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Jane Feinmann: Consumers co-design consumer friendly healthcare

17 Nov, 15 | by BMJ

jane_feinmannI am one of 50 or so attendees on a one day course organised by the Point of Care Foundation learning how patients like myself can work as partners with doctors and nurses to co-design a better healthcare system.

It’s not a new idea. Don Berwick, author of the NHS Patient Safety Review, pointed out ten years ago that “healthcare workers and leaders can often best find the gaps that matter by listening very carefully to the people they serve, patients and families.” While the NHS has so far picked up on the idea of “listening” with initiatives such as the Friends and Family test becoming ubiquitous in GP practices and hospitals, it’s arguable how careful this listening is. more…

Patrick Cullen: Co-design for vulnerable patient groups—transforming patients’ experiences

16 Nov, 15 | by BMJ

patrick_cullen_picRecently I attended a conference at the King’s Fund that focussed on transforming patient experience, particularly the experience of vulnerable patient groups.

To me, the day felt as much like a call to action as a celebration of good practice. Hearing from Catherine Carter, a mother with learning disabilities and Asperger’s, about the distressing experiences of parents with learning disabilities offered a stark reminder of how much stigma there still is around certain conditions.

She described a project to engage people with learning disabilities using maternity services. more…

Richard Lehman’s journal review—16 November 2015

16 Nov, 15 | by BMJ

richard_lehmanNEJM 12 Nov 2015 Vol 373
SPRINTing to conclusions
OL There’s no denying that the research event of the week has been the online publication of the SPRINT hypertension trial. So here I am departing from the usual pattern of these reviews, because it would seem odd not to begin with it. I’m going to be very brief. The trial shows that in people of mean age 68 years with elevated cardiovascular risk, but not diabetes, aiming for a systolic blood pressure target of 120 rather than 140 mmHg produced a significant reduction in death and cardiovascular events over a median period of three years and three months. The patient characteristics, benefits, and harms in this trial are very well described. If you are consulted by an individual who fits its criteria, you could have an informed conversation about their risk lowering options, of which tighter BP control might be one.


Tom Jefferson: Happy birthday Ombudsman

13 Nov, 15 | by BMJ

Tom Jefferson with Emily O'ReillyThe institution of the European Ombudsman celebrated its first 20 years of activity with a party for staff and all those who have and still are contributing to its work. The shindig was held in the European Parliament.

In the words of the current Ombudsman, Emily O’Reilly, the Ombudsman’s function “was born out of the debate on the emerging European citizenship in the early 1990s, and its purpose precisely is to enable those European citizens to hold the ever more powerful EU institutions to account, as the direct effect of what they do impacts more and more on the daily lives of the people. It acts in a complementary way to the courts and to the parliament, as a check on EU institutional power.”

In the current climate, O’Reilly’s words may seem like a wish rather than reality. Except that the office’s record in the matter of access to secret clinical data is exemplary. more…

Mary E Black: How data science will change public health

13 Nov, 15 | by BMJ

maryeblack copyWe are living in a perfect storm: vast amounts of data and rapidly increasing, cheap computing power. The world is shifting towards basing decisions even more on data. I believe, to paraphrase Billy Bosworth, that “10 years from now when we look back at how this era of big data evolved . . . we will be stunned at how uninformed we used to be when we made (public health) decisions.” (Billy Bosworth, DataStax CEO, 2015)

This is groundbreaking stuff. Bring on commercial partnership, academic links, local activist groups, and hackers, for we cannot do this alone, we do not have the firepower. Here are my top 10 change predictions. All of them are already happening . . . somewhere . . . more…

Jeffrey Aronson: When I use a word . . . Let’s twist again

13 Nov, 15 | by BMJ

jeffrey_aronsonThe Indo-European root UER was not the only one that connoted twisting and turning. Others were PLEK, STREB, TERQ or TORQ, TERK, and UEI. Let’s start with PLEK, which in Greek gave πλεκ- and πλο(κ)-, in Latin plec- and plic-. It implied not only to twist, but other twisty actions as well—to braid or weave, to bend or fold. Folding also implied repetition.

DNA is plectonemic (Greek πλεκτός, twisted). Ploce (Greek πλοκή) is a rhetorical device in which the same word is repeated in the same sentence, often in a different sense or grammatical form. Here’s an example from Richard III (II:iv:61): “Make war upon themselves, brother to brother, Blood to blood, self against self.” more…

William Cayley: To doctor is to diagnose—part two

12 Nov, 15 | by BMJ

bill_cayley_2Having recently posted some thoughts on the continuing centrality of diagnosis in doctoring, I was happy to see the recent Institute of Medicine (IOM) report “Improving Diagnosis in Healthcare.” I especially appreciated the IOM’s clear statement that “Improving the diagnostic process . . . represents a moral, professional, and public health imperative.”

The IOM describes a helpful conceptual model of the diagnostic process, and makes eight practical recommendations for moving forwards. I think all eight recommendations sound sensible, and some (such as “enhance healthcare professional education and training in the diagnostic process” and “establish a work system and culture that supports the diagnostic process”) are particularly helpful, however, I fear these steps may only address the “icing” and not the “cake.” more…

Tony Rao: When doctors strike

12 Nov, 15 | by BMJ

tony_rao2To say that junior doctors are dissatisfied would probably be an understatement. It is now almost exactly 40 years since they turned to industrial strike action as a means of opposing a contract that failed to recognise their professional role. The 1975 strike emerged against the background of strike action from a number of other professions that also included nurses and ambulance crew (1). So what motivates a large number of highly respected individuals to turn into a collective political behemoth of the type that the public is now seeing loom large in the media on an almost daily basis? more…

John King: Just tick the boxes

12 Nov, 15 | by BMJ

john_king2The atmosphere at the mothers meeting was warm and friendly. All the local mums were looking forward to sharing the latest news and gossip about their children, as they had done for years now. Suddenly the door was flung open and a man in a smart grey suit appeared, with bulging briefcase and an authoritative air.

“Things are going to change” he announced. “It is not enough just to love your children. You have to prove it.” more…

Mihail Călin: Protests on the streets of Bucharest—”We want hospitals, not cathedrals!

11 Nov, 15 | by BMJ

Mihail_CălinTwelve days have passed since fireworks lit the soundproofing at the Colectiv club in Bucharest, unleashing a deadly combination of fire and toxic fumes over hundreds of concert goers. The death toll has now reached 48, mostly young people, and is likely to increase, given that around 20 others are in critical condition in hospitals. Despite direct warnings from doctors in previous days, the rapid succession of the 16 most recent deaths has shocked the nation. more…

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