Consensus on quality

"At the end of 2014, Solutions for Public Health (SPH) was commissioned to conduct a study to gather consensus from a range of stakeholder groups on what they felt was important to measure in order to understand the quality of healthcare. This study used a Delphi-style consultation approach to interrogate 73 statements that describe the measurable aspects of the quality of healthcare."

Consensus on quality
H Dorning
The Health Foundation, Nuffield Trust
December 2015

Read more here.

Sustainability and financial performance of acute hospital trusts

"The Department, NHS England, Monitor and the NHS TDA need to take a more holistic, coordinated approach to tackling trusts’ persistent financial problems and move beyond quick fixes to cut trusts’ spending. Until there is a clear pathway for trusts to get back to financial stability, we cannot be confident that value for money, defined as financial and service sustainability, will be achieved."

Sustainability and financial performance of acute hospital trusts
National Audit Office
December 2015

Read more here.

NHS Safety Thermometer: Patient Harms and Harm Free Care

"The NHS Safety Thermometer is the measurement tool for a programme of work to support patient safety improvement. It is used to record patient harms at the frontline, and to provide immediate information and analyses for frontline teams to monitor their performance in delivering harm free care."

NHS Safety Thermometer: Patient Harms and Harm Free Care England November 2014 November 2015, official statistics 
Clinical Audit Support Unit
Health & Social Care Information Centre

December 2015

Read more here.

A practical guide to self-management support

"The guide explains what self-management support is and why it is important. It then looks at various aspects of putting it into practice, including planning and commissioning, building knowledge, skills and confidence, and measurement and evaluation"

A practical guide to self-management support: Key components for successful implementation
A de Iongh, P Fagan, J Fenner, L Kidd
The Health Foundation
December 2015

Read more here.

What do patients say about emergency departments in online reviews?

"Consumer rating websites allow patients to provide rapid and public feedback on their experience of medical care. Web-based platforms may offer a novel strategy for assessing patient-centred quality in emergency care."

What do patients say about emergency departments in online reviews? A qualitative study
AS Kilaru, ZF Meisel, B Paciotti, YP Ha, RJ Smith, BL Ranard, RM Merchant
BMJ Quality and Safety 2016;25:14-24 doi:10.1136/bmjqs-2015-004035

Read more here.

Improving the Quality of Orthotics Services in England

"This document sets out a case for action to tackle the rising demand and variation in access and quality of services experienced by children and adults requiring orthotic care in England. It explains why it is important to improve the commissioning of services in terms of clinical and cost benefits and discusses some of the key issues affecting services currently, along with the experiences that patients and their families have had in using those services "

Improving the Quality of Orthotics Services in England
NHS England

November 2015

Read more here. 

The effectiveness of interventions to improve laboratory requesting patterns among primary care physicians

"Interventions such as educational strategies, feedback and changing test order forms may improve the efficient use of laboratory tests in primary care; however, the level of evidence is quite low and the quality is poor." 

The effectiveness of interventions to improve laboratory requesting patterns among primary care physicians: a systematic review

SL Cadogan, John P. Browne1, Colin P. Bradley2 and Mary R. Cahill3
Implementation Science 2015, 10:167  doi:10.1186/s13012-015-0356-4

Read more here.

A qualitative study of how hospital innovations become routine

"Hospitals have an opportunity to promote the integration of new practices by planning for the extended effort required to hold a new practice in place while integration mechanisms take hold. By understanding how integrating mechanisms correspond to innovation characteristics, hospitals may be able to foster integrating mechanisms most likely to work for particular innovations."

Integrating new practices: a qualitative study of how hospital innovations become routine
AL Brewster, LA Curry, EJ Cherlin, K Talbert-Slagle, LI Horwitz, EH Bradley
Implementation Science 2015, 10:168  doi:10.1186/s13012-015-0357-3

Read more here.

Behavioural insights in health care: Nudging to reduce inefficiency and waste

"There is much evidence that suggests the potential for all of these nudge-type interventions to be successful if suitably applied. However, the evidence available is highly variable in terms of quality, relevance to health care and behaviour change impact."

