Patient Safety, Healthcare Worker Safety: Two sides of the same coin

Ayobola Chike-Michael, Patient Safety Project Manager at the Health Innovation Network (HIN) shares her thoughts on how safe health care workers means safe patients.

Focusing on Healthcare workers

Patient safety is a global health priority that aims to prevent errors and adverse effects to patients associated with health care (WHO, 2020). Exponential medical development has contributed to healthcare becoming more effective and efficient. However, these new technologies, medicines and treatments, also present ‘wicked problems’ that demand unprecedented and multifaceted solutions. The 17 of September every year has been coined as World Patient Safety Day, set to promote patient safety by increasing public awareness and engagement, enhancing global understanding, and working towards solidarity and action.

The theme for this year is ‘Safe health workers, Safe Patients’ placing the spotlight on health care workers. The biggest threat to the world in recent times, particularly this year is Covid-19, a pandemic that turned health care workers worldwide into soldiers fighting at the war front. Covid-19 has so far posed the greatest pressure on health care workers and they have had to face the challenges daily. Most of these issues have always been there, but the pandemic magnified them and demanded more from every health care worker.

Speaking to a friend who has been a nurse for 25 years recently, she recounted how one day at the height of the pandemic, she was kitted up for protection before entering the ‘Covid-19 zone’ at work. She admitted how unprepared she was despite her years of experience.  She had taken one look at the room filled with sick Covid-19 patients on one side and on another noted body bags ready to be filled. In her words, she said, ‘it was really a war, there was no time to make sense of everything going on’. After a couple of hours of caring for sick patients and managing expectations of relatives, she described how she steamed up under the protective personal equipment, dripping uncontrollably with sweat and finally bursting into tears.

Recent research showed that many have also suffered psychological and emotional distress, infections, burnout, uncertainty, moral injury, violence, stigma, depression and even death (WHO 2020 and Only Human report 2020). The pandemic has brought new challenges and new ways of working and we cannot talk about patient safety in 2020 and beyond, without talking about staff safety first.

Nobody should have their safety impacted at work and we certainly cannot look away from the risks presented to health care workers whose place of work this year, has been more like the war front. These workers not only have to provide care through it all, but they also must bear the outcome of their lived experience. They must be looked after well, during and after. A Yoruba proverb says, ‘if you find yourself and your child engulfed in fire, you must dust yourself first before you are able to dust your child’. That is, ‘the instinct in an accident is to protect oneself before the thought of anyone else, even your child.

“Most of these issues have always been there, but the pandemic magnified them and demanded more from every single health care worker.”

The link between patient safety and worker safety

It’s no surprise, therefore, that there is a firm link between patient safety and health worker safety. The safety of both patients and staff are inextricably linked, like two sides of the same coin. They are co-dependent. Staff safety is a prerequisite to patients’ safety. Only a safe health care worker can ensure a safe patient.

Stress is the first culprit that creates burnout among health care workers and has a significant impact on the quality of care given to patients and their overall safety. The top reasons for stress are high workload, long hours, strained interpersonal relationships and lack of teamwork. These and many more cause health care workers to be more prone to errors and experience a decline in their own health. (WHO/IOSH, 2020).

Let us share some other painful facts:

  • Health workers have the highest risk of Covid-19 infections, in fact, 10 per cent of all cases globally are among health workers
  • Between 44 per cent and 83 per cent of nurses in clinical settings in Africa have chronic low back pain
  • Between 17 per cent and 32 per cent of health care workers in high-income countries suffer from occupational burnout
  • Globally, 63 per cent of health workers report experiencing a form of violence at the workplace
  • Medical professions are also at higher risk of suicide in all parts of the world
  • During the Covid-19 pandemic, 23 per cent of front-line health care workers suffered depression and anxiety and 39 per cent suffered insomnia
  • One in three health care workers in high income countries suffer from work-related burnout at the workplace (WHO/IOSH, 2020).

Recommendations for post-covid recovery

Global players such as the United Nations, WHO, International Labour Organisation (ILO) among others have shared some resolutions to take necessary steps to alleviate some of these painful facts at country level. Other organisations are working equally hard regionally and locally. All have committed to scale up efforts to improve and promote healthier and safer workplaces. Further recommendations have also been made to support global advocacy for health care workers’ safety.

A few are:

Part of the journey to recovery from the pandemic is the intentional focus on the safety of health care workers. It is important before, during and after the 17 of September, to promote patient safety particularly by increasing awareness on this year’s focus – health care worker’s safety. No one is excluded in responding to the global call for action to speak up for health care workers safety. It is directed to everyone:  patient, family, carer, health care worker, local and international organisations, policymakers, regulators, administrators, managers, patient representative organisations and academic or research institutions. All hands must be on deck to promote the safety of health workers.

