Cost and risk management in critical care: reducing the use of colloids

"In the past, colloid fluid therapy was used as the primary resuscitation fluid in critically ill people. Increasing evidence ... suggests that crystalloid fluids are equivalent in effectiveness and cost considerably less. This project aimed to reduce colloid use by removing them from the clinical area and making them available by consultant prescription only."

Cost and risk management in critical care: reducing the use of colloids
City Hospitals Sunderland NHS Foundation Trust

NICE Quality and Productivity case study

November 2015

Read more here. 

Medicine optimisation can cut the costs of long term conditions

"Medicines optimisation can cut waste, emergency admissions and the cost of long term conditions. But a review of rheumatoid arthritis care reveals how far it has to go"

Medicine optimisation can cut the costs of long term conditions
M Shelley
Health Service Journal Supplement
June 2015

Read more here.

Smoking Cessation Interventions in the Cardiology Ward

"NRT was available for inpatients, but was rarely utilised by junior doctors. With the achievement of NCSCT certification by all the senior house officers, the recording of smoking status in the electronic patient record and the flagging up of patients yet to be queried about their smoking status, NRT prescription significantly increased from 25% to 100%"

Smoking Cessation Interventions in the Cardiology Ward

MP Cassar
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206437.w2654

Read more here.

The use of conscious sedation in elective external direct current cardioversion

"Hospitals that are still using general anaesthesia for patients undergoing DC cardioversion for atrial fibrillation / atrial flutter should consider switching to the use of conscious sedation. This can improve efficiency, cut costs, and reduce waiting times for patients, resulting in improved clinical outcomes."

The use of conscious sedation in elective external direct current cardioversion: a single centre experience
R Lobo, T Kiernan
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u208437.w3377

Read more here.

Management of Urinary Incontinence in females

"The community continence team and Gynaecologists at RCHT therefore worked together and developed an 'easy step' referral pathway for women with symptoms of UI [urinary incontinence]. This has been in use now and has now ensured a more streamlined and easy to follow guidance pathway. Overall, this has improved patient satisfaction and has improved appropriate referrals to the secondary care service thus saving costs."

Management of Urinary Incontinence in females: Are we really NICE?
Royal Cornwall Hospitals NHS Trust
NICE Shared Learning example
March 2015

Read more here.

Mobile clinics for chronic stable glaucoma management

"This initiative aims to improve productivity by reducing demand for appointments from low risk patients in hospital eye clinics, allowing the hospital to see more complex cases. The patient experience should improve because the number of appointments required for testing is reduced and the clinic is brought to locations nearer patients’ homes."

Mobile clinics for chronic stable glaucoma management: improving access and alleviating hospital demand
Ipswich and East Suffolk Clinical Commissioning Group and Ipswich Hospital NHS Trust
NICE Quality and Productivity example
January 2015

Read more here.

Ensuring appropriate use of monitored dosage systems

"This initiative aims to reduce the inappropriate use of monitored dosage systems by ensuring they are only issued on a case-by-case basis to address specific practical problems of medicines adherence."

Ensuring appropriate use of monitored dosage systems: reducing unnecessary pharmacy workload: QIPP Case Study
Taunton & Somerset NHS Foundation Trust
NICE Quality and productivity collection
January 2015

Read more here.

Bipolar disorder clinical audit tool (NICE)

"This clinical audit tool can be used to carry out a clinical audit project that aims to improve the short and longer term management of bipolar disorder in adults in social care."

CG185 Bipolar disorder (update): clinical audit tool
NICE
December 2015

Access the tool here.

Advice from NICE on Medicines Optimisation of Key Therapies

NICE have released a number of evidence-based Key Therapeutic Topics to support medicines optimisation. Access them below:

• Antibiotic prescribing – especially broad spectrum antibiotics (KTT9)
• First-choice antidepressant use in adults with depression or generalised anxiety disorder (KTT8) 
• Low-dose antipsychotics in people with dementia (KTT7)
• Hypnotics (KTT6)
• High-dose inhaled corticosteroids in asthma (KTT5)
• Omega-3 fatty acid supplements (KTT4)
• Lipid-modifying drugs (KTT3)
• Renin-angiotensin system drugs (KTT2)
• Wound care products (KTT14)
• Non-steroidal anti-inflammatory drugs (KTT13)
• Type 2 diabetes mellitus (KTT12)
• Minocycline (KTT11)
• Three-day courses of antibiotics for uncomplicated urinary tract infection
• Laxatives (KTT1)

Insulin pump therapy: clinical audit tool

NICE have published a cost saving audit tool to assist in comparing practice against the NICE technology appraisal guidance for insulin pump therapy.

