Online: Hodges' model in Safety presentation

Later this week I've an online presentation to deliver. The brief is to introduce Hodges' model and relate the model to the matter of safety - some thoughts ...

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

PATIENT safety Task: Attention - Concentration Rest - Sleep psychological environment - safety to ERR is human HUMAN as weakest link risk to SELF Cognitive support - lists, names, informational analysis of environment Critical thinking Situational awareness Therapeutic - OBSERVATIONS ethics- video surveillance

PATIENT - PROCESS safety  - e.g. diagnosis, handover physical safety: 1st law 1st aid. SELF-harm : SELF-neglect Assessments, Plan, Evaluation environment:safety, construction, buildings occupational/disciplinary safety Comms - Information theory  safety as security: lone working signals - alarms, protocols medical safety: medicines, devices risk reduction - management Human factors Human- Computer/Tech/AI Interaction Research - Records Interfaces Public Health Safety: Food, Pollution

risk to others stereotypes - assumptions risk from others - bullying social media teamwork: simulation PRACTICE safety

Law - Health & Safety Reporting - Statistics Transparency Mandatory Training / Learning Whistleblowing safety standards ISO safety organisations The Learning Organisation Other sectors e.g. Aviation, Formula 1 ... Risk of 'groupthink'

 Is it a risk to assume parity of estem in patient safety? What of 'a' patient's safety?

safety
https://hodges-model.blogspot.com/search?q=safety

Textbook of Patient Safety and Clinical Risk Management

Textbook of Patient Safety
and Clinical Risk Management

About this (open access) book

Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems.

The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. 

This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties.

https://link.springer.com/book/10.1007%2F978-3-030-59403-9#about 

My source: HIFA - https://www.hifa.org/

"The complexity of many safety-critical systems makes an a priori analysis of possible system failures and human errors impossible and unreliable. Despite this, it is considered useful to apply this type of healthcare technique to promote reflection among frontline operators before introducing technical or organizational innovation. For example, before introducing a new procedure, it is useful to reflect on the possible, critical aspects of the different phases of the procedure, or, in the case of technological innovation, back-up solutions can be prepared to deal with any malfunctions of the instrument." p.139.

"The role of non-technical skills for patient safety has progressively become more evident through the years and, on this topic, one of the most striking moments of reflection for the healthcare community was Martin Bromiley’s report [10] on the death of his wife in 2005. Fixation errors, absence of  planification, teamwork breakdown, poor communication, unclear leadership, lack of situational awareness, and other non-technical aspects of performance in anesthesiology and critical care medicine can negatively impact patient outcome." p.161.

"In other words, HFE [Human Factors and Eronomics] takes a systems approach that acknowledges the importance of context, emergence and holism in elucidating interactions between various system elements and developing this understanding requires being embedded in the system." p.151.

 W2tQ: safety

 

World Patient Safety Day 2026

World Patient Safety Day calls for global solidarity and concerted action by all countries and international partners to improve patient safety.

The Day brings together patients, families, caregivers, communities, health workers, health care leaders and policy-makers to show their commitment to patient safety.

The resolution WHA 72.6 ‘Global action on patient safety’ recognizes patient safety as a global health priority and endorses the establishment of World Patient Safety Day to be observed annually on 17 September. ...

Source:  https://www.who.int/campaigns/world-patient-safety-day

14-20 March - Patient Safety Awareness Week

Next week 14-20 March is Patient Safety Awareness Week. 

Further information here:

http://www.ihi.org/Engage/Initiatives/Patient-Safety-Awareness-Week/Pages/default.aspx

​​​​​​​​​​​​About the Initiative

Patient Safety Awareness Week is an annual recognition event intended to encourage everyone to learn more about health care safety. During this week, IHI seeks to advance important discussions locally and globally, and inspire action to improve the safety of the health care system — for patients and the workforce.

Patient Safety Awareness Week serves as a dedicated time and platform for growing awareness about patient safety and recognizing the work already being done...

--

 

[See link above for events - webinars.. PJ]

My source:

 

Neil Pakenham-Walsh, HIFA Coordinator, neil AT hifa.org www.hifa.org

HIFA: Healthcare Information For All: www.hifa.org

A "science for safety": getting the formula - and the grid right

The grid holds great fascination for me.

