This Future Hospital Programme case study comes from Withybush Hospital. It lays out the process for initiating an organised quality improvement project run by trainees, with the coordination of a lead doctor.
The aim of the project is to listen to children and young people’s views on how health and care services could be improved. To do this, we worked with Youth Action Wiltshire to train 12 people, aged 16-18 years, in skills such as safeguarding, listening and communication. They can now go out into the community and speak to children and young people about their experiences.
Book review. Writing to Improve Healthcare, edited and authored by David P. Stevens, is a timely and important book that is designed to help quality improvers publish their quality improvement (QI) work. (Dr Stevens was the previous Editor-in-Chief of this journal, when it was called Quality & Safety in Healthcare.) The book is unique in that it applies a healthcare improvement perspective to the traditional manuscript preparation and publication process. This is useful for the novice writer and for authors accustomed to writing more traditional clinical research studies or writing for other biomedical fields. Indeed, while some prospective authors of QI work may not be first-time writers, this may be the …...To read the full article, log in using your MPFT NHS OpenAthens details. To read a copy of the book in this review, please contact the library
Open access. The Care Quality Commission (CQC) is responsible for ensuring the quality of healthcare in England. To that end, CQC has developed statistical surveillance tools that periodically aggregate large numbers of quantitative performance measures to identify risks to the quality of care and prioritise its limited inspection resource. These tools have, however, failed to successfully identify poor-quality providers. Facing continued budget cuts, CQC is now further reliant on an ‘intelligence-driven’, risk-based approach to prioritising inspections and a new effective tool is required.
Two £25 vouchers are up for grabs in the library’s ‘Making the Most of Information’ survey.
To take part, just visit http://goo.gl/AdN4ok by Friday 19th February.
The Care Quality Commission’s Chief Executive, Ian Trenholm and Dr Paul Lelliott, Deputy Chief Inspector (Mental Health) will give evidence to the UK Parliament Human Rights Committee in early June.
High quality care is patient-centred.1 Efforts to promote patient-centred care in clinical practice should improve quality. Both shared decision-making (SDM) and the process of obtaining informed consent could be expressions of patient-centred care—to the extent that they respond to the advocates' call for ‘nothing about me without me’. In this issue of BMJ Quality and Safety, Shahu et al2 discuss variations in the quality of informed consent procedures, which could, in their view, fail to support patient-centred care in general, and SDM specifically. To read the full article, log in using your NHS OpenAthens details.
Editorial. High quality care is patient-centred.1 Efforts to promote patient-centred care in clinical practice should improve quality. Both shared decision-making (SDM) and the process of obtaining informed consent could be expressions of patient-centred care—to the extent that they respond to the advocates' call for ‘nothing about me without me’. In this issue of BMJ Quality and Safety, Shahu et al2 discuss variations in the quality of informed consent procedures, which could, in their view, fail to support patient-centred care in general, and SDM specifically. To read the full article, log in using your NHS OpenAthens details.
Health systems invest in diabetes quality improvement (QI) programmes to reduce the gap between research evidence of optimal care and current care.1 Examples of commonly used QI strategies in diabetes include programmes to measure and report quality of care (ie, audit and feedback initiatives), implementation of clinician and patient education, and reminder systems. A recent systematic review of randomised trials of QI programmes indicates that they can successfully improve quality of diabetes care and patient outcomes.2 Changes in surrogate markers such as blood glucose control, blood pressure or cholesterol levels are used to measure QI intervention effectiveness.2
However, investments in QI strategies are only worthwhile if the programmes that effectively improve care are sustained after trial completion.3. To read the full article, log in using your NHS OpenAthens details.
Managing demand for planned health care is described in this report as a “wicked problem” – demand for healthcare is outpacing capacity to meet it.
Health economies have tried various approaches to managing demand; referral management centres, expanded roles, direct access amongst others. But the evidence base has been mixed, of variable quality and sometimes conflicting findings.
This synthesis of evidence sets out to understand what works but with a particular focus on context, to understand what works, in what settings and why.
The NHS in England faces the immense challenge of bringing about improvements in patient care at a time of growing financial and workload pressures.
In a report published today, we argue that the NHS urgently needs to adopt a quality improvement strategy if it is to rise to this challenge. All NHS organisations need to build in-house capacity for quality improvement and to commit time and resources to acquiring the necessary capabilities. They should do so by learning from the experience in trusts such as Salford, Sheffield and Wigan where quality improvement is well established.
Background The positive deviance approach focuses on those who demonstrate exceptional performance, despite facing the same constraints as others. ‘Positive deviants’ are identified and hypotheses about how they succeed are generated. These hypotheses are tested and then disseminated within the wider community. The positive deviance approach is being increasingly applied within healthcare organisations, although limited guidance exists and different methods, of varying quality, are used. This paper systematically reviews healthcare applications of the positive deviance approach to explore how positive deviance is defined, the quality of existing applications and the methods used within them, including the extent to which staff and patients are involved. To read the full article, log in using your NHS Athens
Open access. It is now 15 years since Bell and Redelemeier published their landmark study demonstrating higher mortality for people admitted to hospital during weekdays compared with the weekend.1 Examining the records of 3.8 million patients admitted over a 10-year period to emergency departments in Ontario, Canada, this ‘weekend effect’ existed over a range of acute conditions, including 23 out of the 100 leading causes of death.