Never again should any health care worker have to work without adequate PPE, never again should any health care worker be overwhelmed with stress, bear the brunt of lack of resources or face avoidable harm for their patients or themselves. As Tedros Adhanom (Director General, WHO) succinctly puts it ‘Together we have a duty to protect those who protect us.’

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Find out more about how the Health Innovation Network supports Patient safety.

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Guidance for Care Homes: Suspected Coronavirus Care Pathway

Guidance for Care Homes: Suspected Coronavirus Care Pathway

The NHS London Out of Hospital Cell, London Clinical Networks, London Directors of Public Health and Adult Social Care, Health Innovation Network and Public Health England have collaborated to provide resources to assist the care and support vulnerable adults receive during Covid-19. 

The practical guidance has been designed to complement, not replace, local guidance and professional judgement. We are actively working on other resources which will be updated to align to national and regional guidelines once published. 

Resources

Advice to Care Homes on Covid-19, please click here.

Care Home resource pack, please click here.

Guide for care homes on saying “goodbye”, please click here.

If you have further questions relating to the above resources, please contact the London Clinical Networks in the first instance by emailing england.london-scn@nhs.net 

Covid-19: Patient Assessment the role of physiology and oximetry

COVID-19: Patient Assessment the role of physiology and oximetry

The assessment of patients who are unwell with Covid-19 or other causes presents a significant challenge for GPs and clinicians working in Primary Care. The Royal College of General Practitioners (RCGP) and the AHSN Network are holding a joint webinar looking at the role of oximetry and other physiology in that assessment.

The webinar will be led by:

  • Dr Jonathan Leach, RCGP Honorary Secretary and Covid Lead
  • Dr Alison Tavaré, Primary Care Clinical Lead at West of England AHSN
  • Dr Simon Stockley, RCGP Lead for Acute Deterioration and Sepsis

Overview of content to be explored:

  • Clinical features of Covid-19
  • Importance of oximetry in Covid
  • Clinical judgement and physiology in Patient assessment
  • Role of NEWS2 in General Practice and Care Homes
  • Remote oximetry in the assessment and management of Covid disease in the community
  • This will be followed by a Q and A session.

The webinar will be held on Wednesday 29 April, 13.30 – 14.30pm and you can register here. The webinar will be recorded and shared afterwards.

New digital innovations tested for vulnerable people during Covid-19 outbreak

New digital innovations tested for vulnerable people during Covid-19 outbreak

Testing starts today as 18 winners of TechForce19 challenge announced

People who are particularly vulnerable or isolated as a result of the coronavirus (Covid-19) outbreak could soon benefit from a range of innovative digital solutions selected as part of the TechForce19 challenge.

NHSX and MHCLG have announced 18 digital solutions that have been awarded funding under the TechForce19 challenge. TechForce19 has awarded up to £25,000 each to innovation that offers a digital way to support vulnerable people who need to stay at home or need other help in the community for extended periods of time. The response to the challenge was extremely strong, with over 1,600 innovations submitted.

The successful solutions will now receive funding to rapidly test their product to meet specific Covid-19 related needs.

This testing phase will last for two to three weeks, and be followed by an assessment to better understand the potential and scope for accelerated deployment at scale, based on evidence.

NHSX has been working with partners PUBLIC and the AHSN Network to run the fast-track competition for innovators, creating a pool of technologies that have the potential to be rapidly scaled regionally and nationally.

Each prospective technology must have the capability to operate on a standalone basis without the need to be integrated with existing health or care systems.

Examples of the solutions going forward include:

  • Feebris for the most vulnerable who are isolating

Feebris helps carers to identify health risks and deterioration within elderly communities. The Feebris app guides a carer through a 10min check-up, including capture of vital signs from connected medical-grade sensors (digital stethoscope, pulse oximeter etc.). Powerful AI augments clinical guidelines and personalised monitoring to help decisions on triaging health issues. The intention is to provide Feebris to care homes to help carers triage the day-to-day health needs of their residents during the Covid-19 pandemic, and also enhance the capabilities of remote clinicians.

  • Neurolove to support young people with mental health

Chanua provides Neurolove.org, a platform providing a friendly ear and human support for young people to help them to keep virtually social and safe online. Supporting young people to manage anxiety and low mood, they can book sessions directly with mentors and therapists and find content that will support them to manage their emotional and mental health in this current period of uncertainty.

