Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications

Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications
N Abdallah, R Conn, A Latif Marini
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u210300.w4189

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Reducing inpatient falls in a 100% single room elderly care environment

"The nurse training programme on falls risk assessment has improved nurse knowledge of falls risk and actual completion of Falls Risk Assessments. This is especially in areas of cognition, environmental hazard, osteoporosis risk. The collaborative quality improvement work has led to a reduction of inpatient falls by 34% in a high-risk 100% single room environment." 

Reducing inpatient falls in a 100% single room elderly care environment: evaluation of the impact of a systematic nurse training programme on falls risk assessment (FRA)
I Singh, J Okeke
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u210921.w4741

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Improving Clinical Remission Rates in Pediatric Inflammatory Bowel Disease with Previsit Planning

"PVP [previsit planning] for management of a chronic disease in pediatrics is feasible, even in a high volume practice. Initiation of this process at MGHfC has resulted in the improvement of care provided to children and adolescents with IBD. The primary goal of increasing clinical remission rate from 77% to greater than 80% within one year of initiating PVP was achieved."

Improving Clinical Remission Rates in Pediatric Inflammatory Bowel Disease with Previsit Planning
JR Savarino, JL Kaplan, HS Winter, CJ Moran, EJ Israel
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u211063.w4361

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Impact of the DoH Commissioning for Quality and Innovation incentive on the success of venous thromboembolism risk assessment

"We achieved 95% RA [Risk Assessment] compliance which has favourably impacted on our daily practice and improved the quality of the clinical care."
The impact of the DoH Commissioning for Quality and Innovation incentive on the success of venous thromboembolism risk assessment in hospitalised patients. 
A Shlebak, P Sandhu, V Ali, G Jones, C Baker
Journal of the Royal Society of Medicine Open June 2016 vol. 7 no. 6 2054270416632702

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Using lean methodology to improve efficiency of electronic order set maintenance in the hospital

"Applying Lean production principles to the order set review process resulted in significant improvement in processing time and increased quality of orders. As use of order sets and other forms of clinical decision support increase, regular evidence and process updates become more critical."

Using lean methodology to improve efficiency of electronic order set maintenance in the hospital
L Idemoto, B Williams, C Blackmore
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u211725.w4724

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Implementation of a Shoulder Soft Tissue Injury Triage Service Improves Time to Surgery

"Our new service resulted in surgical repair of traumatic rotator cuff tears 29 days faster than the traditional system with an extra 38% of patients having surgery within 90 days of injury - a benchmark thought to improve outcome. Future work will aim to improve this percentage further and include long term patient follow up of outcome measures after surgery."

Implementation of a Shoulder Soft Tissue Injury Triage Service in a UK NHS Teaching Hospital Improves Time to Surgery for Acute Rotator Cuff Tears.
M Bateman, G Davies-Jones, A Tambe, DI Clark
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u211254.w4531

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Succeeding in Sustained Reduction in the use of Restraint using the Improvement Model

"As part of the Scottish Patient Safety Programme – Mental Health one of the main drivers was the reduction of harm to patients caused by restraint. The aim of this project was to reduce the number of restraints on our Acute Admissions ward."

Succeeding in Sustained Reduction in the use of Restraint using the Improvement Model
A Bell, N Gallacher
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u211050.w4430

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Improving maternal confidence in neonatal care through a checklist intervention

"These results suggest that introduction of a simple checklist can be successfully utilised to improve confidence of mothers in being able to care for their newborn child. Further investigation is indicated, but this intervention has the potential for routine application in postnatal care."

Improving maternal confidence in neonatal care through a checklist intervention
D Radenkovic et al.
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u210655.w4292

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Improving physical health for people taking antipsychotic medication

"The combination of interventions has created an improvement in monitoring and changes appear to be sustained throughout the project." 

Improving physical health for people taking antipsychotic medication in the Community Learning Disabilities Service
I Hall, A Shah
BMJ Quality Improvement Report 2016;5: doi:10.1136/bmjquality.u209539.w3933

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Reducing blood culture contamination rates in an Emergency Department

"Current guidelines advocate a contamination rate of 2–3%. From January 2013 to November 2014 inclusive, the contamination rate was 4.74% in our Emergency Department, responsible for initial management and investigation of over 40 cases of sepsis per month. A Quality Improvement team was created to try to reduce contamination rates to the recommended target."