Since that paper in 2001, over 100 studies have explored the weekend effect, across a range of patient populations and health systems.2 Surprisingly, despite this large number of studies, there remains ongoing debate about whether the weekend effect exists, and if so, what causes it......
It is now 15 years since Bell and Redelmeier published their landmark study demonstrating higher mortality for people admitted to hospital during weekends compared with during the week.1 Examining the records of 3.8 million patients admitted over a 10-year period to emergency departments in Ontario, Canada, this ‘weekend effect’ existed over a range of acute conditions, including 23 out of the 100 leading causes of death.
Since that paper in 2001, over 100 studies have explored the weekend effect, across a range of patient populations and health systems.2 Surprisingly, despite this large number of studies, there remains ongoing debate about whether the weekend effect exists, and if so, what causes it. For example, one recent and highly influential study found higher rates of in-hospital death following admission on Saturday or Sunday compared with Wednesday admissions (HR 1.10 for Saturday and 1.15 for Sunday).3 To read the full article, log in using your NHS OpenAthens details.
Open access. In 2001, the Institute of Medicine defined high-quality healthcare as care that is safe, effective, patient-centred, timely, efficient and equitable.1 Subsequently, efforts to improve quality have tended to treat the six dimensions as separate rather than interrelated, with improvement in the various dimensions being pursued independently, led by different professions and occupational groups. Investment in research and improvement knowledge across the dimensions has been comparatively uneven, with little shared learning between researchers and professionals working to improve quality in one dimension about the value and efficacy of improvement approaches and methods used in others. Despite policy efforts to define quality in the round as safe, effective and patient-centred,2 3 and despite intermittent calls for patients to be involved in patient safety,4 the dimensions of quality do not have equal status within the improvement community, and patients and families do not play much part in patient safety: their input in this area is seen as subjective and less relevant to outcomes.
Patient safety measurement remains a global challenge. Patients are an important but neglected source of learning; however, little is known about what patients can add to our understanding of safety. We sought to understand the incidence and nature of patient-reported safety concerns in hospital.. To read the full article, log in using your NHS OpenAthens details.
West London NHS Trust has been rated Good overall by the Care Quality Commission.
The trust, which was formerly known as West London Mental Health Trust, was rated Outstanding for being caring, Good for being effective, responsive and well-led, and Requires Improvement for being safe, during the inspection which took place on dates between August and October 2018.
West London NHS Trust provides mental health and an increasing range of community healthcare services in west London and Berkshire.
Open access. South West London and St George's Mental Health NHS Trust developed a system of weekend new patient reviews by higher trainees to provide senior medical input 7 days a week. To evaluate the effectiveness of these reviews, the notes for all patients admitted over 3 months were examined. The mean length of stay for patients before and after the introduction of the weekend new patient reviews were compared via unpaired t-test.
Providers should continue to ensure that they provide communication to families of people who have died using their services and those affected by serious incidents. By Laura Paton. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
The Care Quality Commission has rated wards for people with learning disabilities or autism provided by Central and North West London NHS Foundation Trusts as Outstanding following its latest inspection.
Determination of phosphate solubilization and plant growth promotion of bacterial isolates from paddy rhizosphere Vinithra Muthaiyan, Saravanan...
IJAAR Published such kinds of Articles in every issue. Here is March 3 issue
This quality standard covers short-term prevention and management of violent and physically threatening behaviour among adults, children and young people with a mental health problem. It applies to settings where mental health, health and social care services are provided. This includes community settings and care received at home. It describes high-quality care in priority areas for improvement.
The Shrewsbury and Telford Hospital NHS Trust (SaTH) has been working to improve care for patients who suffer Sepsis and has been using techniques learnt from the Virginia Mason Institute (VMI) in Seattle, as part of a five-year partnership.
This guideline covers assessing and reducing the risk of venous thromboembolism (VTE or blood clots) and deep vein thrombosis (DVT) in people aged 16 and over in hospital. It aims to help healthcare professionals identify people most at risk and describes interventions that can be used to reduce the risk of VTE.
April 2016: Statement 4 describing the use of compression stockings was removed. This is because the guidance from NICE has been updated and the advice on using compression stockings has changed. All other information remains the same.
In the last 10 years or more there has been a proliferation of ‘innovations’ under the guise of improving patient safety and quality improvement. Service and quality improvements have a dominant focus on small-scale projects, incorporating locally collected ‘evidence’ and engaging in small ‘tests of change’ usually using PDSA (Plan, Do, Study, Act) cycles that get scaled up across organisations if considered to be successful....Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Quality improvement initiatives can become bogged down by excessive data collection. Sometimes the question arises—are we doing an adequate job with respect to a recommended practice? Are we complying with some guideline in at least X% of our patients? The perception that one must audit large numbers of charts may present a barrier to initiating local improvement activities. The model for improvement and its Plan–Do–Study–Act (PDSA) cycles typically require frequent data collection to test ideas and refine the planned change strategy. The perception that data collection must involve many patients can lead to insufficiently frequent PDSA cycles.1 In this review, we demonstrate the important contributions that small samples can make to improvement projects, including local audits, PDSA cycles and during broader implementation and evaluation. To read the full article, log in using your NHS Athens
Open access. The Primary Care Patient Measure of Safety (PC PMOS) is designed to capture patient feedback about the contributing factors to patient safety incidents in primary care. It required further reliability and validity testing to produce a robust tool intended to improve safety in practice.