TRON LEGACY

It didn't start with The Grid in TRON, nor obviously TRON Legacy - even though the realisation is superb.

No, the first grid was in the cobbled back alley at my grandparent's house in St Helens. As a kid staying over in the summer I would take a spoon and the melting tar between the cobblestones was a syrupy invitation.

I must have got in trouble, as spoons were lost down the 'grid'.

In the here and now the "science for safety" report^* bears further consideration:

If healthcare is to significantly reduce patient harm, a holistic perspective is necessary to capture the requirements and needs related to the culture, workflow, and technology associated with caring for patients. In this paper, we relate the problem to other industries and how these industries have addressed safety. We identify the current gaps in today’s healthcare approach and describe the actions that can be taken, and the change in mental models that must be made by the global healthcare community, to continuously improve patient safety. p.3 [my emphasis]

The Formula 1 season beckons. The cars tested to the max are still to be tested in anger. They will soon, be ready - on the starting grid.

The "science for safety"
also needs a starting grid.

A conceptual framework recognisable and relevant to all.


^*Transforming Patient Safety: A Sector-Wide Systems Approach
Peter J Pronovost, Alan D Ravitz, Robert A Stoll, Susan B Kenned
https://www.imperial.ac.uk/media/imperial-college/institute-of-global-health-innovation/public/Patient-safety.pdf 

See also: How do you Balance and Elevate Holism and Patient Safety?

Image source:
https://www.artofvfx.com/tron-legacy-chris-harvey-superviseur-vfx-prime-focus/

AI, Nursing, Safety and presentation - 1st Aug 2-3pm

Hodges' model was not created primarily as a safety tool. It cannot claim to achieve or adhere to an ISO standard. ISO 45001 - health and safety management standard, for example. There is however a relation to clinical risk across healthcare professions, disciplines and clinical fields, including community and public (mental) health. To which of course we must now add planetary health. That said, the question of ISO safety and quality standards for Hodges' model has not been assessed. What exactly would certification entail? Would this process be appropriate for what is a generic - foundational tool?

What this means, however, is that as a situated model for reflection, reflective practice and critical thinking Hodges' model constitutes a deliberative step in the right (formal) direction. As noted previously, in template form, Hodges' model acknowledges the initial personal, professional and organisational standards that (must) shape our clinical encounters. That is, if assessed (as students - and our peers clearly are, and you would expect to be), unconditional positive regard would be observed, supported by the required standards of professional behaviour. 

There is another step here. The ethical and legal edict of 'do no harm' must also be central to care delivery, outcomes and evaluation. So from the outset, implicit in Hodges' model is the (NON-LEGAL) statement:

You, the practitioner - agent (student - and your mentor/supervisor) will not knowingly, or through professional ignorance, or neglect  cause physical, psychological, social (cultural), political (power), or spiritual harm to the patient - subject (or their carer - guardian/proxy).

There is no escape from AI and Large Language Models as I noticed in FTWeekend:

'Jilin University Hospital in the eastern city of Changchun has rolled out a diagnostic tool it claims can produce treatment plans through DeepSeek consulting the hospital's database, medical guidelines and drug efficacy results. Jinxin Women and Children's Hospital in south-western China said it had a tool for patients to track their ovulation cycles, with test results combined with the hospital's patient data to produce personalised fertility plans.

One doctor at public hospital in Hubei province in central China said the institution's leadership had issued a directive that DeepSeek should be used as a third-party arbiter if two doctors have differing views on treatment.

 
There have been rollouts in public hospitals in Chengdu, Hangzhou and Wuhan for less complex applications, such as digital nurses directing patients to the right consulting room or explaining complicated medical reports.

 
Several industry insiders warned against taking all the announcements at face value, as some companies were trying to capture investor enthusiasm around DeepSeek without meaningfully deploying its models. Meanwhile, government bodies are also under political pressure to be seen as aligned with China's AI darling.