  • Peppy for new parents

Peppy helps parents-to-be and new parents remotely access trusted, convenient advice from perinatal and mental health experts. This includes remote support via phone/video with lactation consultants, baby sleep consultants, specialist mental health support and more. Peppy provides timely interventions that reduce stress, anxiety and burn out for parents-to-be and new parents.

  • Team Kinetic for volunteers

TeamKinetic’s digital platform helps organisations better manage community-led volunteer programmes. The solution helps manage recruitment and retention of volunteers, as well as monitoring the impact of these programmes in real time. TeamKinetic are also looking at developing and documenting some open standards and establishing a model for better service interconnectivity across the voluntary sector.

  • Vinehealth for cancer patients

Vinehealth is a mobile app to support cancer patients and their loved ones during treatment by allowing them to easily track and understand their care, including their symptoms, side effects, appointments and medications. By completing a 1-minute daily log, cancer patients can develop a clear overview of their progress through treatment and access advice on how to cope and when to access health services. The Vinehealth app empowers cancer patients who are self-isolating to self-manage and feel more in control.

“The TechForce19 challenge has harnessed some of the incredible talent we have in our tech sector to help the most vulnerable. Many of the problems created by isolation lend themselves to digital solutions, and we hope this process will help people take advantage of the potential that digital technology offers.

“The 18 companies we are announcing today have the potential to help a number of the key affected groups during Covid-19, including young parents, the elderly at home, and the homeless, as well as giving people tools to look after their own mental health during isolation.”

Guy Boersma, Digital & AI Lead, The AHSN Network, said:

“This list of solutions is testament to the talent being harnessed to address the consequences of the Covid-19 crisis. The health and care sector has already seen many solutions being deployed to support vulnerable citizens with mental health needs or other specific conditions, and the pandemic makes it even more necessary that we address the needs of citizens unable to access face-to-face care or even their usual social networks.

We are delighted that we have a series of solutions which can be piloted and then scaled to address these pressing needs.”

Daniel Korski, CEO of PUBLIC, said:

“As social distancing measures continue, today’s selections amount to a wealth of possible answers to helping the most vulnerable through these difficult times.

These companies demonstrate the valuable role for new technologies in helping public services adapt to new challenges, and we’re excited to follow their journeys from here through to deployment.”

For more information about the programme visit Techforce19.uk

Full list of digital innovations:

  1. Feebris for the most vulnerable who are isolating

Feebris helps carers to identify health risks and deterioration within elderly communities. The Feebris app guides a carer through a 10min check-up, including capture of vital signs from connected medical-grade sensors (digital stethoscope, pulse oximeter etc.). Powerful AI augments clinical guidelines and personalised monitoring to help decisions on triaging health issues. The intention is to provide Feebris to care homes to help carers triage the day-to-day health needs of their residents during the Covid-19 pandemic, and also enhance the capabilities of remote clinicians.

  1. Chanua / Neurolove to support young people with mental health

Chanua provides Neurolove.org, a platform providing a friendly ear and human support for young people to help them to keep virtually social and safe online. Supporting young people to manage anxiety and low mood, they can book sessions directly with mentors and therapists and find content that will support them to manage their emotional and mental health in this current period of uncertainty.

  1. Peppy for new parents

Peppy helps parents-to-be and new parents remotely access trusted, convenient advice from perinatal and mental health experts. This includes remote support via phone/video with lactation consultants, baby sleep consultants, specialist mental health support and more. Peppy provides timely interventions that reduce stress, anxiety and burn out for parents-to-be and new parents.

  1. Team Kinetic for volunteers

TeamKinetic’s digital platform helps organisations better manage community-led volunteer programmes. The solution helps manage recruitment and retention of volunteers, as well as monitoring the impact of these programmes in real time. TeamKinetic are also looking at developing and documenting some open standards and establishing a model for better service interconnectivity across the voluntary sector.

  1. Vine Health for cancer patients

Vinehealth is a mobile app to support cancer patients and their loved ones during treatment by allowing them to easily track and understand their care, including their symptoms, side effects, appointments and medications. By completing a 1-minute daily log, cancer patients can develop a clear overview of their progress through treatment and access advice on how to cope and when to access health services. The Vinehealth app empowers cancer patients who are self-isolating to self-manage and feel more in control.

  1. Beam for homeless population

Beam is a digital platform that supports the homeless and vulnerable people sleeping rough. Beam takes referrals from local authorities and homeless charities, then ensures goods are funded, delivered and documented.

