Reporting a death to the coroner by a doctor is not a statutory duty. It is, however, expected good practice. This article discusses some of the concerns arising out of current…
Abstract
Reporting a death to the coroner by a doctor is not a statutory duty. It is, however, expected good practice. This article discusses some of the concerns arising out of current everyday practice that can lead to problems for doctors and their employing organisations. The author considers the importance of risk management, clinical audit and clinical governance in identifying what systems may need to be addressed within hospital and primary care trusts to ensure that deaths arising out of, or occurring during, medical care are investigated appropriately. As part of risk management and controls assurance, NHS Trusts should be able to demonstrate that lessons are learnt from adverse outcomes. This article explores the roles of postgraduate tutors, risk managers and the protection organisations in promoting good practice from the start of a doctor’s career.
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NHS trusts are required to have a resuscitation policy in place by April of this year. Chief executives were sent guidance in September 2000, to ensure that policy takes account…
Abstract
NHS trusts are required to have a resuscitation policy in place by April of this year. Chief executives were sent guidance in September 2000, to ensure that policy takes account of patients’ rights and that appropriate arrangements are in place to supervise resuscitation decisions, to audit practice and develop staff training. Existing clinical risk management standards assessed by the NHS Litigation Authority also require that staff are competent to perform basic life support whenever called upon to do so, as there is a “public expectation that clinical staff can undertake basic life support”. This article explores some of the current risk management and clinical governance issues in relation to developing and maintaining a robust policy on resuscitation that aims for high standards of practice, alleviates public concern and will be supportable within the Human Rights Act 1998.
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Recent criticism of some aspects of current practice within the NHS has placed the role of clinical audit increasingly under the spotlight. In a recent publication, the National…
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Recent criticism of some aspects of current practice within the NHS has placed the role of clinical audit increasingly under the spotlight. In a recent publication, the National Institute for Clinical Excellence states that “the time has come for everyone in the NHS to take clinical audit very seriously”. This article considers the intimate link between clinical audit and clinical governance, a philosophy that has not yet been universally adopted. It describes the key principles of risk management within the context of clinical audit, and examines the audit burden imposed on primary and secondary care by assessors, National Service Frameworks and regulatory bodies. It discusses the challenges risk managers face in adopting a systematic review of care that seeks to avoid harm to patients, while improving outcomes and care standards.
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This article discusses the role of clinical risk management in the implementation of the National Service Framework for Coronary Heart Disease (NSFCHD). It considers the practical…
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This article discusses the role of clinical risk management in the implementation of the National Service Framework for Coronary Heart Disease (NSFCHD). It considers the practical difficulties faced in meeting NSF standards, and proposes a combined, complementary approach involving primary and secondary care. While the NSF makes no explicit reference to clinical risk management, the risk manager has an important role to play in ensuring that an adverse event reporting system is in place and its role fully accepted by clinicians. From a medico‐legal standpoint, a commitment to auditing outcomes and maintaining good clinician‐patient communication is viewed as essential. It concludes that doctors’ and patients’ interests are best served by clinicians adopting a clinical risk management approach to implementing the NSFCHD.
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Charlotte Brontë integrated her own and her sisters' traumatic boarding school experiences into her novel, Jane Eyre (1847) as a way of expressing her anger through…
Abstract
Purpose
Charlotte Brontë integrated her own and her sisters' traumatic boarding school experiences into her novel, Jane Eyre (1847) as a way of expressing her anger through autobiographical fiction. The aim is to link contemporary research into boarding school trauma to the relevant events, thereby identifying what she wrote as a testimony contributing to the long history of the problematic nature of boarding schools.
Design/methodology/approach
Autobiographical fiction is discussed as a form of testimony, placing Jane Eyre in that category. Recent research into the traumatic experiences of those whose parents chose to send them to boarding school is presented, leading to an argument that educational historians need to analyse experience rather than limiting their work to structure and planning. The traumatic events the Brontë sisters experienced at the Clergy Daughters' School are outlined as the basis for what is included in Jane Eyre at the fictional Lowood School. Specific traumatic events in the novel are then identified and contemporary research into boarding school trauma applied.