 
The SOE tech supplier said "much work still needs to be done to make these models useful" for more complex work such as medical diagnosis. "It must be trained on enough medical data to produce good results. This will take time and needs collaboration from leading AI companies. It is not something hospitals can buld on their own."

Another doctor described a move to deploy DeepSeek last week at a hospital in eastern Zhejiang as a "publicity stunt".

Even if some announcements should be treated with scepticism, experts say the willingness to test out its models still marks a step change.'

Edited for formatting, some text is emphasised. A vast array of conditions can be substituted (parametrised) for 'fertility'. While nursing is mentioned there is little on testing, but for 'plans' we can read nursing assessment, plans, and evaluations. 

Returning to safety. Following an online chat yesterday, I've an online presentation to the Patient Safety Management Network [Patient Safety Hub] pencilled in for 1st August 2-3pm. Comprised of 40 minutes with questions following - I will, as discussed - focus upon:

• Introduction to the model
• How it can be applied in different situations – safety/risk/improvement
• Examples of its use

This is progress - a step to develop Hodges' model and reveal the limits of the bio-psycho-social model.

^soe - state-owned enterprises.

Olcott, E., Ding, W. AI challenger DeepSeek spreads rapidly across China with the blessing of Beijing, FTWeekend, 1-2 March, 2025. p.13.

"No safety without emotional safety" by Veale, et al. (2022)

 INDIVIDUAL
|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

psychological needs (risk) inc. threat processing - treatment of interpersonal violence 'therapeutic emotional safety (re-traumatisation) control behaviour severe panic with flashbacks, dissociation, and visual hallucinations	physical needs (RISK) 'low intensity touch' environment' ... tepee - in room my safe space physical safety (safe room) to increase physical safety privacy, lighting, doors, window
lived experience family - relationship experience (touch) 'atmosphere'? change in culture, positive risk-taking person-centredness, family orientation in 'team' Leadership 'therapeutic community' Open Dialogue	CONTROL: 'take away' - autonomy, responsibility policies - abuse risk, 'protect' patients and staff regulatory reform in-patient care, pets - policy parity of esteem Access (still) to therapies, CBT Institutional risk Alternative protocols

David Veale, Eleanor Robins, Alex B Thomson, Paul Gilbert, No safety without emotional safety, The Lancet Psychiatry, 2022, ISSN 2215-0366, https://doi.org/10.1016/S2215-0366(22)00373-X. (https://www.sciencedirect.com/science/article/pii/S221503662200373X)

My source:
https://twitter.com/tadhg50/status/1596901626765529091?s=20&t=FJe9qpYUrxHN2yxWEWLUdQ

The purposes of Hodges' model is to identify the concepts that have salience clinically, to the person, be they - patient, carer, student ... and then to integrate care, to draw the care domains together into a 'whole'.

Four original purposes of Hodges' model: 

1. Reflection, reflective practice, critical thinking
2. Person-centred care
3. Holistic - integrated care
4. Bridge the Theory - Practice gap

How do you Balance and Elevate Holism and Patient Safety?

We have tended to focus on problems in isolation, one harm at a time, and our efforts have been simplistic and myopic.

To significantly reduce patient harm, we need to adopt a holistic, systematic approach that extends across cultural, technological and procedural boundaries - one that is based on the evidence of what works.
...
Taking its lead from developments in highway and airline safety, the report^* argues in favour of a holistic approach, integrated systems, comprehensive risk assessment and performance reporting, regulation and the creation of a "science for safety".
Darzi (2015).

What instruments does a "science for safety" need?

How can we balance procedure, patients, practice, drug delivery connections, cost, staffing and technology... How can we elevate care, competency, compassion, communication, commitment, courage and values between individual and group levels?

Having agreed and identified the essential sources of evidence (humanistic and mechanistic), how can we integrate them?

Ara Darzi (2015) Patient safety needs to be improved. Health Service Journal, 13 February. 125: 6434, p.18.