  1. Alcuris Ltd

Alcuris’ Memohub® prolongs the independence of elderly or vulnerable people, enabling them to return to home quicker, from hospital discharge. A digital platform collates data from unobtrusive sensors placed in the home, then provides actionable alerts when behaviour changes, enabling families to intervene early to delay or reduce the frequency of professional ‘crisis intervention’ help. This gives family a reassurance of loved one’s safety and wellbeing even when left alone for extended periods. Also provides objective information to inform professional care planning.

  1. Ampersand

Ampersand Health‘s self-management apps help people with long term, immune mediated diseases (such as Crohn’s and Colitis) live happier and healthier lives. Using behavioural and data science, the apps deliver courses and programmes designed to improve sleep quality, stress management and medication adherence; with modules for activity, diet and relationships in the works. During the Covid-19 crisis, this will help these people better manage their conditions and reduce the need for clinical support. Ampersand are also offering their clinical management portal free of charge to NHS Trusts until January 2021, no strings attached. This will allow clinical teams to help manage their patients, remotely.

  1. Aparito

Aparito uses remote monitoring technology (videos, wearables, photos and text) to gather patient-generated data outside of hospital. This is focused on patients with rare diseases. Data is captured and transferred via the patient’s own smartphone / tablet and made available to clinicians or researchers in real-time to help avoid direct contact during the Covid-19 crisis.

  1. Birdie

Birdie provides a digital platform for home care agencies to better manage the care they provide. Through an easy to use app, care workers capture daily visit logs, and a central hub allows staff to track real-time information. Family members receive live and daily safety and well-being updates through the app, including from optional home monitoring sensors. Birdie helps domiciliary care agencies to increase efficiency, and improves the care people receive in their homes through systematic monitoring, prevention of risks, and support to carers.

  1. Buddi

Buddi Connect is a smartphone app, enabling people to stay in touch with those they care for. Safe groups of connections are united through the app to share private, secure messages and raise instant alerts when help is needed. Important messages from the NHS can be shared directly to users. During this difficult time, while many vulnerable people are missing the face-to-face contact of family, friends and carers, the reassurance that help is available at the touch of a button is more important than ever.

  1. Just Checking

Just Checking supplies activity monitoring systems, used by local authorities to help with assessment of older people in their homes, for social care. Sensors pick up activities of daily living and display the data in a 24-hour chart. The company also has a second, more sophisticated activity monitoring system, to help manage the care and support of adults with learning disabilities.

  1. Peopletoo Ltd/ Novoville

Peopletoo and Novoville have been selected to launch GetVolunteering, a volunteering app to fast track volunteers into clinical and non-clinical roles to support the fight against Covid-19. It will enable local authorities to quickly identify and assess capable volunteers in the local community to fill key roles to support social care in areas that have been impacted by loss of staffing capacity due to Covid-19, or for new roles that are required during the crisis.

  1. RIX Research & Media, University of East London

The RIX Multi Me toolkit provides highly accessible and secure social networking that serves as a support network for people with learning disabilities and mental health challenges. This easy to use multimedia network, with accompanying communication, personal-organiser and goal-setting tools, enables isolated and distanced vulnerable people to build stronger support circles. It helps them self-manage their care and actively limit the impact and spread of Covid-19 infection. Care professionals use the ‘Stay Connected’ RIX Multi Me Toolkit to remotely monitor and support people’s wellbeing in an efficient and friendly way.

  1. Simply Do

Simply Do will develop a virtual community of NHS medical professionals currently in self-isolation. These employees have significant expertise, experience and skills which can be unlocked virtually to help solve Covid-19 care challenges set within the platform. This will create a powerful ‘think-tank’ of medical professionals to contribute virtually to fight Covid-19 by solving wider health challenges (i.e. challenges faced in the care sector).

  1. SureCert

SureCert is a digital platform that connects people with job and volunteering opportunities. The system also manages background checks. SureCert can provide data on successful placements, and information to enable policy makers to better understand the labour market and volunteering supply and demand.

  1. VideoVisit Global Ltd

VideoVisit® HOME allows the elderly to communicate with their family members and home care providers through a virtual care tablet designed specifically for elderly. VideoVisit will measure how this virtual home care service can increase people’s feeling of safety and decrease loneliness during self-isolation.

  1. Virti

Virti aims to make experiential education affordable and accessible for everyone. Virtual and augmented reality, coupled with AI, transports users into difficult to access environments and safely assesses them under pressure to improve their performance. The system is used for training and patient education.

