New Commissioning for Value packs

"The information in the packs will be of particular interest to CCG clinical and management leads with responsibility for finance, performance, improvement and health outcomes; to NHS England regional team leads; and to commissioning support teams who are helping CCGs with this work."

Commissioning for Value – comprehensive data packs to support CCGs and NHS England in the regions
NHS England
January 2016

Access the packs here.

Improving the quality of operative notes by implementing a new electronic template for upper limb surgery

"After implementation of the templates we found no delays in full operative notes being typed and a 100% adherence with the RCS guidelines. This project significantly improved the quality and timely production of electronic surgical notes within a sustainable electronic software solution."

Improving the quality of operative notes by implementing a new electronic template for upper limb surgery at the Royal Derby Hospital

K Theivendran, S Hassan, DI Clark
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u208727.w3498

Read more here.

Analgesia in hip fractures. Do fascia-iliac blocks make any difference?

"Our experience shows a great improvement in compliance with fascia-iliac blocks in the pre-operative period. This work has also underpinned the introduction of a new hip fracture care pathway ultimately to better patient care and outcomes."

Analgesia in hip fractures. Do fascia-iliac blocks make any difference?
J Callear, K Shah
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u210130.w4147

Read more here.

Improving antibiotic prescribing practice in a respiratory ward

"This project aims to improve compliance with documentation of indication and duration of antibiotic use in line with our local antibiotic prescribing guidelines. Post-intervention results were encouraging with compliance rates increasing from 24% to 94% for indication, and from 39% to 71% for duration."

Antimicrobial stewardship: Improving antibiotic prescribing practice in a respiratory ward
JM Yeo
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u206491.w3570

Read more here.

Improving information availability in vascular surgical clinics

"Data driven interventions and repeated PDCA cycles can improve hospital systems for minimal cost. With an annual clinic turnaround of 2500 patients, these interventions can reduce clinic delays and potential harm caused by unavailable records for up to 500 patients a year."

Improving information availability in vascular surgical clinics. A service evaluation and improvement project
K Hurst, S Kreckler, A Handa,
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u210012.w4177

Read more here.

A quality improvement project to tackle under-reporting of hazards by doctors by using an anonymous telephone hotline

"The trial of the reporting answerphone demonstrated that if reporting was made easier, quicker and anonymous then reporting rates increased exponentially."

A quality improvement project to tackle under-reporting of hazards by doctors by using an anonymous telephone hotline
S Johnson
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u208718.w3660

Read more here.

Anticipatory management communication in end-of-shift medicine and nursing handoffs

"The different frequencies for types of AMC likely reflect differences in how residents and nurses work and disparate professional cultures. But, verbal communication in both groups included important information unlikely to be captured in written handoff tools or the electronic medical record, underscoring the importance of direct communication to ensure safe handoffs."

“Mr Smith's been our problem child today…”: anticipatory management communication (AMC) in VA end-of-shift medicine and nursing handoffs
AA Bergman, ME Flanagan, PR Ebright, CM O'Brien, RM Franke
BMJ Quality and Safety 2016;25:84-91 doi:10.1136/bmjqs-2014-003694

Read more here.

Implementing Evidence-based Suicide Prevention Training in Communities

"Suicide prevention trainings are implemented to equip the public’s ability to intervene with those who are at-risk, but their implementation is not often monitored for quality. In this study, we propose a quality improvement model to improve trainer skill, demonstrate evidence of knowledge uptake, and document the quality of training workshop implementation."

Implementing Evidence-based Suicide Prevention Training in Communities: Implications for Quality Improvement
KC Osilla, R Ramchand, R Seelam, D Barnes-Proby, ML Gilbert 
Journal of Community Medicine and Health Education, 2015;5:371. doi:10.4172/2161-0711.1000371

Read more here.

Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis

"Arthritis stakeholders have proposed 28 KPIs [Key Performance Indicators] that should be used in quality improvement efforts when evaluating centralized intake for OA [osteoarthritis] and RA [rheumatoid arthritis]. The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems."

Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis
CE Barber et al.
Arthritis Research & Therapy 2015, 17:322 doi:10.1186/s13075-015-0843-7

Read more here. 

Knowledge Translation and Barriers to Imaging Optimization in the Emergency Department

"This article outlines a research agenda to promote the dissemination and implementation (also known as knowledge translation) of evidence-based interventions for emergency department (ED) imaging, i.e., clinical pathways, clinical decision instruments, and clinical practice guidelines."

Knowledge Translation and Barriers to Imaging Optimization in the Emergency Department: A Research Agenda
MA Probst
Academic Emergency Medicine 2015;22:1455–1464

Read more here.