^*Transforming Patient Safety: A Sector-Wide Systems Approach
Peter J Pronovost, Alan D Ravitz, Robert A Stoll, Susan B Kennedy
https://www.imperial.ac.uk/media/imperial-college/institute-of-global-health-innovation/public/Patient-safety.pdf

RCN Congress 2026 & RCN North West Multicultural Group (NWMG)

England's North West is certainly in the news at present, on two counts:

1. The current Labour party machinations in the Makerfield ward;
2. and RCN Congress in Liverpool.

 As I attend Congress a key focus is the debates and how I can relate these to Hodges'model - (with some links to previous posts):

1. Nursing as a STEM profession
Matter for discussion submitted by the Eastern Board
That this meeting of RCN Congress discusses the recognition of nursing as a STEM (Science, Technology, Engineering, and Mathematics) profession, valuing the scientific, technical and analytical expertise of nurses.

STEM - science : technology : engineering : mathematics

2. Safe, ethical, person‑centred nursing
Resolution submitted by the Cheshire Branch
That this meeting of RCN Congress calls on RCN Council to urgently develop and implement a UK‑wide framework for realistic person‑centred care, ensuring that nursing practice is safe and ethical.

safe : ethics : person-centred 

3. Regular redeployment
Matter for discussion submitted by the Wiltshire Branch
That this meeting of RCN Congress discusses the impact of the daily redeployment of nursing staff on morale, team work and patient safety.

re- deployment

4. Unpaid hours
Matter for discussion submitted by the North East London Inner Branch
That this meeting of RCN Congress discusses the culture of nursing staff missing breaks and working beyond their contracted hours.

work

5. National safety standards for lone working
Resolution submitted by the Health and Safety Reps Committee
That this meeting of RCN Congress calls on RCN Council to lobby for the implementation of national safety standards for lone working, ensuring access to appropriate safety equipment, technology and protocols to protect staff across all care settings.

lone working

6. Accountable, compassionate and psychologically safe leadership
Matter for discussion submitted by the Cheshire Branch
That this meeting of RCN Congress discusses how the RCN can help create a culture where accountability, compassion, and psychological safety coexist, enabling managers to lead effectively while ensuring all staff feel respected and protected.

accountability : compassion : leadership 

7. Misinformation in health care
Matter for discussion submitted by the Women's Health Forum
That this meeting of RCN Congress discusses misinformation in health care and the impact this has on the nursing workforce.

misinformation : information disorder

8. Confidence to address racism
Matter for discussion submitted by the South West London Outer Branch
That this meeting of RCN Congress discusses how to build the confidence of nursing staff in addressing racism.

confidence : racism

Once again the North West Multicultural Group will have a stand:

The RCN North West Multicultural Group (NWMG) creates a community for members across the region from multicultural ethnic backgrounds to connect with each other, share their lived experience, knowledge and diverse ideas that help drive change around racism to ensure that their various organisations is the best place to work.

Membership is open to RCN members of Royal College of Nursing from multicultural backgrounds and their allies.

Mission statement: 

The aim of the North West Multicultural Group is to stand against racism and discrimination by using members lived experiences, encouraging organisations to be anti-racist and with the support of allies.  

Aims and objectives: 

• To raise the issues around race, discrimination and equality in the workplace and to find potential solutions. 
• To challenge misconceptions about people from different ethnic backgrounds.
• To recognise the skills and contribution to care for people from all backgrounds make.
• To acknowledge that racism is a social construct that needs to be eradicated together.  Together we are stronger.
• To be a platform for black, Asian and minority ethnic staff and allies to work collaboratively to address racism in practice.
• To help amplify the voice black, Asian and minority ethnic staff.
• To be role models, set examples as allies and develop confidence.
• To provide training and support about anti-racist practice.
• To work with the RCN to support campaigns to make sure communication is fit for purpose and acknowledges any cultural differences. 

