Improving inpatient care with the introduction of a hip fracture pathway

"A system of payment by results exists for the management of hip fractures in England and Wales. Poor performance against the national standards was noted, reflecting failure to deliver optimal care. Through the introduction of a multi-disciplinary patient pathway and clerking pro forma, the proportion of patients earning the best practice tariff uplift increased from 44.4% to 91.7%. "

Improving inpatient care with the introduction of a hip fracture pathway
M Chamberlain, H Pugh
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u204075.w2786

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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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Implementation of a ward round pro-forma to improve adherence to best practice guidelines

"This study has two main aims. Firstly, to measure the adherence to specific best practice guidelines for the prevention hospital acquired causes of mortality and morbidity (HACMMs) by doctors on a medical assessment unit in regional teaching hospital. Secondly, to measure the effectiveness of the study’s interventional checklist (the ward round pro-forma) on rates of adherence to best practice guidelines."

Implementation of a ward round pro-forma to improve adherence to best practice guidelines
X Boland
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207456.w2979

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Improving smoking cessation policy by assessing user demand for an inpatient smoking cessation service

"The intervention improved rates of documentation of smoking status, cessation advice, and offer of nicotine replacement therapy and referral for inpatients on two psychiatric wards."

Improving smoking cessation policy by assessing user demand for an inpatient smoking cessation service in adult psychiatric wards
K Liu, A Creamer
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207323.w2933

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Improving theatre efficiency and utilisation

"Surgical departments are increasingly put under pressure to improve services, cut waiting lists, increase efficiency and save money. At a district general hospital in the west-midlands we approached the challenge of improving efficiency and optimising the services available in our orthopaedic theatres."

Improving theatre efficiency and utilisation through early identification of trauma patients and enhanced communication between teams
S Roberts, A Saithna, R Bethune

BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206641.w2670

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Mobile clinics for chronic stable glaucoma management

"This initiative aims to improve productivity by reducing demand for appointments from low risk patients in hospital eye clinics, allowing the hospital to see more complex cases. The patient experience should improve because the number of appointments required for testing is reduced and the clinic is brought to locations nearer patients’ homes."

Mobile clinics for chronic stable glaucoma management: improving access and alleviating hospital demand
Ipswich and East Suffolk Clinical Commissioning Group and Ipswich Hospital NHS Trust
NICE Quality and Productivity example
January 2015

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Developing and implementing an Early Barrett's Oesophageal Cancer detection and treatment programme

"Our project aims at removing this inequity for patients living in the North East of England, to offer them the chance of early cancer diagnosis and surviving it. The treatment is also shown to be cost effective (NICE Costing Document 2012) compared to oesophagectomy, and so its implementation in our region will save money for the NHS."

Developing and implementing an Early Barrett's Oesophageal Cancer detection and treatment programme in the Durham & Tees Valley Region
County Durham & Darlington NHS Foundation Trust
NICE Shared Learning example
February 2015

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