TA151 Diabetes - insulin pump therapy: clinical audit tool
NICE
December 2014

Read more here.

The impact of nurse-led annual telephone follow-up of patients with inflammatory bowel disease

"Inflammatory bowel diseases (IBD) are characterised by periods of disease activity and period with disease in remission. In Denmark all patients are seen in hospital settings. The aim of this study was to introduce a nurse-led phone service for stable patients replacing annual visits."

The impact of nurse-led annual telephone follow-up of patients with inflammatory bowel disease

P Bager
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u206365.w2574

Read more here. 

Pressure ulcers: NICE clinical audit tools

NICE have published two clinical audit tools for pressure ulcer prevention, one for paediatric care and one for adults.

"Clinical audit tools are Excel spreadsheets developed to help with clinical audit. They contain clinical audit standards, data collection sheets, a clinical audit report an action plan template and a printable data collection form.  When data is entered into the data collection sheets the audit results are automatically displayed in the audit report."

Access the tools and find out more here.

What is the evidence on the economic impacts of integrated care?

"This report provides a summary of published reviews on the economic impacts of integrated care approaches." 

What is the evidence on the economic impacts of integrated care? 
E Nolte, E Pitchforth
European Observatory on Health Systems and Policies
2014

Read more here.

Prioritising person-centred care - the evidence

"In our search for evidence we looked at how patient involvement interventions contribute to four key outcomes:

•   improving people’s knowledge
•   enhancing people’s experience of services
•   impact on service use and cost, and
•   impact on people’s health"

Prioritising person-centred care - the evidence: summarising evidence from systematic reviews
National Voices
2014

Read more and access the summaries/guides here.

Environmental sustainability in hospitals

"Hospitals and care systems increasingly are looking for ways to improve efficiency and reduce overall costs while also improving the overall patient experience. Sustainability initiatives offer significant environmental and financial benefits for organizations—benefits that will help hospitals and care systems thrive now and in the future."

Environmental sustainability in hospitals: the value of efficiency
Health Research & Educational Trust
May 2014

Read more here.

Solving the NHS care and cash crisis

“We have, in short, a health and care system that is both unnecessarily expensive and poorly designed to meet modern needs.”

Solving the NHS care and cash crisis: routes to health and care renewal
N Warner, J O’Sullivan
Reform
March 2014

Read more here

Improving contraceptive services

"Investment in contraception saves money by reducing unintended pregnancy rates. This, in turn, will reduce costs for: the NHS, the education system, welfare" 

Contraceptive services
NICE local government briefings
March 2014

Read more here.

Accountable care organisations: Testing, evaluating and learning what works

"Now more than ever the NHS needs to be able to innovate at scale and pace and testing out a variety of ways of integrating care should be encouraged."

Accountable care organisations in the United States and England: Testing, evaluating and learning what works
Stephen Shortell, Rachael Addicott, Nicola Walsh, Chris Ham
The King's Fund
March 2014

Read more here.

Telehealth and telecare

"Increased use of technology such as telehealth and telecare may help to improve quality of care and reduce costs. This note describes current UK telehealth and telecare initiatives and the role they may play in delivering future care."

Telehealth and telecare - POST Note
P Border
Parliamentary Office of Science and Technology
February 2014

Read more here.

Focus On: Social care for older people

"Given the future trends in population growth and the visible constraints to local government, which is facing further budget cuts in the coming years, it is imperative that we develop better information systems that span care providers for older people."

Focus On: Social care for older people: Reductions in adult social services for older people in England 

S Ismail, R Thorlby, H Holder

The Health Foundation, Nuffield Trust

March 2014

Read more here.