Your executive team:

Chair: Olanike Babalola
Vice Chair: Susan Owen-Naz
Communications Officer: Mark Anthony

9. Advanced nursing practice
Resolution submitted by RCN Council
That this meeting of RCN Congress agrees that the RCN will act upon attempts to undermine advanced nursing practice.

advanced : practice : theory

10. Protecting nurse education
Resolution submitted by the Education Forum
That this meeting of RCN Congress asks RCN Council to lobby UK governments to protect nurse education from university sector economic pressures.

protect

11. Quality of clinical placements
Matter for discussion submitted by the Students Committee
That this meeting of RCN Congress discusses ways in which the quality of clinical placements can be ensured and consistent across all 4 countries.

quality : placement

12. Bank rates
Resolution submitted by the South Yorkshire Branch
That this meeting of RCN Congress demands that employers pay nursing staff bank shifts at their substantive rate.

pay

13. Are external reviews meaningful?
Matter for discussion submitted by the Midwifery Forum
That this meeting of RCN Congress discusses whether external reviews and inquiries are genuinely driving meaningful improvements in safety across health and social care.

inquiry : review

14. Improving acute mental health crisis services for children and young people
Resolution submitted by the London Board
That this meeting of RCN Congress calls on RCN Council to lobby UK governments to improve the provision of services to children and young people presenting in acute mental health crisis.

children : mental health

15. Access to specialist pain services
Matter for discussion submitted by the Pain and Palliative Care Forum
That this meeting of RCN Congress discusses access to specialist pain services and the role of the registered nurse in caring for those in pain.

pain

16. Palliative and end-of-life care
Resolution submitted by the Pain and Palliative Care Forum
That this meeting of RCN Congress calls on RCN Council to lobby UK governments to ensure everyone living across all 4 nations has access to specialist palliative and end-of-life care.

palliative

17. Accessible and affordable travel
Matter for discussion submitted by the North Central London Inner Branch
That this meeting of RCN Congress discusses what accessible and affordable travel means for the nursing workforce.

18. Uptake of physical health checks
Resolution submitted by the Public Health Forum
That this meeting of RCN Congress requests RCN Council to lobby UK governments to improve the uptake of physical health checks for people with learning disabilities and serious mental illnesses (SMI).

serious mental illness (SMI)

19. Eye donation
Matter for discussion submitted by the Greater Glasgow Branch
That this meeting of RCN Congress discusses the role nursing has in eye donation in end-of-life care planning.

eye : vision

20. 35-hour week
Resolution submitted by the Lothian and Borders Branch
That this meeting of RCN Congress calls on RCN Council to instigate a campaign for a maximum 35 hour working week for the nursing workforce.

21. Inappropriate delegation
Matter for discussion submitted by the Berkshire Branch
That this meeting of RCN Congress discusses the delegation of health care tasks to school staff and non-health care professionals.

22. Access to medicinal cannabis
Matter for discussion submitted by the Cheshire Branch
That this meeting of RCN Congress discusses the impact of current NHS prescribing practice on access to medicinal cannabis.

medicinal cannabis

23. SPA time
Resolution submitted by the Wiltshire Branch
That this meeting of RCN Congress calls on RCN Council to lobby for the inclusion of Supporting Professional Activities (SPA) time in all nursing job-plans.

See: https://www.rcn.org.uk/Congress/Agenda 

Are there any lessons from this exercise? Well, I have no posts tagged 'donor', or 'medicinal cannabis' - to make an important distinction. Something to correct and try to follow this week. 

See you there ...?

(I may need to reduce the link-count here.) 

Invitation to EPI-WIN webinar: 1 Dec, on UNiTE to end digital violence ...

... why digital safety is a gender and public health imperative in emergencies

UNiTE to end digital violence:
why digital safety is a gender and public
health imperative in emergencies

We are delighted to invite you to join our webinar on #UNiTE to end digital violence, on 1 December 2025, 13.00 CET (geneva time), with Ms Reem Alsalem, UN Special Rapporteur for violence against women, its causes and consequences, Dr Stella Chungong, Director and Chair of the WHO Health Emergencies Gender Working Group, and voices of community experiences.  

Please do join the discussion and share widely.

Title: UNiTE to end digital violence: why digital safety is a gender and public health imperative in emergencies

Time and Date: 13:00 – 14:30 CET (Geneva), Monday, 1 December 2025

Registration: https://bit.ly/4prKGeu

Webpage: WHO EPI-WIN webinar: UNiTE to end digital violence: why digital safety is a gender and public health imperative in emergencies

Digital violence, such as doxxing, deepfakes, and online harassment, poses significant public health risks. Millions of women, girls, and adolescents face harassment, stalking, and threats in digital spaces meant for connection.

