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02/17/2020 - 11:04pm

Whatever the Ministry finds in his weekly blood samples they will never share, but we’ve shared a room for the few years my little brother has been alive, and if his uneasy breathing worsened or improved I would notice at once. The health drone’s visits are neither for him nor for us. His blood is for the epidemiological surveillance network - a stream in the red delta of hundreds of other kids with weak immune systems.

“Sleep well, little hero,” I whisper towards his bed, quietly enough not to wake him, loud enough that our phones will hear. I think I do a good job of keeping my bitterness from the software snitches, and hope this might help balance the way Mom had to pry him from my Dad’s arms last morning so he could leave the apartment. They know enough to keep their arguments silent, but are too old-fashioned not to do dangerous things in front of the TV....

02/17/2020 - 11:04pm
Ce texte est une contribution de l’AFT adressée à la Commission Française pour l’UNESCO dans le cadre de son projet “Penser le Transhumanisme (2018-2021)”*.
02/17/2020 - 6:44pm

by Julia Knopes, Ph.D.

Recently, the National Board of Medical Examiners (NBME) announced that the USMLE Step 1 exam for medical students will change its score reporting from a numeric score to pass/fail as of 2022. This news signals a substantial shift for medical education in North America and in particular the United States, as numeric Step 1 scores have been traditionally used to screen the most competitive applicants for physician residency programs. My hope is that the change in Step 1 scoring may lead to more holistic residency applications, as well as reduced medical student burnout when facing these life-altering exam scores.…

02/17/2020 - 7:00am

By John Tingle

There is always a lot happening with patient safety in the NHS (National Health Service) in England. Sadly, all too often patient safety crises events occur. The NHS is also no sloth when it comes to the production of patient safety policies, reports, and publications. These generally provide excellent information and are very well researched and produced. Unfortunately, some of these can be seen to falter at the NHS local hospital implementation stage and some reports get parked or forgotten. This is evident from the failure of the NHS to develop an ingrained patient safety culture over the years. Some patient safety progress has been made, but not enough when the history of NHS policy making in the area is analysed.

Lessons going unlearnt from previous patient safety event crises is also an acute problem. Patient safety events seem to repeat themselves with the same attendant issues

NHS Patient Safety News

Recently the media spotlight has been turned yet again on some poor NHS care practices in maternity care. On a positive note, the new national NHS patient safety syllabus, draft 1.0 has been published.

Maternity Care Patient Safety Failings

Lintern, S. in the Independent newspaper reports that they have learned of dozens of deaths at East Kent Hospitals with more than 130 babies suffering brain damage as a result of being starved of oxygen during their birth over a four -year period.

“Warning in 2016 that lives were at risk because consultants were not showing up for weekend and evening shifts”.

This maternity crisis follows the recent one being investigated in Shrewsbury and Telford where BBC news had the banner headline stating:

“Shrewsbury and Telford Hospital: Babies and mums died ‘amid toxic culture”.

Boseley, S. states in the Guardian newspaper:

“Some women claim that they are being denied epidurals because of what the Sunday Telegraph says is “a cult of natural childbirth” in six hospital trusts. Several claimed they were told they were either insufficiently dilated or too far dilated to have an epidural.”

Unlearnt lessons

It is clear following on from the very serious patient safety failings chronicled by Kirkup in 2015 in the Morecambe Bay maternity care inquiry report that patient safety lessons still need to be learned in the NHS in this care area.

A national NHS patient safety syllabus: draft published

A fundamental pre-requisite to developing an ingrained patient safety culture in the NHS is to provide education and training in the subject to all staff. A national patient safety syllabus was heralded in the new NHS Patient Safety Strategy. The first iteration of it has recently been published by AOMRC (Academy of Medical Royal Colleges). It is described as the first NHS-wide patient safety syllabus and that it is applicable to all staff. It provides a common language and patient safety framework. Incident reporting and investigation is included along with other content such as creating a safety culture, human factors, and proactive risk management:

“The syllabus is based on a systems approach to human factors. It is holistic in its use of human factors, both system-and person based” (P5).

Don’t forget and about health law and ethics

In implementing and teaching the new syllabus, the study of health care law and ethics should not be neglected as these subjects permeate through many patient safety issues. The new syllabus is to be welcomed; it has the potential to positively galvanize NHS staff action and learning in patient safety.

A key issue will be how well the various sections of the NHS respond to, resource, and teach the syllabus in a cash strapped NHS. There are also dangers with a systems approach to patient safety, which can possibly work to deflect or obscure the personal, professional accountability of NHS staff for error. We always do need to promote the fact that nurses and doctors also owe individual, professional, legal duties to patients which they cannot detract from.

 

 

The post The NHS In England: Patient Safety News Roundup appeared first on Bill of Health.

02/17/2020 - 3:30am

Watch this 25-minute film of a patient who does VSED.

