Improving the quality of care in the last days of life: medication

"This document identifies best practice in the way medications should be managed in the last days of life. It sets out practical, high level, evidence-based recommendations to help guide those responsible for care to review their processes and consider ways to make change where necessary."

Improving the quality of care in the last days of life: A practical guide to getting the medications right
London Clinical Networks
April 2016

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London acute neurology services: A case for change

This document describes why neurological services must change how patients are managed upon entering the health system through emergency and urgent care routes.

London acute neurology services: A case for change
London Clinical Networks
January 2015

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Strategic quality improvement

"The King’s Fund was commissioned by Oxleas NHS Foundation Trust to work with their Quality Board to facilitate an assessment of its existing approaches to quality improvement and to develop a strategy for future work. This case study details the approach and philosophy behind this work, which involved working with the trust’s five directorates to develop their ability to appraise their own approach to quality improvement with a view to improving performance, achieving better clinical outcomes and building further on the trust’s capacity as a learning organisation."

Strategic quality improvement: An action learning approach
V Nath
The King's Fund
May 2016

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A clear road ahead: Creating a coherent quality strategy for the English NHS

"A clear road ahead sets out a practical and feasible set of actions for policymakers to safeguard and improve care within current priorities, as well as support the development of the NHS for years to come."

A clear road ahead: Creating a coherent quality strategy for the English NHS
A Molloy, S Martin, T Gardner, S Leatherman
The Health Foundation
July 2016

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Progressing patient and public involvement in healthcare improvement

"Our findings point to a need to re-evaluate methods and approaches for involving patients and the public in all aspects of healthcare and in healthcare improvement. Partnership working has long been the explicit stated goal of involvement. However, current involvement practices at a national and local level often involve a narrow group of individuals in involvement activities, with little consideration given to including a broader demographic of the population."

From tokenism to empowerment: progressing patient and public involvement in healthcare improvement
J Ocloo, R Matthews
BMJ Quality and Safety 2016;25:626-632 doi:10.1136/bmjqs-2015-004839

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Uptake, outcomes, and costs of implementing non-invasive prenatal testing for Down’s syndrome into NHS maternity care

"Implementation of NIPT [non-invasive prenatal testing] as a contingent test within a public sector Down’s syndrome screening programme can improve quality of care, choices for women, and overall performance within the current budget."

Uptake, outcomes, and costs of implementing non-invasive prenatal testing for Down’s syndrome into NHS maternity care: prospective cohort study in eight diverse maternity units
LS Chitty
BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i3426

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Building Q: Learning from designing a large scale improvement community

"The report identifies lessons for anyone seeking to support improvement work across organisations or through networks, as well as those engaged in designing initiatives with many diverse stakeholders. It draws on a variety of sources including the independent real-time evaluation of Q undertaken by RAND Europe."

Building Q: Learning from designing a large scale improvement community
P Pereira, H O'Malley
The Health Foundation
May 2016

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Abdominal drainage versus no drainage post-gastrectomy for gastric cancer

"This Cochrane review concludes that there is no convincing evidence to support the routine use of abdominal drains in patients under-going gastrectomy for gastric cancer"

Abdominal drainage versus no drainage post-gastrectomy for gastric cancer

The UK Cochrane Centre and NICE
Quality and Productivity case study

April 2016

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Developing and evaluating oncology trainee education around minimization of adverse events and improved patient quality and safety

"Our study demonstrates that an online game is well accepted by junior doctors as a method to increase their quality improvement awareness. Developing effective and sustainable training for doctors is important to ensure positive patient outcomes are maintained in the hospital setting."

A mixed methods approach to developing and evaluating oncology trainee education around minimization of adverse events and improved patient quality and safety
A Janssen et al.
BMC Medical Education, 2016 16:91, DOI: 10.1186/s12909-016-0609-1  J

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Bringing together physical and mental health

"The report identifies 10 areas where there is particular scope for improvement. These span the full range of health system activities, illustrating that change is needed across the system. Commissioners and providers can use these 10 areas as a guide to identify where some of the most significant opportunities for quality improvement and cost control lie."