In crisis settings, these digital threats create multiple challenges. Understand what they are and why it is important to integrate digital safety into humanitarian health responses.

Tentative Agenda and Speakers

Welcome/Opening remarks: Digital safety as a public health imperative in crises:  Dr Stella Chungong, Director, Department of Health Emergency Preparedness & Chair, WHE Gender Working Group

Preparedness begins with protection: why digital violence must be addressed in humanitarian health work: Dr Stella Chungong, Director, Department of Health Emergency Preparedness & Chair, WHE Gender Working Group

UNFPA perspective from Executive Director, UNFPA: delivered by Dr Eugene Kongyuy, Deputy Director of Humanitarian Response Division to represent the United Nations Population Fund (UNFPA).

Keynote address: Ms Reem Alsalem, UN Special Rapporteur for Violence Against Women, its causes and consequences

Risk communication, community engagement and infodemic management: digital violence as a driver of misinformation: Dr Kai Von Harbou, Unit Head, Community Protection & Resilience, WHO 

Surviving Digital Violence: DR Millie Phiri, journalist, researcher and author on digital violence

Community Voice:  Ms Sohaila Shamseldeen, Youth and Development Coordinator, Etijah

Musings... building models, health & safety, group and individual

....

Basic foundations and minimal defaults
[Accounting for the I-G (individual-group) axis]

Since nurses and technologists are concerned with communication then the foundation from which they begin to (build and model their) work is of fundamental importance. The foundation needs to be generic in the first instance. Generic in the sense of the commonality that language instills, enables and facilitates within and between communities. Not only that, but if we take the property of 'generic' to its extreme then the foundation must be stripped down to the barest of defaults: there are no 'types'.

To use the safety analogy we need to risk assess the extent of our model building activities.

We can do this by asking: is this a one, or at most two dimensional venture; such that we can rest secure on terra firma? Or are we above 'ground' floor and immediately required to address health and safety legislation?

Since medicine and nursing are concerned with safety and so must be evidence based, there is an immediate vertical challenge in the hierarchies inherent in the sciences and the structure of knowledge.

Science is not the only influence here. The foundation of what we are modelling and building must reflect the ultimate subjects (the person - patients, carers, communities, whole populations) must incorporate the individual and collective nature of our activities. So, the individual (whose very safety is our concern!) must be factored in and the public's health. Systems of assurance are then needed and founded in human rights. This in turn is a measure of the level of social coherence, coherence through a level of social and political organisation that allows leaders to effect positive change and betterment. The person, the individual is built not upon the shoulders of giants, but ordinary people - our ancestors and peers. ...

Axes in hand and mind
...
PJ Dec 2010

UK: The assessment of risk and safety in mental health services

Background

Managing the safety of patients in mental health services is a core function. A variety of tools or scales are being used in mental health services, some of which are locally developed and typically not validated. In 36% of suicides the quality of risk assessment was considered unsatisfactory (NCISH). We are conducting a nationwide evaluation of safety management in the UK.

Aims of the study

• What are the views of mental health professionals, service users and carers on the safety planning process in mental health services and how this could be improved? 
• Which risk assessment tools are currently being used in mental health services in the UK? 
• How are these tools being used prior to suicide? 

Method

The study will use both quantitative and qualitative methods to examine which assessment tools for safety are currently used in mental health services in the UK, and how staff, patients and carers view them. There are three data collection sources for the study:

1. Web-based survey
2. Targeted survey of mental health services
3. Interviews with clinicians

For more information and to participate in the survey please see the NCISH website and follow the link -

http://research.bmh.manchester.ac.uk/cmhs/research/centreforsuicideprevention/nci/

My source:

Jane Graney 

jane.graney AT manchester.ac.uk

Study on attitudes to epistemic uncertainty in safety - Call for participants

From: Eugenio Alberdi, e.alberdi AT CSR.CITY.AC.UK
To: SOCIOTECH AT JISCMAIL.AC.UK
Sent: Tuesday, 17 September 2013, 19:57
Subject: Study on attitudes to epistemic uncertainty in safety - Call for participants

The Centre of Software Reliability and the Department of Psychology at City University London are running a study on reactions to epistemic uncertainty in decision problems about safety.