A change of culture: reducing blood culture contamination rates in an Emergency Department
J Bentley, S Thakore, L Muir, A Baird, J Lee
BMJ Quality Improvement Report 2016;5: doi:10.1136/bmjquality.u206760.w2754

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Improving the quality of handover in a liaison psychiatry team

"Without guidelines handover between shifts is of a poor quality, and often lacks key information to allow colleagues to identify patients and prioritise need. Education of those performing these handovers did not produce any benefits, either immediately following its delivery or in longer term follow up. The implementation of a template to aid clinicians in recording this data did produce improvements and received positive feedback from doctors."

Improving the quality of handover in a liaison psychiatry team
J Brook, M Amaro Calcia
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u206492.w3442

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Secular trends and evaluation of complex interventions

"Understanding the rising tide phenomenon is important for a more nuanced interpretation of null results arising in the context of system-wide improvement. Recognition that a rising tide may have predisposed to a null result in one health system cautions against generalising the result to another health system where strong secular trends are absent."

Secular trends and evaluation of complex interventions: the rising tide phenomenon
YF Chen, K Hemming, AJ Stevens, RJ Lilford
BMJ Quality and Safety 2016;25:303-310 doi:10.1136/bmjqs-2015-004372

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User road testing of a draft version of SQUIRE 2.0

"Our findings show that writing scholarly healthcare improvement work requires a specific knowledge base, and this knowledge is not universally held. We now know some of the specific gaps that should be addressed to help SQUIRE 2.0 reach its goal of improving the reporting of improvement work. The findings should be helpful not just for the development of SQUIRE 2.0 but also in the education of the next generation, for whom exposure to improvement work is now becoming standard."

Findings from a novel approach to publication guideline revision: user road testing of a draft version of SQUIRE 2.0
L Davies, KZ Donnelly, DJ Goodman, G Ogrinc
BMJ Quality and Safety 2016;25:265-272 doi:10.1136/bmjqs-2015-004117

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A project to reduce the number of PIMs (potentially inappropriate medications) on an elderly care ward

"A systematic approach to ward rounds with a ward round checklist offers a rigorous method to reduce the prevalence of PIMs, and the frequency of adverse drug events. This has important implications in the wider context of growing pressures to deliver higher standards of cost effective clinical care."

Less is more: a project to reduce the number of PIMs (potentially inappropriate medications) on an elderly care ward
T H Aung, A J Beck, T Siese, R Berrisford
BMJ Quality Improvement Reports 2015;5: doi:10.1136/bmjquality.u207857.w4260

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The Participative Design of an Endoscopy Facility using Lean 3P

"The Lean 3P method provided a structured approach for corporate and clinical staff to work together with patient representatives as cross-functional teams. This participative approach facilitated communication and learning between stakeholders about care processes and personal preferences. Lean 3P therefore appears to be a promising approach to improving the healthcare facilities design process to meet user requirements."

The Participative Design of an Endoscopy Facility using Lean 3P
I Smith
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u208920.w3611

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The use of a pro forma to improve quality in clerking vascular surgery patients

"We found that using a pro forma helped to aid junior doctors in clerking new patients, and significantly improved the quality of their history and examinations. This leads to a potential positive impact on patient safety during their inpatient stay, and should be rolled out more widely across the hospital."

The use of a pro forma to improve quality in clerking vascular surgery patients
J Kentley, A Fox, S Taylor, Y Hassan, A Filipek
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u210642.w4280

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Eliminating guidewire retention during ultrasound guided central venous catheter insertion

"A multi-modal structured training program, integrated with a modified, pre-packed CVC set, and drapes with reminder stickers (all included in CVC PLUS) were cost effective, and improved patient safety by eliminating guidewire retention during CVC insertion."

Eliminating guidewire retention during ultrasound guided central venous catheter insertion via an educational program, a modified CVC set, and a drape with reminder stickers
WM Peh, WJ Loh, GC Phua, CM Loo
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u209550.w3941

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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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Improving the quality of operative notes by implementing a new electronic template for upper limb surgery

"After implementation of the templates we found no delays in full operative notes being typed and a 100% adherence with the RCS guidelines. This project significantly improved the quality and timely production of electronic surgical notes within a sustainable electronic software solution."

Improving the quality of operative notes by implementing a new electronic template for upper limb surgery at the Royal Derby Hospital

K Theivendran, S Hassan, DI Clark
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u208727.w3498

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Improving information availability in vascular surgical clinics

"Data driven interventions and repeated PDCA cycles can improve hospital systems for minimal cost. With an annual clinic turnaround of 2500 patients, these interventions can reduce clinic delays and potential harm caused by unavailable records for up to 500 patients a year."

Improving information availability in vascular surgical clinics. A service evaluation and improvement project
K Hurst, S Kreckler, A Handa,
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u210012.w4177

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