Understanding patient flow in hospitals

"Previous Nuffield Trust work has argued that although the target can be over-emphasised, struggles in meeting it are associated with deeper problems in the capacity to move patients into hospital wards. This briefing draws on theories about congestion to look at why this has become more difficult, and what can be done about it. It aims to be useful to the hospital managers and people involved in Sustainability and Transformation Plans who tackle these problems on the front line, as well as to the policymakers who oversee them."

Understanding patient flow in hospitals
S Karakusevic, N Edwards
Nuffield Trust
October 2016

Read more here.

Investigating the impact of out-of-hours GP services on A&E attendance rates

"The satisfaction with overall GP services is significantly associated with the level of attendance at A&E both overall and during out-of-hours only. A 1% increase in ‘patients satisfied with their GP practice’s opening hours’ is associated with a 1% reduction in A&E attendance."

Investigating the impact of out-of-hours GP services on A&E attendance rates: multilevel regression analysis
National Audit Office
September 2015

Read more here.

Access to hospital care: is the NHS on target?

"Our fourth policy briefing in the run-up to the General Election 2015 examines how hospital trusts in England are performing against six national targets. The paper argues against the notion that dips in performance can be attributed to a handful of poorly performing hospital trusts, and finds there has been deterioration across the board in some measures."

Access to hospital care: is the NHS on target?
H Dorning, I Blunt
Nuffield Trust
March 2015

Read more here.

Improving safety through the establishment of a Hospital Alcohol Liaison Service

"The message to others is to ensure that in establishing a new service, this should be done with complete staff engagement in respect to understanding the direct effect of service change on creating a positive patients pathway with sustained positive clinical outcomes. The frontline workforce are key in delivering changes, therefore it is imperative that they are fully involved in the process."

Improving safety - through the establishment of a Hospital Alcohol Liaison Service (HALS), alongside the launch of a therapeutic Chlordiazepoxide prescribing Detoxification Regime
Tameside Hospital NHS Foundation Trust
NICE Shared learning example
January 2015

Read more here.

The Flex Track: Flexible Partitioning between Low- and High-Acuity Areas of an Emergency Department

"Using discrete-event simulation, we have shown that adding some flexibility into bed allocation between low- and high-acuity can provide substantial reductions in overall patient waiting and a more efficient ED [Emergency Department]."

The Flex Track: Flexible Partitioning between Low- and High-Acuity Areas of an Emergency Department
LF Laker, CM Froehle, CJ Lindsell, MJ Ward
Annals of Emergency Medicine. 2014; 64(6): 591–603. doi:  10.1016/j.annemergmed.2014.05.031

Read more here.

Accident and emergency survey 2014

"Read the results of our latest survey which asked people about their experiences of accident and emergency (A&E) departments in 2014."

Accident and emergency survey 2014
Care Quality Commission

Read more here.

The reconfiguration of clinical services

"This paper aims to help those planning and implementing major clinical service reconfigurations ensure that change is as evidence-based as possible. It investigates the five key drivers – quality, workforce, cost, access and technology"

The reconfiguration of clinical services: What is the evidence?
C Imison, L Sonola, M Honeyman, S Ross
The King's Fund
November 2014

Read more here.

Myocardial infarction (acute): Early rule out using high-sensitivity troponin tests

NICE have created a costing statement and audit tool to help implement and assess the impact of diagnostic guidance for acute Myocardial infarction.

Myocardial infarction (acute): Early rule out using high-sensitivity troponin tests (Elecsys Troponin T high-sensitive, ARCHITECT STAT High Sensitive Troponin-I and AccuTnI+3 assays)
NICE
October 2014

Access the tools here.

Focus on: A&E attendances

"We explored a range of factors thought to be contributing to increased pressure on A&E in the English NHS and tested whether recent changes in these factors could explain the current pressures observed in the system." 

Focus on: A&E attendances: Why are patients waiting longer?
I Blunt
Nuffield Trust, The Health Foundation
July 2014

Read more here.

Senior staff cover means earlier discharges

"Patients admitted to A&E in the evening can stay in hospital up to four days longer than those admitted in the morning. To reduce their stays, trusts can take targeted action during the assessment phase"

Senior staff cover means earlier discharges
S McGirr, A Mullarkey, S Graham, R Sowney, R Emeny, V Connolly
Health Service Journal, June 2014

Read more here.

Whole-system solutions for urgent and emergency care

"Demand for urgent and emergency care continues to increase year on year and it has been evident for some time that the system for delivering this care must adapt to meet ongoing and new challenges."

Ripping off the sticking plaster: Whole-system solutions for urgent and emergency care
Urgent and Emergency Care Forum
NHS Confederation
March 2014

Read more here.

How is the health and social care system performing?

"The Quarterly monitoring report combines publicly available data on selected NHS performance measures with views from NHS trust finance directors, clinical commissioning group (CCG) finance leads, and local authority directors of adult social services."

How is the health and social care system performing? Quarterly monitoring report
The King's Fund
January 2014

Read more here.

Focus On: Distance from home to emergency care

"This QualityWatch Focus On report examines the typical distances from home that people travel to receive emergency care, and how this has changed over time. It explores the distances between a person’s home and the hospital at which they attended A&E, or received an emergency inpatient admission, using Hospital Episode Statistics."

Focus On: Distance from home to emergency care
A Roberts, I Blunt, M Bardsley
The Health Foundation and the Nuffield Trust, London
February 2014

Read more here.

Driving improvement in A & E services

"Trusts have reduced reattendance rates by providing comprehensive information and followup advice when patients leave A & E."

Driving improvement in A & E services
Foundation Trust Network
October 2012

Read more here.

Consumer quality index (CQ-index) in an accident and emergency department

"The Consumer Quality index for the accident and emergency department measures patients' experiences of A&E healthcare performance."

The consumer quality index (CQ-index) in an accident and emergency department: development and first evaluation
N Bos, LM Sturms, AJP Schrijvers, HF van Stel
BMC Health Services Research, 2012, 12:284

Read more here.