Perceived errors in such decisions are often debated hotly after the fact, but there is still a need to study how the input to the decision maker can help or hinder correct decisions.

If you are involved in any capacity with probabilistic reasoning about safety and risk, we would be grateful if you take the survey at:

...

This study arises from research project UnCoDe -
(UNcertainty and COnfidence in safety arguments: effect on expert DEcision makers).

All participants will have the opportunity to read the final report from the study and the other project outputs.

Regards,

_eugenio

Dr. Eugenio Alberdi

Research Fellow, Centre for Software Reliability,

City University, London, Northampton Square, London EC1V 0HB

Primary Health Care Specialist Group (PHCSG) Summer Conference 2009: Patient Safety – who cares?!

Patient Safety – who cares?!

Primary Health Care Specialist Group (PHCSG) Summer Conference 2009

29th June – 1st July at Chesford Grange Warwickshire

The event attracts a wide group of people including GP’s, other practice staff, nurses and allied health professionals, ICT staff, PCT staff, system suppliers and researchers.

UKCHIP Accredited towards Continued Professional Development (CPD)

Programme and online booking available at http://www.phcsg.org/

Programme Topics include:

• Clinical Risk Management
• Clinical Safety Testing of the Care Record, and Information Governance
• The Future of NHS IT: life after NPfIT in primary care
• Patient Confidentiality – the current legal position
• Practice Accreditation
• Data Extraction from Primary Care Systems (GPES)
• Updates on GP2GP and EPS
• NHS Resources Centre – free training for staff
• Care Pathways- peril or profit?
• Use of Clinical Indications
• Medication Safety Alerts
• RCGP Guide – Making IT work for you

Exhibition - As well as the formal programme the conference provides an excellent opportunity for networking and is supported by an exhibition, which features many of the established IT suppliers to primary care alongside suppliers with exciting new products and services. Come and chat to exhibitors and hear how they are developing and promoting their products or services to enable “Patient Safety”.

Interested in Exhibiting or Sponsorship Opportunities, or need further information?
Contact Jill Riley email jill at phcsg.org

Mechanisms, Individuals and Collective

Last week I joined a webinar:

 

https://www.biokoinos.org/events

BioKoinos Research Seminar

Saúl Pérez González & Elena Rocca - 

Evidence-based and patient-centred clinical practice. The bridging role of evidence of mechanism.

  

I have mapped some of the concepts to Hodges' model. A link to the paper is included below. The session was very helpful, especially with ongoing developments in genomics and personalised medicine.

 

INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

patient-centred evidence safety of a certain intervention for a particular patient safety efficacy	individual - epidemiology - population patient-centred evidence safety of a certain intervention for a particular patient biology pathophysiological mechanism prediction ... confirming and disconfirming - depending on whether or not it supports that certain epidemiological results apply to the single patient.
evidence safety efficacy	evidence safety efficacy

Pérez-González, S., & Rocca, E. (2022). Evidence of Biological Mechanisms and Health Predictions: An Insight into Clinical Reasoning. Perspectives in Biology and Medicine 65(1), 89-105.  

http://philsci-archive.pitt.edu/20364/1/Postprint%20Evidence%20of%20biological%20mechanisms%20and%20health%20predictions.pdf

 

RCN Congress iii 2025 - Accountability for patients in ambulances

The resolution (with a reading list) on Accountability for patients in ambulances

- drew attention to language once again (yes, well there's a truism: what do you expect!). This time highlighting how corridor care is now variegated. In addition, politically you can circumvent addressing an issue, by referring to 'never events', and 'zero tolerance' as we read:

'This agenda item addresses the urgent issue of accountability, for both registered nurses and the organisations they work for, when patients are cared for in ambulances waiting to access emergency departments.

The resolution comes at a time when, across all four countries, there are unprecedented ambulance handover delays with patients left in vehicles which are neither appropriately staffed nor resourced outside overwhelmed emergency departments. Despite the prolific nature of this practice, there is no clear guidance on accountability. Who is responsible for the care and safety of those patients - the ambulance service, the hospital, the emergency department, or the individual registered nurse providing care?

