Weak signals in healthcare: The case study of the Mid-Staffordshire NHS Foundation Trust

Most organisational disasters have warning signals prior to the event occurring, which are increasingly appearing in accident reports. In the case of the Mid-Staffordshire Disaster, the disaster was not as a result of component failure or human error but rather an organisation that drifted into failure with precursory warning signals being ignored. It has been estimated that between 400 and 1200 patients died as a result of poor care between 2004 and 2009. The aim of this study was to identify the precursory signals and their rationalizations that occurred during this event. Qualitative document analysis was used to analyse the independent and public inquiry reports. Signals were present on numerous system levels. At a person level, there were cases of staff trying to make management aware of the problems, as well as the campaign “Cure the NHS” started by bereaved relatives. At an organisational level, examples of missed signals included the decrease in the trust’s star rating due to failure to meet targets, the NHS care regulator voicing concern regarding the unusually high death rates and auditors’ reports highlighting concerns regarding risk management. At an external level, examples included negative peer reviews from various external organizations

A snapshot review of culturally competent compassion as addressed in selected mental health textbooks for undergraduate nursing students

Background The recent scandals involving poor healthcare put nurses under the spotlight in an attempt to understand how compassionate they are towards their patients. The aim of this article is to investigate how compassion is embedded in the textbooks of the undergraduate mental health nursing degree. Methods A snapshot review of key textbooks used, was conducted through the distribution of a list of textbooks and search terms to a panel of mental health teachers in four United Kingdom (UK) universities. They were asked to comment on the list’s completeness, and the terms’ suitability, comprehensiveness and sensitivity regarding culturally competent and compassionate care. Relevant data were extracted independently by each author followed by meetings to compare and discuss their findings and engage in deeper levels of analysis. Results The review found that despite the fact that few textbooks touched on a number of the search terms none of them directly addressed the issue of compassion or culturally competent compassion. This means that mental health undergraduate nurses may not be adequately prepared to provide culturally competent compassion. Conclusions Culturally competent compassion is not something we are born with. Imaginative teaching methods, good textbooks, good role models and opportunities to practice what one learns under supervision is required to nurture compassion in order to re-establish itself as the essence of nursing. Key textbooks need to be revised to reflect the virtue of culturally competent compassion

The relationship between perceived organisational threat and compassion for others: Implications for the NHS

© 2017 John Wiley & Sons, Ltd. The National Health Service (NHS) is known to be a challenging place to work, with financial and performance targets placing increasing pressure on the organisation. This study aimed to investigate whether these pressures and threats might be detrimental to the quality of care and the compassion that the NHS strives to deliver. Quantitative data were collected via self-report questionnaires from healthcare professionals across 3 NHS trusts in England in order to measure Self-compassion; Compassion for Others; Perceived Organisational Threat; and Perceived Organisational Compassion. Qualitative data were also collected to explore the threats considered most pertinent to healthcare professionals at present. The key findings suggest that an increase in Perceived Organisational Threat may reduce an individual's ability to give compassion to others; however, Self-compassion and Perceived Organisational Compassion were better predictors of Compassion for Others. This highlights the need to consider compassion at a systemic level, providing interventions and training not only to cultivate self-compassion in healthcare professionals, but also to encourage compassion across the NHS more generally. In promoting self-compassion and increasing the level of compassion that employees feel they receive at work, healthcare professionals may be better able to maintain or improve their level of compassion for service users and colleagues. Key Practitioner Message: Increases in Perceived Organisational Threat were found to be related to a decrease in healthcare professionals' level of Compassion for Others. However, Self-compassion and Perceived Organisational Compassion were significantly better predictors of level of Compassion for Others than was Perceived Organisational Threat; an increase in Self-compassion and Perceived Organisational Compassion related to an increase in Compassion for Others. Healthcare service development and staff interventions may benefit from greater focus on cultivating and promoting self-compassion and on systemic interventions promoting compassion across all levels of an organisation. Future research should examine the feasibility and effectiveness of compassion-focussed interventions amongst professionals in healthcare organisations and would benefit from further investigation into the impact this may have for service users

Dignity and Respect in Midwifery Education in the UK: a survey of Lead Midwives of Education

In the UK respect, dignity and compassion are the underpinning values which must determine service user care in the National Health Service (NHS). In midwifery education it is unclear how students are being taught these values. We created a study that aimed to explore how learning about dignity and respect is facilitated and assessed within pre-registration midwifery curricula. An online survey was devised and distributed to all Lead Midwives for Education in the UK. The findings are presented under the three main themes of understanding the meaning of dignity and respect, teaching and assessment and experiences. The study concludes that, though there are some good areas of education practice there is inconsistency in how Nursing and Midwifery Council (NMC) guidelines are transferred into curricula. This leads to students receiving differing emphasis of education on the values of dignity and respect