NHS Improving Quality: end of life care webpages

"Our web pages can help organisations/communities deliver excellent end of life care by providing access to a wide range of resources that support good practice.  They offer opportunities for organisations/communities to share learning and improve the way they deliver care."

Access the resource here.

One chance to get it right

"This document sets out the approach to caring for dying people that health and care organisations and staff caring for dying people in England should adopt in future. The approach should be applied irrespective of the place in which someone is dying: hospital, hospice, own or other home and during transfers between different settings."

One chance to get it right: improving people’s experience of care in the last few days and hours of life
Leadership Alliance for the Care of Dying People
Department of Health
June 2014

Read more here.

Quality of physical therapy from a patient’s perspective

"We recommend a thrice-yearly, shorter survey of triangulated patients who are randomly selected from the Electronic Medical Records. Besides this, a visible and mandatory complaint desk (physical or digital) should be implemented to monitor the quality of care at all times. If need be, the Inspectorate can audit the low performing practices based on the number of complaints or low performance on the surveys."

Quality of physical therapy from a patient’s perspective; factor analysis on web-based survey data revealed three dimensions on patient experiences with physical therapy
M Scholte, H Calsbeek, MWG Nijhuis-van der Sanden, J Braspenning
BMC Health Services Research, 2014, 14: 266

Read more here.

NHS Choices: patient safety

A section on patient safety has been added to the NHS Choices website signposting patients to information on hospital performance and patient safety initiatives. 

Access the resource here.

Sign up to safety

"Sign up to Safety is a new national patient safety campaign that was announced in March by the Secretary of State for Health. It launched on 24 June 2014 with the mission to strengthen patient safety in the NHS and make it the safest healthcare system in the world."

Organisations and individuals can sign up to the campaign to pledge their commitment.

Sign up to safety: listen, learn, act
NHS England

Read more here.

Variations and inter-relationship in outcome from emergency admissions in England

"Hospital-level risk-standardised outcomes for emergency admissions across a range of specialties vary considerably and cross traditional speciality boundaries. This suggests that global institutional infra-structure and processes of care influence outcomes."

Variations and inter-relationship in outcome from emergency admissions in England: a retrospective analysis of Hospital Episode Statistics from 2005-2010
PJ Holt, S Sinha, BA Ozdemir, A Karthikesalingam, JD Poloniecki, MM Thompson
BMC Health Services Research, 2014, 14: 270

Read more here.

Surgeon's experiences of receiving peer benchmarked feedback

"Policy makers and researchers need to increase professionals’ awareness of the numerous purposes and benefits of using PROMs"

Surgeon's experiences of receiving peer benchmarked feedback using patient-reported outcome measures: a qualitative study
MB Boyce, JP Browne, J Greenhalgh
Implementation Science, 2014, 9: 84

Read more here.

Closing the gap through changing relationships

"The evaluation drew on the principles of the ‘realistic evaluation’ approach, focusing on clarifying the ‘context – mechanism – outcome’ dynamics underpinning the various interventions. The linkages between interventions, changing relationships and quality improvement are complex and multi-directional." 

Closing the gap through changing relationships: an independent evaluation of the programme
C Hoong Sin, H Heathfield, K Fitzpatrick, L Benson
The Health Foundation
June 2014

Read more here.

Accelerating improvement through systems engineering

"Systems engineering has often produced dramatically positive results in the small number of health-care organizations that have implemented such concepts. These efforts have transformed health care at a small scale, such as improving the efficiency of a hospital pharmacy, and at much larger scales, such as coordinating operations across an entire hospital system or across a community."

Better health care and lower costs: accelerating improvement through systems engineering
President’s Council of Advisors on Science and Technology

May 2014

Read more here. 

Prioritising person-centred care - the evidence

"In these pages you can find the evidence from 779 systematic reviews of ways to make person centred care happen. We provide accessible and accurate information so commissioners, health professionals and service-user groups can see what works best and how to invest time and resources."

Prioritising person-centred care - the evidence
National Voices
June 2014

Read more here.

North West London Integration Toolkit

"The North West London Integration Toolkit is intended to support commissioners, providers and communities across health- and social-care as they work toward the shared vision of integrated care. It may be useful as the basis for discussions and will help in the completion of business cases for local initiatives."

North West London Integration Toolkit
North West London Integrated Care
2014

Read more here.

Commissioning to meet hearing need

"Commissioners and providers alike need to develop an overarching commissioning framework for hearing services, within which commissioners, providers and potential providers can work together at local level to achieve the best outcomes and support for patients at all points along the pathway including a flourishing hospital-based audiology and ENT services for those who need specialist referral." 