The digital revolution: eight technologies that will change health and care

"Some of the technologies we discuss are on the horizon – others are already in our pockets, our local surgeries and hospitals. But none are systematically deployed in our health and care system. Each could represent an opportunity to achieve better outcomes or more efficient care."

The digital revolution: eight technologies that will change health and care
C Gretton, M Honeyman
The King's Fund
January 2016

Read more here.

A zero cost way to reduce missed hospital appointments

"This randomised controlled trial tested the effectiveness of the reminder message sent to outpatients. Results showed if the message included the specific cost to the NHS of not attending then the patient was more likely to attend or rearrange their appointment – rather than miss it."

A zero cost way to reduce missed hospital appointments
Department of Health
January 2016

Read more here.

Middle managers’ experience implementing healthcare innovations in practice

"If engaging in hypothesized roles promotes implementation effectiveness, then the middle manager role theory should be leveraged to develop an intervention to enable middle managers to fulfill hypothesized roles with the support of top managers; doing so may promote the implementation of innovations intended to reduce the gap between evidence and practice."

Elaborating on theory with middle managers’ experience implementing healthcare innovations in practice
SA Birken, LD DiMartino, MA Kirk, SD Lee, M McClelland, NM Albert
Implementation Science 2016, 11:2  doi:10.1186/s13012-015-0362-6

Read more here.

BRAFV600E mutation testing for thyroid cancer

"The BRAF V600E mutation test is more than 99% specific for thyroid cancer, so a positive result means that it is more than 99% likely that the patient has a malignancy and the entire thyroid can be removed in 1 operation rather than 2. This reduces the risks of complications and shortens the total time spent in hospital and recovery."

BRAFV600E mutation testing for thyroid cancer: avoiding unnecessary surgery 
NICE Quality and productivity example
Portsmouth Acute Hospitals NHS Trust
December 2015

Read more here. 

Unbundling recovery: A step-by-step guide to audit and modelling

"This practical guide sets out a methodology for providers to audit whether the recovery aspects of a patient's acute hospital stay could be better provided and to model the impact of varying lengths of stay on tariff and bed utilisation."

Unbundling recovery: A step-by-step guide to audit and modelling
NHS Improving Quality
June 2015

Read more here.

A directory of organisations, groups and teams that support innovation, improvement, leadership development and systems leadership

"The Directory is a first run at describing the kinds of support available, at regional and national levels, to the vanguard localities for new care models and those leading other priority work of the Five Year Forward View. The offer encompasses systems leadership support, advice and guidance in relation to workforce and organisational development issues, help with transformational change and assistance with data-sharing and capitated budgets."

A directory of organisations, groups and teams that support innovation, improvement, leadership development and systems leadership: How they could potentially support new care models and other priorities in the Five Year Forward View
NHS Improving Quality
September 2015

Read more here.

Evaluation of the physician quality improvement initiative

The PQII provides an opportunity for physician development, affirmation and reflection, but also a structure to further departmental quality improvement, best practices, and finally, an opportunity to enhance communication, accountability and relationships between the organization, department chiefs and their staff.

Evaluation of the physician quality improvement initiative: the expected and unexpected opportunities
K Wentlandt, A Bracaglia, J Drummond, L Handren, J McCann, C Clarke, N Degendorfer, CK Chan
BMC Medical Education 201515:230

Read more here.

Transforming end of life care in acute hospitals

"Throughout this guide, you will be encouraged to use existing models and practical tools already identified as examples of good practice. They can help you achieve the improvements you wish to prioritise locally to improve the quality of end of life care for your patients and their families."

Transforming end of life care in acute hospitals: The route to success ‘how to’ guide
NHS England
December 2015

Read more here.

Emergency Care Improvement Programme

"The Emergency Care Improvement Programme will focus on helping 28 urgent and emergency care systems across England that are under the most pressure and will deliver real improvements in quality, safety and patient flow."

Access improvement tools, videos and more at the NHS Emergency Care Improvement Programme website.

Medication safety curriculum: enhancing skills and changing behaviors

"Students that participate in medication reconciliation/ optimization curricular activities are better prepared to critically assess medications for safety and efficacy in medical practice."

Medication safety curriculum: enhancing skills and changing behaviors
KD Karpa, LL Hom, P Huffman, EB Lehman, VM Chinchilli, P Haidet, SL Leong
BMC Medical Education (2015) 15:234

Read more here.

Leading in a crisis: the power of transparency

"Leaders who promote and model transparent behaviours and instil a transparent culture in their organisations can use crises as learning and improvement opportunities." 

Leading in a crisis: the power of transparency
B Sadler, K Stewart
The Health Foundation
December 2015

Read more here.