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Tech challenge launched to offer digital support during Covid-19 outbreak

Tech challenge launched to offer digital support during COVID-19 outbreak

  • Tech challenge launched to combat effects of social isolation;
  • Innovators urged to find ways to deliver mental health and social care support digitally;
  • £500,000 worth of Government funding available to start work within weeks.

People confined at home because of Coronavirus (Covid-19) could soon benefit from new technology to combat the effects of social isolation.

Funding is being made available by NHSX through ‘Techforce 19’, for innovators who can find digital ways to support those who need help, including people requiring mental health support and those with social care needs.

The technology is intended to support those who may be most affected by the consequences of remaining housebound for long periods of time.

Announcing the fund, Matt Hancock, Secretary of State for Health and Social Care, said:

“If people cannot leave the house, we need to quickly find ways to bring support to them and today I am calling on the strength of our innovative technology sector to take on this challenge. Techforce19 will mobilise the UK’s incredible reservoir of talent to develop simple, accessible tools that can be rolled out quickly and help tackle the effect of social isolation.”

The programme is being launched by NHSX and is being managed by GovTech venture firm PUBLIC and the AHSN Network.

Piers Ricketts, Chair of the AHSN Network, said:

“The AHSN Network is dedicated to furthering successful collaborations between innovators and the health and social care system. Our well-connected teams throughout the country are ready to support NHSX and PUBLIC with this important call out to industry.

I encourage all innovators with a relevant idea, or with existing technology which could be adapted or scaled, to apply to this programme and help support the most vulnerable and isolated during this difficult time.”

In total, there is £500,000 available to bid for – with funding of up to £25,000 per company available to innovators with solutions that could be deployed at scale in the next few weeks. Specifically, the programme is looking for digital solutions that can be deployed quickly, and could include:

  • Providing remote social care;
  • Optimisation of the care and volunteer sector;
  • Messaging and communication;
  • Mental health support – for example through peer communities or self-management tools;
  • Any other solutions to ease pressures on services and people during this time.

Matthew Gould, Chief Executive of NHSX, said:

“Tech can play an important role in helping the country deal with the challenges created by the Coronavirus.  This competition is focussed on the problems created by isolation, which lend themselves to digital solutions. It will allow NHSX to accelerate the development of those solutions, so within weeks they can help those in isolation suffering from loneliness, mental health issues and other problems.”

The Government has strongly advised everyone in the country – but especially those aged 70 or over, people with underlying medical conditions or pregnant women – to reduce social interaction to help minimise the spread of the virus. Those considered most at risk of having serious complications from the virus – for instance people receiving treatment for cancer – have also been asked to stay at home for 12 weeks as part of efforts to ‘shield’ them from the virus.”

Techforce19 is a new challenge, open to innovative tech companies in this country who will compete to develop accessible digital tools to support people who are staying at home over the coming weeks and months.

For more information on the programme and how to apply, visit Techforce19.uk.

Recruitment for innovators taking part in the challenge programme opens today, Monday 23 March. The closing date for applications is 1 April 2020.

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How is the AHSN Network supporting the response to Covid-19?

Map of the AHSNs

How is the AHSN Network supporting the response to COVID-19?

All AHSNs within the AHSN Network are actively supporting the NHS and social care system regarding the Covid-19 pandemic.

If you would like advice on immediate or future needs, and how best to present your offer to local and/ or national commissioners, please contact the commercial team at your local AHSN via the AHSN Network Innovation Exchange or register online. Use the postcode checker to help you find your local AHSN.

The government has provided national guidance on where to register products to support the Covid-19 response. Please find these details below.

PPE (Personal Protection Equipment)

Contact the Surgical MedTech Co-operative (one of NIHR’s Medtech and In vitro diagnostics Co-operatives) if you have a technology that could be adapted quickly for the healthcare setting to help protect healthcare workers against aerosol contamination. Find out more about their ‘Covid-19 PPE Challenge’ here.

 Vaccines

Contact Public Health England: nervtag@phe.gov.uk

 Ventilators

Contact the Government’s Department for Business, Energy & Industrial Strategy (BEIS): ventilator.support@beis.gov.uk or call 0300 456 3565

 Innovation and Tech

Contact NHSX: DNHSX@nhsx.nhs.uk

 Diagnostics

Contact Public Health England: coviddiagnostics@phe.gov.uk

General

The UK government has set up a service allowing businesses to share any support that might help the Covid-19 response, from PPE and medical testing equipment to transport/logistics and warehouse space. Find out more here.

If you have any other solutions (not specifically Covid-19 related) that could be useful to the health and care system during this unprecedented time, you can access AHSN advice and support by visiting www.ahsninnovationexchange.co.uk.