Commissioning to meet hearing need and for better access, outcomes, quality and choice: community based adult hearing services: guidance for commissioners and providers
National Community Hearing Association, British Society of Hearing Aid Audiologists
June 2014

Read more here.

The UK healthcare system scores highest on quality, access and efficiency

"The United Kingdom ranks first overall, scoring highest on quality, access, and efficiency"

Mirror, mirror on the wall: how the performance of the U.S. health care system compares internationally
K Davis, K Stremikis, D Squires, C Schoen
The Commonwealth Fund
June 2014

Read more here.

Organizational impact of evidence-informed decision making training initiatives

"factors before, during and after training can influence the extent of skills and knowledge transfer. Our evaluation went further than previous research by revealing the influence—both positive and negative—of specific organizational factors on extending the impact of training programs."

Organizational impact of evidence-informed decision making training initiatives: a case study comparison of two approaches
F Champagne, L Lemieux-Charles, MF Duranceau, G MacKean, T Reay
Implementation Science 2014, 9:53

Read more here.

Improving diabetes care through examining, advising, and prescribing

"We will conduct a two-armed cluster randomised controlled trial in 44 general practices in the North East of England to evaluate a theory-based behaviour change intervention. We will target improvement in six underperformed clinical behaviours highlighted in quality standards for type 2 diabetes"

Improving diabetes care through examining, advising, and prescribing (IDEA): protocol for a theory-based cluster randomised controlled trial of a multiple behaviour change intervention aimed at primary healthcare professionals
J Presseau, G Hawthorne, FF Sniehotta, N Steen, JJ Francis, M Johnston, J Mackintosh, JM Grimshaw, E Kaner, M Elovainio, M Deverill, T Coulthard, H Brown, M Hunter, MP Eccles
Implementation Science, 2014, 9: 61

Read more here.

Did a quality improvement collaborative make stroke care better?

"Some aspects of stroke care improved during the quality improvement collaborative, but the effects of the quality improvement collaborative were modest and further improvement is needed." 

Did a quality improvement collaborative make stroke care better? A cluster randomized trial
M Power, PJ Tyrrell, AG Rudd, MP Tully, D Dalton, M Marshall, I Chappell, D Corgié, D Goldmann, D Webb, M Dixon-Woods, G Parry
Implementation Science, 2014, 9: 40

Read more here.

The implementation leadership scale

"The ILS is a brief tool that may be used in implementation research to assess the extent to which leaders support their staff in implementing EBP."

The implementation leadership scale (ILS): development of a brief measure of unit level implementation leadership
GA Aarons, MG Ehrhart, LR Farahnak
Implementation Science, 2014, 9: 45

Read more here.

A patient-centered network approach to multidisciplinary-guideline development

"Guideline development and uptake are still suboptimal; they focus on clinical aspects of diseases rather than on improving the integration of care. We used a patient-centered network approach to develop five harmonized guidelines (one multidisciplinary and four monodisciplinary) around clinical pathways in fertility care."

A patient-centered network approach to multidisciplinary-guideline development: a process evaluation
EME Den Breejen, MAHW Hilbink, WLDM Nelen, TJ Wiersma, JS Burgers, JAM Kremer, RPMG Hermens
Implementation Science, 2014, 9: 68

Read more here.

Preferences of users of electronic medical records in hospitals

"Currently electronic medical records (EMRs) are implemented in hospitals, because of 
expected benefits for quality and safety of care...This paper quantifies the relative importance of known barriers and facilitators of EMR, experienced by the users (i.e., nurses and physicians in hospitals)"

The preferences of users of electronic medical records in hospitals: quantifying the relative importance of barriers and facilitators of an innovation
MHL Struik, F Koster, AJ Schuit, R Nugteren, J Veldwijk, MS Lambooij
Implementation Science, 2014, 9: 69

Read more here.

Insight: getting it right (systemising commissioning)

"Systemising commissioning processes and utilising Right Care data has enabled two CCGs in Sefton to deliver improvements"

Insight: getting it right
M Cunningham
The Commissioning Review
June 2014

Read more here.

Priority setting - NHS Right Care reading list

"Priority-setting is by no means clear-cut, in part because it involves values as well as evidence. People who are responsible for resources, whether those resources be financial or time related, have to make priority decisions. They either have to allocate new resources or reallocate existing resources."

Right Care essential reading: priority-setting/prioritisation
N Pearce-Smith, M Gray
NHS Right Care
May 2014

Access the reading list here.

What is the evidence on the economic impacts of integrated care?

"Evidence that is available points to a positive impact of integrated care programmes on the quality of patient care and improved health or patient satisfaction outcomes but uncertainty remains about the relative effectiveness of different approaches and their impacts on costs."

