Friday 18 December 2015

Consensus on quality

"At the end of 2014, Solutions for Public Health (SPH) was commissioned to conduct a study to gather consensus from a range of stakeholder groups on what they felt was important to measure in order to understand the quality of healthcare. This study used a Delphi-style consultation approach to interrogate 73 statements that describe the measurable aspects of the quality of healthcare."

Consensus on quality
H Dorning
The Health Foundation, Nuffield Trust
December 2015

Read more here.

Wednesday 16 December 2015

Sustainability and financial performance of acute hospital trusts

"The Department, NHS England, Monitor and the NHS TDA need to take a more holistic, coordinated approach to tackling trusts’ persistent financial problems and move beyond quick fixes to cut trusts’ spending. Until there is a clear pathway for trusts to get back to financial stability, we cannot be confident that value for money, defined as financial and service sustainability, will be achieved."

Sustainability and financial performance of acute hospital trusts
National Audit Office
December 2015

Read more here.

NHS Safety Thermometer: Patient Harms and Harm Free Care

"The NHS Safety Thermometer is the measurement tool for a programme of work to support patient safety improvement. It is used to record patient harms at the frontline, and to provide immediate information and analyses for frontline teams to monitor their performance in delivering harm free care."

NHS Safety Thermometer: Patient Harms and Harm Free Care England November 2014 November 2015, official statistics 
Clinical Audit Support Unit
Health & Social Care Information Centre
December 2015

Read more here.

A practical guide to self-management support

"The guide explains what self-management support is and why it is important. It then looks at various aspects of putting it into practice, including planning and commissioning, building knowledge, skills and confidence, and measurement and evaluation"

A practical guide to self-management support: Key components for successful implementation
A de Iongh, P Fagan, J Fenner, L Kidd
The Health Foundation
December 2015

Read more here.

What do patients say about emergency departments in online reviews?

"Consumer rating websites allow patients to provide rapid and public feedback on their experience of medical care. Web-based platforms may offer a novel strategy for assessing patient-centred quality in emergency care."

What do patients say about emergency departments in online reviews? A qualitative study
AS Kilaru, ZF Meisel, B Paciotti, YP Ha, RJ Smith, BL Ranard, RM Merchant
BMJ Quality and Safety 2016;25:14-24 doi:10.1136/bmjqs-2015-004035

Read more here.

Monday 7 December 2015

Improving the Quality of Orthotics Services in England

"This document sets out a case for action to tackle the rising demand and variation in access and quality of services experienced by children and adults requiring orthotic care in England. It explains why it is important to improve the commissioning of services in terms of clinical and cost benefits and discusses some of the key issues affecting services currently, along with the experiences that patients and their families have had in using those services "

Improving the Quality of Orthotics Services in England
NHS England
November 2015

Read more here

The effectiveness of interventions to improve laboratory requesting patterns among primary care physicians

"Interventions such as educational strategies, feedback and changing test order forms may improve the efficient use of laboratory tests in primary care; however, the level of evidence is quite low and the quality is poor." 

The effectiveness of interventions to improve laboratory requesting patterns among primary care physicians: a systematic review

SL Cadogan, John P. Browne1, Colin P. Bradley2 and Mary R. Cahill3
Implementation Science 2015, 10:167  doi:10.1186/s13012-015-0356-4

Read more here.

A qualitative study of how hospital innovations become routine

"Hospitals have an opportunity to promote the integration of new practices by planning for the extended effort required to hold a new practice in place while integration mechanisms take hold. By understanding how integrating mechanisms correspond to innovation characteristics, hospitals may be able to foster integrating mechanisms most likely to work for particular innovations."

Integrating new practices: a qualitative study of how hospital innovations become routine
AL Brewster, LA Curry, EJ Cherlin, K Talbert-Slagle, LI Horwitz, EH Bradley
Implementation Science 2015, 10:168  doi:10.1186/s13012-015-0357-3

Read more here.

Friday 4 December 2015

Behavioural insights in health care: Nudging to reduce inefficiency and waste

"There is much evidence that suggests the potential for all of these nudge-type interventions to be successful if suitably applied. However, the evidence available is highly variable in terms of quality, relevance to health care and behaviour change impact."

Behavioural insights in health care: Nudging to reduce inefficiency and waste
C Perry, K Chhatralia, D Damesick, S Hobden, L Volpe
The Health Foundation
December 2015

Read more here.

The Health Foundation: November Research Scan

The Health Foundation have released their November research scan summarising the latest research of interest to those working in healthcare quality improvement. The scan covers the themes of person-centred care, patient safety, value for money and improvement approaches.

Clinical guidance promoting safer medical care of patients detained under the Mental Health Act

"Through this project, we were able to identify defects in a system, provide needed guidance to enable safer and more equitable care to a vulnerable group, and foster closer collaboration between junior doctors and managers in the design and use of services."

How safe is our "place of safety"? Clinical guidance promoting safer medical care of patients detained under section 136 of the Mental Health Act
J Mouko, A Goddard, V Nimmo-Smith
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209141.w3721

Read more here.

Improving documentation within the acute stroke unit

"The results of this project have shown that by introducing a stroke specific clerking document, the quality of information recorded has significantly improved."

Improving documentation within the acute stroke unit: Introducing a stroke specific clerking proforma
S Patel
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u208852.w3847

Read more here.

Improving emergency department flow through Rapid Medical Evaluation unit

"By specifically re-purposing a fraction of existing staff, resources, and infrastructure for patients with lower acuity presentations, we were able to streamline their care and decrease wait times in the ED"

Improving emergency department flow through Rapid Medical Evaluation unit
L Chartier, T Josephson, K Bates, M Kuipers
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206156.w2663

Read more here.