Findings
The findings reveal Charlotte's remarkable insight into the psychological impact on children being sent away to board at a time when understandings about trauma and boarding school trauma did not exist. An outcome of the analysis is that it places the novel within the field of the history of education as a testimony of boarding school life.
Originality/value
This is the first application of boarding school trauma research to the novel.
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The new National Patient Safety Agency (NPS) has set itself (and NHS organisations) an ambitious agenda. The success of the new reporting system will depend not only on concerned…
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The new National Patient Safety Agency (NPS) has set itself (and NHS organisations) an ambitious agenda. The success of the new reporting system will depend not only on concerned staff’s awareness about what constitutes an adverse incident but also on the convergence of their individual judgements of what grading to apply to those incidents. Medical Protection Society (MPS) experience indicates that raising staff awareness alone is a monumental task. Achieving convergence in the grades they assign to such incidents is likely to present even greater difficulties. Draft guidance was published in August 2001, but it does not address the crucial issue of consistency within and across organisations. The system, as envisaged, would also discourage organisations from allocating “red” codes to more serious incidents.
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Education is seen to be a key ingredient in today's wine marketing and an important tool for the winery in attracting and maintaining its consumer base in an increasingly…
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Education is seen to be a key ingredient in today's wine marketing and an important tool for the winery in attracting and maintaining its consumer base in an increasingly competitive marketplace. Wine education therefore plays an important part in the health and future of the industry: ‘Wine education plays a key role in converting the occasional wine drinker into a dedicated wine appreciator.’ (The Australian Grapegrower and Winemaker, 1996). Until recently wine research has focused on the specialisms and technicalities associated with winemaking and neglected the importance of research activity into the motivations and behavioural patterns of the wine consumer. This paper will report on the findings from the initial qualitative research process. The exploratory stage involved identifying and conducting key informant interviews with owners or managers of wineries with an education focus in the Swan Valley and Margaret River wine regions. Focusing on the provision for consumer education within wineries in Western Australia, the research aims to identify current awareness levels amongst Australian winery owners into the value and importance of education to the wine tourist. Demandby wine tourists for educational provision within the winery setting was also examined.
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Responding to a commitment made in the NHS plan, the Department of Health produced a series of documents (not yet widely distributed and discussed) during 2001 aimed at improving…
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Responding to a commitment made in the NHS plan, the Department of Health produced a series of documents (not yet widely distributed and discussed) during 2001 aimed at improving the process of obtaining consent in the NHS and aiming for consistent practice across the NHS, so that patients and health care professionals will be familiar with the process as they are looked after by or work for different organisations. Trusts have a very tight timescale for the introduction and use of the new style consent forms and the implementation of the model policy. While the basics are there, feels debate is necessary within each organisation as to how best these forms should be used. Discusses these issues, and claims the new standards currently are not achievable within an under‐resourced service. Concludes that those agencies established to assess the quality of health care need to be mindful of the severe constraints that exist in attempting to push forward this initiative by the end of 2002, before criticising trusts for their failure to do so.
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Geoff Plimmer, Jane Bryson and Stephen T.T. Teo
The purpose of this paper is to explore how HIWS may shape organisational capabilities, in particular organisational ambidexterity (OA) – the ability to be both adaptable to the…
Abstract
Purpose
The purpose of this paper is to explore how HIWS may shape organisational capabilities, in particular organisational ambidexterity (OA) – the ability to be both adaptable to the wider world, and internally aligned so that existing resources are used well. Given the demands on public agencies to manage conflicting objectives, and to do more with less in increasingly complex environments, this paper improves our understanding of how HIWS can contribute to public sector performance. The paper sheds light inside the black box of the HIWS/organisational performance link.
Design/methodology/approach
This multi-level quantitative study is based on a survey of 2,123 supervisory staff, and 9,496 non-supervisory employees in 56 government organisations.
Findings
The study identifies two paths to organisational performance. The first is a direct HIWS performance link. The second is a double mediation model from HIWS to organisational systems, to OA and then performance.
Practical implications
A focus on developing HIWS provides an alternative means to public sector performance, than restructuring or other performative activities.
Originality/value
This is one of the few studies that explore how HIWS can develop collective as well as individual capabilities. Studies in the public sector are particularly rare.