What is the evidence on the economic impacts of integrated care?
E Nolte, E Pitchforth
European Observatory on Health Systems and Policies, World Health Organization
2014

Read more here.

Report cards and outcome measurements to improve the safety of surgical care

"This review summarises the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and describes the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety."

The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program
M Maggard-Gibbons
BMJ Quality and Safety, 2014; 23: 589-599

Read more here.

Promoting engagement by patients and families to reduce adverse events

"While patient engagement in safety is an appealing approach, there is still little evidence regarding the particular details of implementation needed"

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review
Z Berger, TE Flickinger, E Pfoh, KA Martinez, SM Dy
BMJ Quality and Safety, 2014; 23: 548-555

Read more here.

Relationship between patient reported experience and patient reported outcomes in elective surgery

"our results have implications for the concerns of some clinicians who have questioned whether the effectiveness and safety of their practice (measured using PROMs) may instead reflect patients’ views of their level of satisfaction with the experience of care"

Relationship between patient reported experience (PREMs) and patient reported outcomes (PROMs) in elective surgery
N Black, M Varaganum, A Hutchings
BMJ Quality and Safety, 2014; 23: 534-542

Read more here.

Quality and the curate’s egg

"To truly understand quality, we will have to look at both the sum and the function of its parts and understand it all within the context in which it was delivered."

Quality and the curate’s egg
F Greaves, AK Jha
BMJ Quality and Safety, 2014; 23: 525-527

Read more here.

How nurses and their work environment affect patient experience

"Nurses feel pressured to increase productivity and report a high administrative workload. They stated that these factors will not improve patient experiences of the quality of nursing care."

How nurses and their work environment affect patient experiences of the quality of care: a qualitative study
RAMM Kieft, BBJM de Brouwer, AL Francke, DMJ Delnoij
BMC Health Services Research, 2014, 14: 249

Read more here.

Senior staff cover means earlier discharges

"Patients admitted to A&E in the evening can stay in hospital up to four days longer than those admitted in the morning. To reduce their stays, trusts can take targeted action during the assessment phase"

Senior staff cover means earlier discharges
S McGirr, A Mullarkey, S Graham, R Sowney, R Emeny, V Connolly
Health Service Journal, June 2014

Read more here.

Looking forward to later life

"If...public services, businesses, civil society and all of us as individuals were ready, both to take advantage of the opportunities and to successfully navigate the challenges of later life, we would experience a triple dividend – increased wellbeing, reduced costs, and increased contribution."

Looking forward to later life: taking an early action approach to our ageing society
Early Action Task Force
2014

Read more here.

UK healthcare expertise collection

This is a collection of documents from Healthcare UK containing "information about the UK's different healthcare capabilities including case studies of successful overseas partnerships and projects with the UK"; including:

• Primary care: working in partnership
• Education and training in healthcare: working in partnership
• Infrastructure for health: working in partnership
• Digital health: working in partnership
• Health systems development: working in partnership
• Healthcare: public private partnerships

Read more here.

Improving the quality of costing in the NHS

"there were only a limited number of organisations where cost information was used routinely outside of the finance department, and even less where it was used by clinicians to improve their own efficiency and the care that they delivered."

Improving the quality of costing in the NHS: Payment by Results data assurance framework
CAPITA
June 2014

Read more here.

Reforming the NHS from within

"NHS reform has relied too much on external stimuli such as targets and performance management, inspection and regulation, and competition and choice, and too little on bringing about improvement ‘from within’."

Reforming the NHS from within: beyond hierarchy, inspection and markets
C Ham
The King's Fund
June 2014

Read more here.

Draft Health Education England research and innovation strategy

"This R&I Strategy addresses the research capacity and capability of our multi-professional workforce, for example through an academic career pathway for all healthcare professionals. It also addresses the importance of creating a workforce that is responsive to research and innovation and an education and training system that is evidence based." 

Research and Innovation Strategy: delivering a flexible workforce receptive to research and innovation 

Health Education England

HEE are accepting feedback on the strategy until 13th June 2014.

Read more here.

Leading and transforming outcomes conference: presentations

These are the agenda and presentations from #LTO14 - Healthcare Scientists Leading and Transforming Outcomes. This was the Chief Scientific Officer's two-day leadership conference held on 31 Mar 2014 and 1 April 2014.

Read the presentations here.

Cardiovascular disease commissioning for value focus pack

"National benchmarked data for heart disease and stroke used to understand variation across the pathway for each Clinical Commissioning Group in England to help improve cardiovascular disease commissioning"

Cardiovascular Disease (CVD) Commissioning for Value focus packs
Public Health England
May 2014

Access the packs and all the resources here.

