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C7RKY's profile
John Clarke
John Clarke
John Clarke
@C7RKY

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John Clarke

@C7RKY

Of course views all mine. All without prejudice. Just a regular chap after all. Oh...and RT's may equally imply ridicule as endorsement.

UK
Joined December 2011

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    1. Dr Umesh Prabhu‏ @DrUmeshPrabhu 4 Dec 2017
      Replying to @rodkelly50 @juniordrblog and

      I know

      1 reply 0 retweets 0 likes
    2. Dr Dominic Pimenta‏ @juniordrblog 4 Dec 2017
      Replying to @DrUmeshPrabhu @rodkelly50 and

      I have to agree. We should chat in the open.

      2 replies 0 retweets 4 likes
    3. Dr Ben White‏Verified account @drbenwhite 5 Dec 2017
      Replying to @juniordrblog @DrUmeshPrabhu and

      See: https://www.youtube.com/watch?v=fxh95M_85PM … Watch from 2min. Worth listening to whole thing. Looks like '90% reduced' derived from HSMR / Dr Foster & other figures. I have put a couple of the useful slides as images. @DrHugoA @drtomhine @mgtmccartney @trishgreenhalghpic.twitter.com/Tn8jmStFw6

      2 replies 10 retweets 7 likes
    4. Dr Ben White‏Verified account @drbenwhite 5 Dec 2017
      Replying to @drbenwhite @juniordrblog and

      Wigan introduced Consultant case note review of all 'unexpected deaths' also, which is a good thing. Unsure if this is wildly different from other DGHs.

      1 reply 3 retweets 3 likes
    5. Dr Umesh Prabhu‏ @DrUmeshPrabhu 5 Dec 2017
      Replying to @drbenwhite @juniordrblog and

      Also introduced 300 patient safety champions and 50 Dementia champions and weekly #Governance meeting where MD Chairs and discusses openly complaints, litigation SUI, clinical incidents anyone raising concerns openly learns lessons. Removed culture of naming, shaming bullying

      2 replies 2 retweets 2 likes
    6. John Clarke‏ @C7RKY 6 Dec 2017
      Replying to @DrUmeshPrabhu @drbenwhite and

      After years of studying every CQC board meeting, I stopped watching just a few months before that one. Decided I'd suffered enough! But it was worth enduring another to watch that - compelling viewing and the headline figures appear hard to ignore. Impressive at first glance. >>

      1 reply 0 retweets 1 like
    7. John Clarke‏ @C7RKY 6 Dec 2017
      Replying to @C7RKY @DrUmeshPrabhu and

      May I ask a couple of question on the weekly death reports please? (Are you still doing them btw?) You exclude from investigation: > Pts admitted to die > Pts admitted to ITU > Pts put on the dying pathway Why this last group? How many are excluded because of that factor alone?

      3 replies 2 retweets 3 likes
    8. Dr Umesh Prabhu‏ @DrUmeshPrabhu 8 Dec 2017
      Replying to @C7RKY @drbenwhite and

      In theory death review is good only if it is done properly and with #Candour and full engagement of families.

      1 reply 0 retweets 0 likes
    9. John Clarke‏ @C7RKY 8 Dec 2017
      Replying to @DrUmeshPrabhu @drbenwhite and

      Absolutely. I appreciate that. My question is more to do which cases you include for review - and specifically why you choose to exclude those placed on the death pathway.

      1 reply 0 retweets 0 likes
    10. Dr Umesh Prabhu‏ @DrUmeshPrabhu 8 Dec 2017
      Replying to @C7RKY @drbenwhite and

      1 Unexpected death 2 Family unhappy or has concerns 3 Death which should be referred to #Coroner and any one has any concerns This is my personal view @martinfarrier is an expert

      1 reply 1 retweet 1 like
      John Clarke‏ @C7RKY 8 Dec 2017
      Replying to @DrUmeshPrabhu @drbenwhite and

      Ok, thanks Umesh. Wonder if @martinfarrier will have any thoughts on this question? The point was discussed at CQC's board meeting just 10m15s into the video >https://m.youtube.com/watch?v=fxh95M_85PM …

      11:32 AM - 8 Dec 2017
      • 1 Retweet
      • 1 Like
      • Dr Umesh Prabhu
      4 replies 1 retweet 1 like
        1. New conversation
        2. Martin Farrier‏ @martinfarrier 8 Dec 2017
          Replying to @C7RKY @DrUmeshPrabhu and

          Unexpected death should = a death where anticipatory care is not given. That’s really the deaths we review.

