The importance of significant event analysis

Significant event analysis (SEA) is a structured quality improvement activity that is well established in general practice. Participation in SEA prompts primary care teams to reflect on their clinical reasoning, to highlight exemplary care, and to identify any potential improvements in both practice and wider healthcare systems. This article provides an overview of the SEA process and the events surrounding a SEA meeting. Cancer care examples are used to demonstrate how SEA can be used to enhance team-based learning and improve future patient care

Medical professionalism: navigating modern challenges

Medical professionalism is an evolving entity, requiring continual development according to shifting societal priorities. The public trust which underpins the medical profession is imperative for maintaining effective partnerships with patients, their families and the wider community. This article provides an overview of what constitutes medical professionalism, including the current protocols and assessments for general practice training. The aim is to improve understanding of the current issues surrounding professionalism in primary care. Fictional case scenarios are used to illustrate modern professional dilemmas and to promote reflection on the complex interacting factors which influence professional practice and clinical decision-making

Learning from new colorectal cancers: a qualitative synthesis of significant event reports

Background Colorectal cancer is the second leading cause of cancer-related mortality in the United Kingdom and a significant contributor to morbidity and mortality worldwide. Early diagnosis provides opportunities for intervention and improved survival. Significant Event Analysis (SEA) is a well-established quality improvement method for learning from new cancer diagnoses. Aim This study aimed to provide additional insights into diagnostic processes for colorectal cancer and to identify areas for improvement in patient care pathways. Design & setting 53 general practices across Pennine Lancashire, England, submitted one or more SEA reports as part of an incentivised scheme. Method A standardised data collection form was used to collate learning points and recommendations for improvements. 161 reports were analysed using an inductive framework analysis approach. Results There was an overarching theme of building vigilance and collaboration between and within general practices and secondary care. Four main sub-themes were also identified including education, individualised and flexible care, ownership and continuity, and communication. Conclusion These findings provide additional insights into colorectal cancer pathways from a primary care perspective. Practices should be supported in developing protocols for assessment and follow-up of patients with varying presentations. Screening and access to investigations are paramount for improving early diagnosis, however, a flexible diagnostic approach is required according to the individual circumstances of each patient

Practical tips for virtual facilitation: Lessons from the Lancashire Next Generation GP team

The problem Working in health and care against the backdrop of COVID-19 has led to significant changes in practice, priorities and people. There will no doubt be many lessons to emerge from this time over the coming months and years. Not least how the workforce, together with the community, came together (despite being physically distant) to respond with courage, creativity and a determination to adapt where possible. Here we share how the Next Generation GP Lancashire team adapted their approach, looked for the opportunities and embraced the learning to emerge from working virtually. The approach In March 2020, the Lancashire Next Generation GP team were in the process of organising physical events for a local leadership programme based on the existing national programme model. Following cancellation of the programme due to COVID-19, regular virtual meetings were held to explore how to work differently. An associate from the NHS North West Leadership Academy contributed to discussions exploring virtual facilitation, leadership approaches and community building. The learning to emerge has shaped the design and delivery of the first virtual Lancashire and Manchester Next Generation GP programme. Findings Several recommendations emerged from the discussions around the transition towards working virtually. Firstly, there was early recognition of transition points indicating when to work differently, which were openly communicated with participants. Secondly, the new context presented the opportunity to reflect on how to shape the new approach to design, including building on feedback on both local leadership and community needs. Following this, community principles were examined to reduce potential barriers to virtual engagement and detailed consideration was given to the transition from creating a virtual community space into relationship building. 90 participants were subsequently recruited to the virtual programme, which is currently ongoing. Feedback from participants will be available to share at the meeting. Implications The complex adaptive system environments in which we work require different approaches to leadership and facilitation at different points in time. These recommendations can be applied to establish a social learning architecture which optimises engagement and relationship building among virtual communities. Ten top tips will be presented in the meeting, which can be flexibly applied to develop shared leadership approaches and design of other educational programmes which are transitioning into virtual delivery

Standalone vertex finding in the ATLAS muon spectrometer

A dedicated reconstruction algorithm to find decay vertices in the ATLAS muon spectrometer is presented. The algorithm searches the region just upstream of or inside the muon spectrometer volume for multi-particle vertices that originate from the decay of particles with long decay paths. The performance of the algorithm is evaluated using both a sample of simulated Higgs boson events, in which the Higgs boson decays to long-lived neutral particles that in turn decay to bbar b final states, and pp collision data at √s = 7 TeV collected with the ATLAS detector at the LHC during 2011

Measurements of Higgs boson production and couplings in diboson final states with the ATLAS detector at the LHC

Measurements are presented of production properties and couplings of the recently discovered Higgs boson using the decays into boson pairs, H →γ γ, H → Z Z∗ →4l and H →W W∗ →lνlν. The results are based on the complete pp collision data sample recorded by the ATLAS experiment at the CERN Large Hadron Collider at centre-of-mass energies of √s = 7 TeV and √s = 8 TeV, corresponding to an integrated luminosity of about 25 fb−1. Evidence for Higgs boson production through vector-boson fusion is reported. Results of combined fits probing Higgs boson couplings to fermions and bosons, as well as anomalous contributions to loop-induced production and decay modes, are presented. All measurements are consistent with expectations for the Standard Model Higgs boson

Measurement of the top quark-pair production cross section with ATLAS in pp collisions at \sqrt{s}=7\TeV

A measurement of the production cross-section for top quark pairs(\ttbar) in $pp$ collisions at \sqrt{s}=7 \TeV is presented using data recorded with the ATLAS detector at the Large Hadron Collider. Events are selected in two different topologies: single lepton (electron $e$ or muon $\mu$) with large missing transverse energy and at least four jets, and dilepton ($ee$, $\mu\mu$ or $e\mu$) with large missing transverse energy and at least two jets. In a data sample of 2.9 pb-1, 37 candidate events are observed in the single-lepton topology and 9 events in the dilepton topology. The corresponding expected backgrounds from non-\ttbar Standard Model processes are estimated using data-driven methods and determined to be $12.2 \pm 3.9$ events and $2.5 \pm 0.6$ events, respectively. The kinematic properties of the selected events are consistent with SM \ttbar production. The inclusive top quark pair production cross-section is measured to be \sigmattbar=145 \pm 31 ^{+42}_{-27} pb where the first uncertainty is statistical and the second systematic. The measurement agrees with perturbative QCD calculations.Comment: 30 pages plus author list (50 pages total), 9 figures, 11 tables, CERN-PH number and final journal adde

Measurement of the top quark pair cross section with ATLAS in pp collisions at √s=7 TeV using final states with an electron or a muon and a hadronically decaying τ lepton

A measurement of the cross section of top quark pair production in proton-proton collisions recorded with the ATLAS detector at the Large Hadron Collider at a centre-of-mass energy of 7 TeV is reported. The data sample used corresponds to an integrated luminosity of 2.05 fb -1. Events with an isolated electron or muon and a τ lepton decaying hadronically are used. In addition, a large missing transverse momentum and two or more energetic jets are required. At least one of the jets must be identified as originating from a b quark. The measured cross section, σtt-=186±13(stat.)±20(syst.)±7(lumi.) pb, is in good agreement with the Standard Model prediction