Bringing together physical and mental health: A new frontier for integrated care
C Naylor, P Das, S Ross, M Honeyman, J Thompson, H Gilburt
The King's Fund
March 2016

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Improving acute psychiatric care for adults in England

"The Commission’s starting point is that patients with mental health problems should have the same rapid access to high quality care as patients with physical health problems. It proposes the introduction of firm targets for improvement combined with new approaches to quality, data management, innovation and investment."

Old problems, New solutions: Improving acute psychiatric care for adults in England
The Independent Commission on Acute Adult Psychiatric Care
February 2016

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Characteristics of morbidity and mortality conferences associated with the implementation of patient safety improvement initiatives

"This study suggests that the implementation of improvement initiatives relates to MCC [Morbidity and mortality conferences] characteristics. Recommendations for developing more effective patient safety-oriented MMCs can be proposed."

Characteristics of morbidity and mortality conferences associated with the implementation of patient safety improvement initiatives, an observational study
P François, F Prate, G Vidal-Trecan, JF Quaranta, J Labarere, E Sellier
BMC Health Services Research, 2016, 16:35 DOI: 10.1186/s12913-016-1279-8

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Patient representatives’ views on patient information in clinical cancer trials

"The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language, structured text and illustrations to improve the informed consent process and thereby patient enrolment into clinical trials."

Patient representatives’ views on patient information in clinical cancer trials
P Dellson, M Nilbert, C Carlsson
BMC Health Services Research, 2016, 16:36 DOI: 10.1186/s12913-016-1272-2

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Implementing Evidence-based Suicide Prevention Training in Communities

"Suicide prevention trainings are implemented to equip the public’s ability to intervene with those who are at-risk, but their implementation is not often monitored for quality. In this study, we propose a quality improvement model to improve trainer skill, demonstrate evidence of knowledge uptake, and document the quality of training workshop implementation."

Implementing Evidence-based Suicide Prevention Training in Communities: Implications for Quality Improvement
KC Osilla, R Ramchand, R Seelam, D Barnes-Proby, ML Gilbert 
Journal of Community Medicine and Health Education, 2015;5:371. doi:10.4172/2161-0711.1000371

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Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis

"Arthritis stakeholders have proposed 28 KPIs [Key Performance Indicators] that should be used in quality improvement efforts when evaluating centralized intake for OA [osteoarthritis] and RA [rheumatoid arthritis]. The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems."

Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis
CE Barber et al.
Arthritis Research & Therapy 2015, 17:322 doi:10.1186/s13075-015-0843-7

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Evaluation of the physician quality improvement initiative

The PQII provides an opportunity for physician development, affirmation and reflection, but also a structure to further departmental quality improvement, best practices, and finally, an opportunity to enhance communication, accountability and relationships between the organization, department chiefs and their staff.

Evaluation of the physician quality improvement initiative: the expected and unexpected opportunities
K Wentlandt, A Bracaglia, J Drummond, L Handren, J McCann, C Clarke, N Degendorfer, CK Chan
BMC Medical Education 201515:230

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Transforming end of life care in acute hospitals

"Throughout this guide, you will be encouraged to use existing models and practical tools already identified as examples of good practice. They can help you achieve the improvements you wish to prioritise locally to improve the quality of end of life care for your patients and their families."

Transforming end of life care in acute hospitals: The route to success ‘how to’ guide
NHS England
December 2015

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Emergency Care Improvement Programme

"The Emergency Care Improvement Programme will focus on helping 28 urgent and emergency care systems across England that are under the most pressure and will deliver real improvements in quality, safety and patient flow."

Access improvement tools, videos and more at the NHS Emergency Care Improvement Programme website.

The Health Foundation: November Research Scan

The Health Foundation have released their November research scan summarising the latest research of interest to those working in healthcare quality improvement. The scan covers the themes of person-centred care, patient safety, value for money and improvement approaches.

Statistical process control and interrupted time series: a golden opportunity for impact evaluation in quality improvement

"A key question in quality improvement is ‘What works?’ More and better use of data from SPC-projects can strengthen the evidence base and lead to more effective quality improvement strategies. Applying ITS analysis should be a matter of routine when SPC data are used for impact assessment."

Statistical process control and interrupted time series: a golden opportunity for impact evaluation in quality improvement

A Fretheim, O Tomic
BMJ Quality and Safety 2015;24:748-752 doi:10.1136/bmjqs-2014-003756

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