A simple prioritisation system to improve the electronic handover

"Overall the introduction of an uncomplicated traffic light system provided an effective addition to the electronic handover structure aimed to allow patient prioritisation and improved efficiency during weekend hours."

A simple prioritisation system to improve the electronic handover
L Ah-kye, M Moore
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u205385.w4127

Read more here.

Improving the quality of the surgical preoperative assessment in a district general hospital

"The interventions described proved to be cheap and effective methods of improving the quality of the preoperative assessment, bringing it in line with the anaesthetic assessment and reducing the risk of same day cancellations."

Improving the quality of the surgical preoperative assessment in a district general hospital
J Koris, C Hopkins
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u205381.w3406

Read more here.

Implementing the NICE guideline on Transition between inpatient hospital settings and community or care home settings for adults with social care needs

"Overall, it is expected that implementing the guideline will be cost saving. Implementing the guideline is likely to have resource implications (both costs and savings) for health and social care commissioners and for providers"

Implementing the NICE guideline on Transition between inpatient hospital settings and community or care home settings for adults with social care needs (NG27) 
NICE (Costing statement)
December 2015

Read more here.

Improving Diagnosis in Health Care

"Improving the diagnostic process is not only possible, but it also represents a moral, professional, and public health imperative. Achieving that goal will require a significant reenvisioning of the diagnostic process and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers."

Improving Diagnosis in Health Care
EP Balogh, BT Miller, JR Ball
National Academies Press
September 2015

Read more here.

Wednesday 2 December 2015

Do pneumonia readmissions flagged as potentially preventable by the 3M PPR software have more process of care problems?

"Among VA [Veterans Health Administration] pneumonia readmissions, PPR [Potentially Preventable Readmissions] categorisation did not produce the expected quality of care findings. Either PPR–yes cases are not more preventable, or preventability assessment requires other data collection methods to capture poorly documented processes (eg, direct observation)."

Do pneumonia readmissions flagged as potentially preventable by the 3M PPR software have more process of care problems? A cross-sectional observational study
AM Borzecki et al.
BMJ Quality and Safety 2015;24:753-763 doi:10.1136/bmjqs-2014-003911

Read more here.

Statistical process control and interrupted time series: a golden opportunity for impact evaluation in quality improvement

"A key question in quality improvement is ‘What works?’ More and better use of data from SPC-projects can strengthen the evidence base and lead to more effective quality improvement strategies. Applying ITS analysis should be a matter of routine when SPC data are used for impact assessment."

Statistical process control and interrupted time series: a golden opportunity for impact evaluation in quality improvement

A Fretheim, O Tomic
BMJ Quality and Safety 2015;24:748-752 doi:10.1136/bmjqs-2014-003756

Read more here.

The SQUIRE Guidelines: an evaluation from the field

"The original SQUIRE Guidelines help with planning healthcare improvement work, but are perceived as complicated and unclear during writing. Key goals of the revision will be to clarify items where conflict was identified and outline the key components necessary for complete reporting of improvement work."

The SQUIRE Guidelines: an evaluation from the field, 5 years post release
L Davies, P Batalden, F Davidoff, D Stevens, G Ogrinc
BMJ Quality and Safety 2015;24:769-775 doi:10.1136/bmjqs-2015-004116

Read more here.

Development of the Quality Improvement Minimum Quality Criteria Set

"We developed a ready-to-use, valid and reliable critical appraisal instrument applicable to healthcare QI intervention publications, but recognise scope for continuing refinement."

Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications
S Hempel, PG Shekelle, JL Liu, M Sherwood Danz, R Foy, YW Lim, A Motala, LV Rubenstein
BMJ Quality and Safety 2015;24:796-804 doi:10.1136/bmjqs-2014-003151

Read more here.

NHS reference costs 2014 to 2015

"This publication sets out where over £61 billion has been spent by NHS providers in delivering
health care in 2014-15."

NHS reference costs 2014 to 2015
Department of Health
November 2015

Read more and access the data here.

Intentional whole health system redesign

"This case study has been written to offer inspiration for commissioners and providers in the English NHS, in particular the vanguards in the NHS’s new care models programme, embarking on system redesign. It aims to provide a description of Southcentral’s transformation journey as well as a snapshot of its service and organisational model, focusing on issues that are likely to be of most relevance to local NHS systems developing new care models"

Intentional whole health system redesign: Southcentral Foundation’s ‘Nuka’ system of care
Ben Collins
The King's Fund
November 2015

Read more here.

Tuesday 1 December 2015

Infection prevention and control: lessons from acute care in England

"This learning report is based on the findings of a large research study that identified and consolidated published evidence about infection prevention and control initiatives...The report considers what has been learned from the infection prevention and control work carried out over the last 15 years in hospitals in England. It looks at the lessons learned and outlines future directions for effective infection prevention and control." 

Infection prevention and control: lessons from acute care in England: Towards a whole health economy approach
The Health Foundation
November 2015

Read more here.

Continuous improvement of patient safety

"This report makes the case for changing the way patient safety is approached in the NHS. It argues that change is needed in: how safety is understood, because current approaches to measurement don’t provide the full picture; how safety is improved, because existing approaches alone will not address the most intractable problems; how risk is perceived, because comfort-seeking behaviours will not create a genuine culture of learning."

Published alongside the report is a safety improvement check list, as well as pointers to a host of other resources from the Health Foundation focused on assisting organisations in improving patient safety.

Continuous improvement of patient safety: The case for change in the NHS
J Illingworth
The Health Foundation
November 2015

Read more here.