"My outspoken mother insisted I film our family as we navigated this fraught process together. My brother and I cared for her round the clock during the ten days it took her to die at home. We then washed her body, set her hair, and, from YouTube videos, figured out how to keep her mouth and eyelids closed (a strip of cloth and a bag of rice). We then laid her into a coffin we’d built a few weeks before, which her granddaughter painted with unicorns, sunflowers and a giant smiley face. In helping her die, we continued a conversation about death we’ve been having for decades."...

02/16/2020 - 11:27am

Join me on Wednesday, February 19, 2020, for a C-TAC webinar, "Leveraging Video Technology to Enhance Patient Safety and Deliver Concordant Care."

Advance care planning conversations are the first step in ensuring that people communicate their preferences and goals of care, but how can we make sure that those wishes are understood and honored? ...

02/16/2020 - 11:27am

Join me on Wednesday, February 19, 2020, for a C-TAC webinar, "Leveraging Video Technology to Enhance Patient Safety and Deliver Concordant Care."

My talk is based on my forthcoming article: "Video Advance Directives: Growth and Benefits of Audiovisual Recording." This will be in a symposium issue of the SMU Law Review celebrating the 30th anniversary of Cruzan.

Advance care planning conversations are the first step in ensuring that people communicate their preferences and goals of care, but how can we make sure that those wishes are understood and honored? 

TRIAD VIII was the first evidence-based study to evaluate how Scripted Patient To Clinician Video messaging can allow clinicians to hear what matters most to a patient straight from the patient’s mouth, even when a medical crisis renders them unable to speak for themselves. MIDEO®, a state of the art ACP platform, utilizes ID cards and medallions that connects to a video recording in seconds, which patients can state their care preferences. MIDEO is leading this charge in this space as a patient safety tool to prove goal concordant care.

During this webinar, MIDEO® creator Ferdinando Mirarchi, D.O, and legal & ethical experts will discuss how technology can play a role in ensuring that patient wishes are heard and honored.

Speakers:
• Ferdinando Mirarchi, D.O., Creator, MIDEO®, Founder, Institute on Healthcare Directives
• Charles Sabatino, JD, Director, Commission on Law and Aging, American Bar Association
• Thaddeus Pope, JD, PhD, Director, Health Law Institute at Mitchell Hamline School of Law
• Paul Malley, President, Aging with Dignity (Moderator)


02/15/2020 - 11:31am

NCCMAID has been valuable. I have had the opportunity to meet both prescribing and consulting physicians from almost every state where it is available. I got a chance to catch up with leading Canadian clinicians like Stephanie Green and Ellen Wiebe.

...

02/15/2020 - 11:31am

NCCMAID has been valuable. I have had the opportunity to meet both prescribing and consulting physicians from almost every state where it is available. I got a chance to catch up with leading Canadian clinicians like Stephanie Green and Ellen Wiebe.

...

02/14/2020 - 7:00am

By: Leslie E. Wolf, JD, MPH, Georgia State University College of Law, Interim Dean and Distinguished University Professor and Laura M. Beskow, MPH, PhD, Ann Geddes Stahlman Chair in Medical Ethics, Center for Biomedical Ethics and Society, Vanderbilt University Medical Center

In our article, Genomic databases, subpoenas, and Certificates of Confidentiality, published in Genetics in Medicine, the official journal of the American College of Medical Genetics and Genomics (ACMG), we considered the protections available to research genomic databases in light of law enforcement’s use of ancestry databases to help solve crimes.

The arrest of the notorious Golden State Killer, who allegedly is responsible for dozens of rapes and a dozen murders over decades, brought law enforcement’s use of ancestry databases to public attention. In that case, law enforcement uploaded crime scene DNA to identify relatives of the suspect. This information ultimately helped them to identify and gather evidence against the suspect, Joseph James DeAngelo. Since then, numerous cold cases have since been solved using similar techniques.

Law enforcement’s use of commercial ancestry databases for solving crimes has not been without controversy. Individual decisions to obtain and share DNA profiles have implications for relatives; research has suggested that a majority of Americans of European descent can be identified through such sites, even if they have not submitted their own DNA. As concerns have arisen, some ancestry databases are seeking to assure consumers that they will not share their DNA with law enforcement unless they agree. In addition, the U.S. Department of Justice recently adopted an interim policy that limits use of ancestry databases by its agencies or those it funds.

Company attempts to protect users’ confidentiality may be unsuccessful. In July, a Florida judge issued a warrant enabling a police officer to access GEDMatch’s genomic profiles, regardless of individuals’ stated preferences. The impact of this case is, as yet, unclear, but suggests law enforcement will continue to seek access to such data. Accordingly, those running large-scale genomic research studies should pay attention to these cases and be prepared to use the Certificates of Confidentiality that are now automatically issued to NIH-funded research databases – and may be granted upon application to other research databases – to protect participants’ data. Although, as we outlined in our article, there are some uncertainties about the Certificates’ protections, research databases at least have this option; non-research databases do not have these kinds of legal protections.

The post DNA databases, cracking crimes, and confidentiality appeared first on Bill of Health.