Behavioural insights in health care: Nudging to reduce inefficiency and waste
C Perry, K Chhatralia, D Damesick, S Hobden, L Volpe
The Health Foundation
December 2015

Read more here.

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.

Clinical guidance promoting safer medical care of patients detained under the Mental Health Act

"Through this project, we were able to identify defects in a system, provide needed guidance to enable safer and more equitable care to a vulnerable group, and foster closer collaboration between junior doctors and managers in the design and use of services."

How safe is our "place of safety"? Clinical guidance promoting safer medical care of patients detained under section 136 of the Mental Health Act
J Mouko, A Goddard, V Nimmo-Smith
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209141.w3721

Read more here.

Improving documentation within the acute stroke unit

"The results of this project have shown that by introducing a stroke specific clerking document, the quality of information recorded has significantly improved."

Improving documentation within the acute stroke unit: Introducing a stroke specific clerking proforma
S Patel
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u208852.w3847

Read more here.

Improving emergency department flow through Rapid Medical Evaluation unit

"By specifically re-purposing a fraction of existing staff, resources, and infrastructure for patients with lower acuity presentations, we were able to streamline their care and decrease wait times in the ED"

Improving emergency department flow through Rapid Medical Evaluation unit
L Chartier, T Josephson, K Bates, M Kuipers
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206156.w2663

Read more here.

A simple prioritisation system to improve the electronic handover

"Overall the introduction of an uncomplicated traffic light system provided an effective addition to the electronic handover structure aimed to allow patient prioritisation and improved efficiency during weekend hours."

A simple prioritisation system to improve the electronic handover
L Ah-kye, M Moore
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u205385.w4127

Read more here.

Improving the quality of the surgical preoperative assessment in a district general hospital

"The interventions described proved to be cheap and effective methods of improving the quality of the preoperative assessment, bringing it in line with the anaesthetic assessment and reducing the risk of same day cancellations."

Improving the quality of the surgical preoperative assessment in a district general hospital
J Koris, C Hopkins
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u205381.w3406

Read more here.

Implementing the NICE guideline on Transition between inpatient hospital settings and community or care home settings for adults with social care needs

"Overall, it is expected that implementing the guideline will be cost saving. Implementing the guideline is likely to have resource implications (both costs and savings) for health and social care commissioners and for providers"

Implementing the NICE guideline on Transition between inpatient hospital settings and community or care home settings for adults with social care needs (NG27) 
NICE (Costing statement)
December 2015

Read more here.

Improving Diagnosis in Health Care

"Improving the diagnostic process is not only possible, but it also represents a moral, professional, and public health imperative. Achieving that goal will require a significant reenvisioning of the diagnostic process and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers."

Improving Diagnosis in Health Care
EP Balogh, BT Miller, JR Ball
National Academies Press
September 2015

Read more here.

Do pneumonia readmissions flagged as potentially preventable by the 3M PPR software have more process of care problems?

"Among VA [Veterans Health Administration] pneumonia readmissions, PPR [Potentially Preventable Readmissions] categorisation did not produce the expected quality of care findings. Either PPR–yes cases are not more preventable, or preventability assessment requires other data collection methods to capture poorly documented processes (eg, direct observation)."

Do pneumonia readmissions flagged as potentially preventable by the 3M PPR software have more process of care problems? A cross-sectional observational study
AM Borzecki et al.
BMJ Quality and Safety 2015;24:753-763 doi:10.1136/bmjqs-2014-003911

Read more here.

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

Read more here.

The SQUIRE Guidelines: an evaluation from the field

"The original SQUIRE Guidelines help with planning healthcare improvement work, but are perceived as complicated and unclear during writing. Key goals of the revision will be to clarify items where conflict was identified and outline the key components necessary for complete reporting of improvement work."

The SQUIRE Guidelines: an evaluation from the field, 5 years post release
L Davies, P Batalden, F Davidoff, D Stevens, G Ogrinc
BMJ Quality and Safety 2015;24:769-775 doi:10.1136/bmjqs-2015-004116

Read more here.

