Improving Pre-emptive Prescribing to Relieve Patient Discomfort Occurring Out of Hours

"Junior doctors are commonly asked to prescribe simple medications for symptom relief for patients out of hours. Unfortunately, time constraints and other pressures may lead to delays before the medications are prescribed. A quality improvement project was conducted at a large university teaching hospital to establish the extent of the problem, with the aim of finding measures to improve preemptive prescribing for patients."

Improving Pre-emptive Prescribing to Relieve Patient Discomfort Occurring Out of Hours
R Williams, F Herbert, A Orme, G Casswell

BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u206301.w3757

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Out of hours intravenous fluid therapy

"Recent NICE guidance has highlighted the importance of appropriate and safe intravenous fluid use. We aimed to improve the quality of out of hours fluid prescription in a Bristol hospital by ensuring that indications and cautions for fluid therapy were clearly documented at the time of initiation."

Out of hours intravenous fluid therapy: a prompt to guide prescribing
J Fehmi et al.
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u204010.w3139

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Confusion: delirium and dementia - a smartphone app to improve cognitive assessment

"The results of this study suggest that the introduction and use of a smartphone app for junior doctors increases the likelihood of older patients receiving a cognitive assessment for detecting delirium and dementia on specialist elderly and orthopaedic trauma wards."

Confusion: delirium and dementia - a smartphone app to improve cognitive assessment
S Sangha, J George, C Winthrop, S Panchal
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u202580.w1592

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Finding patients before they crash: the next major opportunity to improve patient safety

"We believe that the coming together of four major trends or innovations promises substantial improvements to patient outcomes by preventing this perennial problem of delayed recognition and management of deteriorating patients on general hospital wards."

Finding patients before they crash: the next major opportunity to improve patient safety
DW Bates, E Zimlichman
BMJ Quality and Safety 2015;24:1-3 doi:10.1136/bmjqs-2014-003499

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The Francis Report: one year on

"Many senior leaders of the acute trusts said that the publication of the Francis Report had prompted them to reflect in greater depth on the quality of care being delivered in their organisations." 

The Francis Report: one year on: The response of acute trusts in England
R Thorlby, J Smith, S Williams, M Dayan
Nuffield Trust
February 2014

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NHS in transition: key questions

"The most costly care – typically hospital based care – should ideally be used only when necessary, and non-hospital based alternatives should be encouraged, provided that they can help patients for less cost."

NHS in transition: key questions
Nuffield Trust
November 2013

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