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.

Improving length of stay: what can hospitals do?

"This report on length of stay by the Nuffield Trust is part of a larger project undertaken by Monitor which aims to find the best ways to improve quality of care across the health system in light of recent pressures on urgent and emergency care."
Improving length of stay: what can hospitals do?
N Edwards, R Lewis Nuffield Trust
September 2015

Read more here.

Enabling the local implementation of sustainable urgent and emergency care models

"To break the vicious circle resulting in increased pressures on A&Es, and ensure patients have access to the right care, in the right place at the right time, efforts should focus on building an effective community offer. This will require adequate investment to transform primary, community and social care – while ensuring that acute and emergency care remains sustainable."

Rip off the sticking plaster now: Enabling the local implementation of sustainable urgent and emergency care models in 2015/16
NHS Confederation, Urgent and Emergency Care Forum
April 2015

Read more here.

How is the NHS performing? April 2015

"As the NHS begins a new financial year and we move from one parliament to another, it is clear from the performance on key headline targets and standards and from our latest survey of finance directors that the NHS will face huge challenges this year – very possibly the most difficult for many years."

How is the NHS performing? April 2015: Quarterly monitoring report
J Appleby, J Thompson, J Jabbal
The King's Fund

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Are people waiting longer for health care?

"This overview considers the performance of the NHS in England in providing timely access to health care during the current parliament. We look at available data on waiting time targets across key services, including accident and emergency (A&E), ambulances, cancer treatment, secondary care and primary care."

Are people waiting longer for health care?
T Gardner
The Health Foundation
March 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.

A novel approach to improving coagulation sample ordering in an emergency department

"Through a simple change in longstanding clinical practice, we were able to reduce the number of unnecessary coagulation samples sent from the emergency department."

A novel approach to improving coagulation sample ordering in an emergency department
E Murphy, S MacGlone, C McGroarty
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u204785.w2857

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.

Improving the quality of initial management of self harm and suicide patients in A+E

"This audit cycle has shown an initial poor compliance to the NICE guidelines on initial management of self harm and suicide attempts in the James Paget A+E, which has been improved greatly with simple interventions."

Improving the quality of initial management of self harm and suicide patients in A+E at the James Paget Hospital
B Cracknell
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207272.w2919

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.

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.

Crisis response falls team: reducing admissions and repeat falls

"This initiative saves money by reducing the proportion of falls related calls that result in hospital admission. From over 1300 referrals accepted by the CRFT in Northamptonshire in 2012, just over 1000 admissions were avoided." 

Crisis response falls team: reducing admissions and repeat falls
East Midlands Ambulance Service NHS Trust
QIPP Case Study
August 2014

Read more 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.

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.

Evaluating adverse drug event reporting in administrative data from emergency departments

"Adverse drug events to outpatient medications were underreported in emergency department administrative data compared to the number of adverse drug events diagnosed and recorded at the point-of-care."

Evaluating adverse drug event reporting in administrative data from emergency departments: a validation study
CM Hohl, L Kuramoto, E Yu, B Rogula, J Stausberg, B Sobolev
BMC Health Services Research, 2013, 13:473

Read more here.

NHS England: Improving A&E Performance Gateway ref: 00062

"Working closely with other key stakeholders, and building on the views already shared from CCGs and providers, NHS England will put in place an approach that will support the emergency and urgent care system, reduce pressure and ensure that patients do not have to wait longer than the agreed standards as identified in the NHS constitution and thus meet the national operating target of 95%."

Read more here.

Emergency department visits for nonurgent conditions

"If health plans, policy makers, and providers want to reduce use of the ED for nonurgent problems, they must ensure that their interventions are evidence- based and tailored to address the needs and concerns of the populations they are designed to serve."

Emergency department visits for nonurgent conditions
L Uscher-Pines, J Pines, A Kellermann, E Gillen, A Mehrotra
The American Journal of Managed Care, 2013, 19(1):47-59

Read more here.

Making ambulance handover delays a thing of the past

"In this report, we have looked at ambulance turnaround delays on a national and whole system basis for the first time. "

Zero tolerance: making ambulance handover delays a thing of the past
NHS Confederation, Association of Ambulance Chief Executives
December 2012

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.