These delays accessing care and the lack of guidance on who is accountable for the waiting patients, compromises the ability of health care staff to provide good quality care and risks patient safety. It also exposes registered nurses and other health care professionals to professionally, ethically and legally ambiguous situations. It could also contribute to the crisis in nursing wellbeing, raising issues such as moral distress and professional, emotional and physical burnout. It may, therefore, also impact the already perilous recruitment and retention.'

Student nurses, paramedics ... please take note: There is a paper to be written on Hodges' model and the gaps we encounter in health and social care. For Brian Hodges this started with the theory-practice gap; one of four original stimuli for the creation of the model. 

As the idealised standards, quality and safety of care being delivered are surrendered; this gap stands out as the virtual keystone.

individual

|

INTERPERSONAL : SCIENCES

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

individual - PURPOSES patient safety - distress nurse wellbeing emotional burnout moral distress personal ethics individual responsibilities	procedure delivered care - observation mattress, trolley .. ambulance design instrumentation, noise time - duration logistics - PROCESSES - handover physical resources - beds
communities of PRACTICE team working - coherence team experience - students THE DAMAGE - that is 'BOOK-PASSING' The public's - carer's experience (wither friends and family)	law - guidance - ambiguity POLICY professional accountability risk management organisational responsibility workforce recruitment & retention

Previously: 'RCN' : 'gap' : 'accountability' : 4Ps

'Safe space' - which one?

 Individual
  |

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

psychological safety

physical safety

social safety

"NHS staff will be able to speak out about mistakes without fear of reprisal for the first time, thanks to a new investigation unit with "safe space" powers. The Health Services Safety Investigations Body (HSSIB), which was launched last week, has been granted a remit that in effect means any testimony or evidence given to it by doctors, nurses and other staff medical staff will not be handed over to another agency - such as the police, a coroner or the General Medical Council - unless the High Court rules that it must."

Lintern, S. 'Safe space' unit to protect NHS staff reporting medical errors, The Sunday Times, 22nd October 2023, p.11.

Relative poverty (1) - intrapersonal

There are many paradoxes in life and many of these are concentrated in the realm of health and medicine (a major sub-division of life and death).

For decades the link between poverty and standards and quality of health has been recognised and politicised in the media and policy. Just this past week was news of a Bill to make the eradication of child poverty a legal obligation not something that can be the political objective at the start of a Government and then cast aside.

Many things are relative and poverty is often described in this way applying to individuals, social classes, communities, regions and whole nations. Using the knowledge domains of Hodges' model what reflections does this prompt? Let us see:

INTRAPERSONAL: On one level highlighting poverty here appears a nonsense as usually we think of material wealth; the ability of people to be able to put decent quality - nourishing food on the table. In the miserable trap that poverty presents, it is perverse to suggest that health and social care workers - indeed all 'customer facing personnel' seek poverty. But they should exercise: poverty of thought.

Health and social care are often couched in terms of being a safety net, especially in community care - this conception emphasizes health and social care as a physical resource. In the intra-interpersonal domain though we are concerned with individual mental life, beliefs, attitudes, thoughts and emotions....

So here it is as if we must adopt the philosophy of Bruce Lee and turn the 'art of fighting without fighting' into the 'art of caring without caring' through a momentary forgetting in order to care effectively. We suspend our thoughts - take a mental breath, bring our training and current evidence to the fore. The conceptual safety net does not work if it comes pre-filled with bias, prejudice, pre-conceived ideas and negative expectations. There is of course a very poignant irony in calling for people to forget, suspend belief - even for an instant - at this time and in this domain. For health and social care workers in wiping the slate clean we do not think, but are VERY receptive to what follows.

This is where the wealth is:
between us.

We should not play the greedy capitalist and keep collaborative tools like Hodges' model to ourselves.

It was made to share: in my mind and yours a global health resource...

Image source: BBC

safety net: http://blogs.jamaicans.com/metinking/2009/04/30/a-jamaican-legacy-that-deserves-our-support/

Additional links: 'Poverty' on W2tQ

http://www.bmj.com/cgi/content/citation/325/7354/51