in practice. The aim of this study was to investigate the different pressures that healthcare workers experience, what risk trade-off decisions they make in response to pressures, and to analyse the implications for quality and safety.
View Article and Find Full Text PDFBackground: In the simulation community, colleagues who are no longer clinically practicing were often proximal to the COVID-19 response, not working in the frontlines of patient care. At the same time, their work as simulationists changed dramatically or was halted. This research explored the experiences of those simulationists who have clinical backgrounds but did not provide direct patient care during the initial pandemic response.
View Article and Find Full Text PDFEur J Psychotraumatol
March 2022
Background: Responding to a mass casualty event can cause significant distress, even for highly trained medical and emergency services personnel.
Objective: The purpose of the study was to understand more about first responders' perspectives about their participation in major incident responses, specifically how and which individual and system factors contributed to their preparedness or may have enabled or hindered their response. The aim of the work was to improve preparedness and response for future incidents.
Objectives: To identify the patterns of teamwork displayed by interprofessional teams during simulated management of medical deterioration in pregnancy and examine whether and how they are related to clinical performance in simulated practice.
Design: Exploratory observational cohort study.
Setting: Interprofessional clinical simulation training with scenarios involving the management of medical deterioration in pregnant women.
Objective: This scoping review aims to examine and map the evidence regarding communication skills in dietetic practice and the education strategies used to develop them. Specifically, the review will address usage in practice, perceptions, and experiences, as well as the teaching and assessment of communication skills in student dietitians and dietitians.
Introduction: Communication skills are a key element of practice for dietitians.
Objectives: To explore and explain success and limiting factors in UK health service innovation.
Design: Mixed methods evaluation of a series of health service innovations involving a survey and interviews, with theory-generating analysis.
Setting: The research explored innovations supported by one of the UK's Academic Health Science Networks which provides small grants, awards and structural support to health service innovators including clinical academics, health and social care professionals and third-sector organisations.
J Health Serv Res Policy
July 2021
Health care teamwork is a vital part of clinical work and patient care but is poorly understood. Despite poor teamwork being cited as a major contributory factor to adverse events, we lack vital knowledge about how teamwork can be improved. Teams in health care are diverse in structure and purpose, and most patient care depends on the ability of different professionals to coordinate their actions.
View Article and Find Full Text PDFSimulation exercises are an important part of emergency preparedness activities for the healthcare community but evidence of their impact on the response to real major incidents is limited. This project studied the impact of health emergency preparedness exercises (HEPEs) on the response to a mass casualty terrorist incident. The mixed methods study design was adopted comprising an on-line survey and follow up individual interviews.
View Article and Find Full Text PDFIntroduction: System learning from major incidents is a crucial element of improving preparedness for response to any future incidents. Sharing good practice and limitations stimulates further actions to improve preparedness and prevents duplicating mistakes.
Methods: This convergent parallel mixed methods study comprises data from responses to an online survey and individual interviews with healthcare staff who took part in the responses to three terrorist incidents in the UK in 2017 (Westminster Bridge attack, Manchester Arena Bombing and London Bridge attack) to understand limitations in the response and share good practices.
J Contin Educ Health Prof
June 2020
The rise of academic clinical education programs underlines the growing influence of faculty development on how health care is taught and therefore practiced. Research to date has outlined the rapid rise of these postgraduate qualifications and their impact on their graduates' professional identities. Given the scale and nature of the change, it is worth considering these programs from a broader perspective.
View Article and Find Full Text PDFObjective: Effective teamwork is critical to patient safety across multiple healthcare settings. However, current observational tools assessing teamwork performance tend to be developed for specific settings or tasks and do not capture temporal features of interaction. This study aimed to develop a valid and reliable observational teamwork behaviour framework, which is based on healthcare practice, applicable across a variety of healthcare contexts and can be used to capture temporal team dynamics.
View Article and Find Full Text PDFBackground: As clinical simulation has evolved, it is increasingly used to educate staff who work in healthcare contexts (e.g. hospital administrators) or frequently encounter clinical populations as part of their work (e.
View Article and Find Full Text PDFAm J Disaster Med
December 2018
Objective: To review and analyze evaluation methods currently utilized in health emergency preparedness exercises (HEPE).
Design: This study, part of a larger scoping review that systematically collected and reviewed published evidence related to the benefits of HEPE, provides a further analysis of the evaluation methods utilized in such exercises. We separately analyzed discussion-based and operation-based exercises according to their purpose.