          1 reply 1 retweet 1 like
        3. John Clarke‏ @C7RKY 8 Dec 2017
          Replying to @martinfarrier @DrUmeshPrabhu and

          Appreciated. My concern was the inclusion of those put on the death pathway as a separate category. If they were not admitted to die & not admitted to ICU, I just thought any such pt then put on the death pathway would be reason to investigate death, not exclude. Is it just me..?

          1 reply 0 retweets 1 like
        4. Martin Farrier‏ @martinfarrier 9 Dec 2017
          Replying to @C7RKY @DrUmeshPrabhu and

          We did multiple months of “death pathway” reviews and found fewer errors. These deaths turned out to be the low risk deaths.

          1 reply 0 retweets 0 likes
        5. John Clarke‏ @C7RKY 9 Dec 2017
          Replying to @martinfarrier @DrUmeshPrabhu and

          Interesting, thanks. What kind of volume of pts did this specific category involve? I can't imagine there should be too many who having not been admitted to die, or admitted to ICU, then subsequently find themselves on the death pathway?

          1 reply 0 retweets 0 likes
        6. Martin Farrier‏ @martinfarrier 9 Dec 2017
          Replying to @C7RKY @DrUmeshPrabhu and

          Then you imagine wrong. Many ICU patients die on a pathway. There are plenty of the remaining group, not admitted to due, but path appr.

          1 reply 1 retweet 2 likes
        7. John Clarke‏ @C7RKY 9 Dec 2017
          Replying to @martinfarrier @DrUmeshPrabhu and

          Really? So there's a notable volume of pts who don't arrive in hospital in a condition which would indicate that their death is imminent, but who then subsequently find themselves on the death pathway anyway? You're right, I did imagine wrong. I'm quite surprised by that.

          2 replies 0 retweets 0 likes
        8. Martin Farrier‏ @martinfarrier 9 Dec 2017
          Replying to @C7RKY @DrUmeshPrabhu and

          Yes, though if we sat and discussed case, you would say events were predictable. Dementia and frailty dominates. Final wks unpredictable

          1 reply 1 retweet 2 likes
        9. John Clarke‏ @C7RKY 9 Dec 2017
          Replying to @martinfarrier @DrUmeshPrabhu and

          Fair enough. I can see that. So out of interest, how do you ensure pt's deterioration onto a death pathway has not resulted from some unseen, underlying problem with the care they received?

          1 reply 0 retweets 0 likes
        10. 1 more reply
        1. New conversation
        2. Martin Farrier‏ @martinfarrier 8 Dec 2017
          Replying to @C7RKY @DrUmeshPrabhu and

          The crucial step that allows candour is immediacy. We do the reviews the week the patient dies. No reopening of wounds.

          1 reply 3 retweets 2 likes
        3. John Clarke‏ @C7RKY 8 Dec 2017
          Replying to @martinfarrier @DrUmeshPrabhu and

          And I absolutely applaud you for this. Speed is of the essence. A family's desire for answers can leave their imagination to eat away at them over time. How soon do you share findings with the families?

          1 reply 0 retweets 1 like
        4. John Clarke‏ @C7RKY 8 Dec 2017
          Replying to @C7RKY @martinfarrier @DrUmeshPrabhu

          ...and thank you Martin, for taking the time to respond. Much appreciated.

          1 reply 0 retweets 1 like
        5. Martin Farrier‏ @martinfarrier 9 Dec 2017
          Replying to @C7RKY @DrUmeshPrabhu

          The first part of the conversation can happen in days. Later parts vary. The first contact is the essential one.

          0 replies 0 retweets 0 likes
        6. End of conversation
        1. New conversation
        2. Martin Farrier‏ @martinfarrier 8 Dec 2017
          Replying to @C7RKY @DrUmeshPrabhu and

          Reviewing deaths where the family is unhappy is just sensible! It helps everyone.

          1 reply 3 retweets 2 likes
        3. John Clarke‏ @C7RKY 8 Dec 2017
          Replying to @martinfarrier @DrUmeshPrabhu and

          Totally agree with your thinking here.

          0 replies 1 retweet 2 likes
        4. End of conversation
        1. New conversation
        2. Dr Umesh Prabhu‏ @DrUmeshPrabhu 8 Dec 2017
          Replying to @C7RKY @drbenwhite and

          I am sure Martin will comment. he has huge experience and expertise

          1 reply 0 retweets 1 like
        3. John Clarke‏ @C7RKY 8 Dec 2017
          Replying to @DrUmeshPrabhu @martinfarrier

          Thanks Umesh. I was delighted to find that Martin already follows me. I feel honoured...

          0 replies 1 retweet 2 likes
        4. End of conversation

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