Improving the management of iron deficiency in ambulatory heart failure patients

"In an attempt to improve patient and physician satisfaction we piloted an ambulatory outpatient service to deliver iv iron. We demonstrated that this service was feasible and more efficient as less time was required waiting for a bed or spent in hospital and was less costly."

Improving the management of iron deficiency in ambulatory heart failure patients
C Hayward, H Patel, C Allen, A Vazir
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u209822.w4076

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Home administration of intravenous diuretics to heart failure patients

"Originally a 2-year pilot programme to assess safe and effective ways for specialist nursing teams to administer intravenous (IV) diuretics to people at home or in a day-care setting, preventing hospital admissions and improving patient experience. Without this service patients would be admitted to hospital to receive IV diuretics."

Home administration of intravenous diuretics to heart failure patients: Increasing productivity and improving quality of care
Quality and Productivity case study
British Heart Foundation
June 2015

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Triggers for palliative care: Improving access

"This report explores the evidence around access to palliative care for people with terminal illnesses other than cancer."

Triggers for palliative care:  Improving access to care for people with diseases other than cancer
Marie Curie
June 2015

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Outcomes in patients with heart failure treated in hospitals with varying admission rates

"Heart failure admission rates exhibited variability between institutions, and patients who presented to emergency departments with low admission rates experienced higher rates of subsequent adverse outcomes in a single-payer health system."

Outcomes in patients with heart failure treated in hospitals with varying admission rates: population-based cohort study
RS Bhatia, PC Austin, TA Stukel, MJ Schull, A Chong, JV Tu, DS Lee
BMJ Quality and Safety 2014;23:981-988 doi:10.1136/bmjqs-2014-002816

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Best BMJ Quality & Safety articles 2013

"This special collection reflects the depth and breadth of content from BMJ Quality & Safety, which encourages innovation and creative thinking to improve the quality of health care and the science of improvement."

Articles included in the collection are:

• Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia
• The global burden of unsafe medical care: analytic modelling of observational studies
• Systematic review of the application of the plan–do–study–act method to improve quality in healthcare
• Assessing adverse events among home care clients in three Canadian provinces using chart review
• 'Care left undone’ during nursing shifts: associations with workload and perceived quality of care
• Allocating scarce resources in real-time to reduce heart failure admissions: a prospective, controlled study
• Culture and behaviour in the English National Health Service: overview of lessons from a large
  multimethod study

BMJ Quality & Safety: A collection of key articles
The Health foundation

April 2014

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QIPP case study: Home administration of intravenous diuretics to heart failure patients

This case study "summarises a two-year pilot programme to assess safe and effective ways for specialist nursing teams to administer intravenous (IV) diuretics to people at home or in a day-care setting preventing hospital admissions and improving patient experience."

Home administration of intravenous diuretics to heart failure patients: Increasing productivity and improving quality of care
British Heart Foundation
December 2013

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Telemonitoring after discharge from hospital with heart failure

"Cost-effectiveness analyses suggest that telemonitoring was an optimal strategy in most scenarios, but there is considerable uncertainty in relation to clear descriptions of the interventions and robust estimation of costs."

Telemonitoring after discharge from hospital with heart failure: cost-effectiveness modelling of alternative service designs
P Thokala, et al.
BMJ Open, 2013, 3:e003250

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Reducing cardiac arrests in the acute admissions unit

"Through adoption of a shared goal, application of improvement methodology including the model for improvement to test new innovations, and promotion of a safety culture in the AAU, cardiac arrests were successfully reduced to <1/1000 admissions per month with an associated significant fall in mortality. This was achieved with negligible cost."

Reducing cardiac arrests in the acute admissions unit: a quality improvement journey
DJ Beckett, M Inglis, S Oswald, E Thomson, W Harley, J Wilson, RC Lloyd, KD Rooney
BMJ Quality & Safety, 2013, 7(17)

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Allocating scarce resources to reduce heart failure readmissions

"An electronic medical record-enabled strategy that targeted scarce care transition resources to high-risk HF patients significantly reduced the risk-adjusted odds of readmission."

Allocating scarce resources in real-time to reduce heart failure readmissions: a prospective, controlled study
R Amarasingham, PC Patel, K Toto, LL Nelson, TS Swanson, BJ Moore, B Xie, S Zhang, KS Alvarez, Y Ma, MH Drazner, U Kollipara, EA Halm,
BMJ Quality and Safety Online First, published on 31 July 2013

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Contemporary evidence about hospital strategies for reducing 30-day readmissions

"Although most hospitals have a written objective of reducing preventable readmissions of patients with heart failure or acute myocardial infarction, the implementation of recommended practices varied widely."

Contemporary evidence about hospital strategies for reducing 30-day readmissions: a national study
EH Bradley, et al.
Journal of the American College of Cardiology, 2012, online first

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