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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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

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Improving patient safety by implementing a new general surgical on-call rota for FY1 doctors

"This project demonstrates that altering rotas can improve junior doctor's perception of patient safety, and also shows that junior team members, with departmental support, can overcome barriers to change and implement new rotas."

Improving patient safety by implementing a new general surgical on-call rota for FY1 doctors
H Walton, M Uheba
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206069.w3327

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Improving venous thromboembolism (VTE) prophylaxis in acute urological admissions

"The aim of our quality improvement programme (QIP) was to monitor our practice regarding VTE prophylaxis of the patients' admitted urgently in our department, and then implement a measure to increase compliance if found to be poor."

Improving venous thromboembolism (VTE) prophylaxis in acute urological admissions during out of hours through the introduction of a urological admission proforma

E Gerakopoulos
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206418.w2677

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Ceiling of care decisions at an older person's mental health unit

"The issue was that decisions around ceilings of care for patients were often not discussed or at least recorded in the electronic notes and as a result when reviewing deteriorating patients out of hours trainees would find themselves without any guidance on the treating medics opinion on what was in the best interests of the patient."

Ceiling of care decisions at an older person's mental health unit in Gloucestershire
P Slack, A Rose
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207618.w3050

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Wireless working in hospitals: Improving efficiency and safety of out-of hours

"This initiative introduced a wireless IT system to manage workflow out of hours in hospitals, replacing the pager system. The objectives were to improve the quality and speed of communication between doctors and nurses, reduce information loss and improve satisfaction for both clinicians and patients." 

Wireless working in hospitals: Improving efficiency and safety of out-of hours
Nottingham University Hospitals NHS Trust
NICE QIPP Case Study
Quality and productivity example

June 2014

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