Organisational features and patient outcomes in congenital heart disease services

"Overall, we found a substantial number of studies reporting a positive relationship between volume and outcome, particularly for highly complex cases. However, the complexity of the evidence requires careful interpretation."

What evidence is there for a relationship between organisational features and patient outcomes in congenital heart disease services? A rapid review. 

J Turner, L Preston, A Booth, C O’Keeffe, F Campbell, A Jesurasa, K Cooper, E Goyder 

School for Health and Related Research, University of Sheffield

2014

Read more here.

NHS England's commitment for carers

"Carers are a hugely important asset to the NHS as well as to the people for whom they provide care for. This document sets out a series of commitments that NHS England will do to support carers, reflecting what NHS England has heard from carers during a number of engagement events."

NHS England's commitment for carers

NHS England

April 2014

Read more here.

Discrimination in governance and leadership and the potential impact on patient care

"Leadership bodies which are significantly unrepresentative of their local communities, such as NHS Trust Boards, will have more difficulty ensuring that care is genuinely patient centred – with resultant failings in the provision or quality of services to specific local communities that have particular health needs, including BME communities and patients."

The “snowy white peaks” of the NHS: a survey of discrimination in governance and leadership and the potential impact on patient care in London and England
R Kline
Middlesex University
2014

Read more here.

Diagnosing bowel cancer early: right test, right time

"With the added pressures that the increase in demand is likely to present, ensuring endoscopy units continue to be of the highest quality is paramount to prevent people from dying prematurely."

Diagnosing bowel cancer early: right test, right time
Bowel Cancer UK
2014

Read more here.

Examining, diagnosing, and treating systems (video)

"In a new Institute for Healthcare Improvement Open School video resource, MIT senior lecturer and IHI Senior Fellow Steve Spear explains why he thinks seven steps needed to care for patients are essentially the same as those needed to fix systems of care. He also shares common trouble areas and gives an example of a successful improvement."

Examining, diagnosing, and treating systems

S Spear

Institute for Healthcare Improvement

May 2014

Find out more and access the video resource here.

Environmental sustainability in hospitals

"Hospitals and care systems increasingly are looking for ways to improve efficiency and reduce overall costs while also improving the overall patient experience. Sustainability initiatives offer significant environmental and financial benefits for organizations—benefits that will help hospitals and care systems thrive now and in the future."

Environmental sustainability in hospitals: the value of efficiency
Health Research & Educational Trust
May 2014

Read more here.

Video guides to Patient Reported Outcome Measures (videos)

The Health and Social Care Information Centre have produced some brief instructional videos to help you use and access their Patient Reported Outcomes Measures (PROMs) publications.

Access the videos here.

Dementia roadmap

"The Dementia Roadmap provides high quality information about the dementia journey alongside local information about services, support groups and care pathways to assist primary care staff to more effectively support people with dementia and cognitive impairment, their families and carers."

Find out more and access the resource here.

The open data era in health and social care

"This report examines the current literature, drawing on case studies and published research to highlight the following value propositions for using more open data in healthcare:

• Accountability
• Choice
• Efficiency
• Outcomes
• Patient satisfaction and customer service
•  Economic growth and innovation"

The open data era in health and social care
S Verhulst, BS Noveck, R Caplan, K Brown, C Paz
The Governance Lab
May 2014

Read more here.

Review of specialist pharmacy services in England

"This report summarises the findings and recommendations of the Review of Specialist Pharmacy Services (SP Srvcs) in England."

The Review of Specialist Pharmacy Services in England

K Ridge

NHS England

May 2014

Read more here. 

Alcohol care teams: reducing acute hospital admissions and improving quality of care

This QIPP case study recently won a BMJ Award.

Quality and Productivity: Proven case study: alcohol care teams: reducing acute hospital admissions and improving quality of care 
The British Society of Gastroenterology and Bolton NHS Foundation Trust
Updated May 2014

Read more here.

CCG Learning Environment

The NHS England/NHS Commissioning Assembly Learning Environment hosts a range of knowledge sharing tools for CCGs, allowing them to share best practice and seek advice and support. The website includes case studies, private forums, a search tool to identify similar CCGs, and a directory of support providers.

Find out more and access all the resources here.

Nutrition education and leadership for improved clinical outcomes

"Whilst we will continue to focus on increasing nutrition awareness in hospitals to improve patient care and safety, we believe that knowledge is essential, but the addition of leadership, change management and communication skills are key to improving the sustainable delivery of optimal nutritional care."

Nutrition education and leadership for improved clinical outcomes: training and supporting junior doctors to run 'Nutrition Awareness Weeks' in three NHS hospitals across England
S Ray et al.
BMC Medical Education, 2014, 14:109

Read more here.