Development of the Quality Improvement Minimum Quality Criteria Set

"We developed a ready-to-use, valid and reliable critical appraisal instrument applicable to healthcare QI intervention publications, but recognise scope for continuing refinement."

Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications
S Hempel, PG Shekelle, JL Liu, M Sherwood Danz, R Foy, YW Lim, A Motala, LV Rubenstein
BMJ Quality and Safety 2015;24:796-804 doi:10.1136/bmjqs-2014-003151

Read more here.

NHS reference costs 2014 to 2015

"This publication sets out where over £61 billion has been spent by NHS providers in delivering
health care in 2014-15."

NHS reference costs 2014 to 2015
Department of Health
November 2015

Read more and access the data here.

Intentional whole health system redesign

"This case study has been written to offer inspiration for commissioners and providers in the English NHS, in particular the vanguards in the NHS’s new care models programme, embarking on system redesign. It aims to provide a description of Southcentral’s transformation journey as well as a snapshot of its service and organisational model, focusing on issues that are likely to be of most relevance to local NHS systems developing new care models"

Intentional whole health system redesign: Southcentral Foundation’s ‘Nuka’ system of care
Ben Collins
The King's Fund
November 2015

Read more here.

Infection prevention and control: lessons from acute care in England

"This learning report is based on the findings of a large research study that identified and consolidated published evidence about infection prevention and control initiatives...The report considers what has been learned from the infection prevention and control work carried out over the last 15 years in hospitals in England. It looks at the lessons learned and outlines future directions for effective infection prevention and control." 

Infection prevention and control: lessons from acute care in England: Towards a whole health economy approach
The Health Foundation
November 2015

Read more here.

Continuous improvement of patient safety

"This report makes the case for changing the way patient safety is approached in the NHS. It argues that change is needed in: how safety is understood, because current approaches to measurement don’t provide the full picture; how safety is improved, because existing approaches alone will not address the most intractable problems; how risk is perceived, because comfort-seeking behaviours will not create a genuine culture of learning."

Published alongside the report is a safety improvement check list, as well as pointers to a host of other resources from the Health Foundation focused on assisting organisations in improving patient safety.

Continuous improvement of patient safety: The case for change in the NHS
J Illingworth
The Health Foundation
November 2015

Read more here.

Improving the Quality of Weekend Medical Handover at a London Teaching Hospital

"A new weekend handover pro forma modelled on RCP guidance can improve the quality of information provided to the weekend team. This can help the on-call team to manage the weekend more effectively and safely. A Friday WR [ward round] sheet can also improve the availability of thorough patient summaries in the notes in the event that someone needs to be reviewed unexpectedly over the weekend."

"Chase CRP", "Review patient": Improving the Quality of Weekend Medical Handover at a London Teaching Hospital
A Saifuddin, L Magee, R Barrett
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u201656.w1919

Read more here.

Hypoglycaemia monitoring in a medical receiving ward

"The study successfully demonstrated that simple measures can significantly improve the quality care of inpatient diabetic patients in relation to hypoglycaemia management."

Hypoglycaemia monitoring in a medical receiving ward
R Ellis
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207104.w2859


Read more here.

Reducing turnaround time of surgical pathology reports in pathology and laboratory medicine departments

"This project improvement idea of mapping out the workflow process has led to process and systems improvement. Focusing on fixing subprocesses within the sample flow process had led to more than 94% of all routine surgical pathology cases being reported within less than two days and meeting the CAP standards."

Reducing turnaround time of surgical pathology reports in pathology and laboratory medicine departments
Saeed Alshieban, Khaled Al-Surimi
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209223.w3773

Read more here.

Improving sexual health for patients in stroke rehabilitation

"Sexual health contributes greatly to quality of life. Research shows that stroke survivors want to learn and talk about sexual health, but are not given information. In keeping with the Canadian Best Practice Recommendations for Stroke Care, this project aimed to provide all stroke rehabilitation inpatients with the opportunity to discuss sexual health concerns with healthcare providers at West Park Healthcare Centre"

Let's Talk About Sex! - Improving sexual health for patients in stroke rehabilitation
M Guo, S Bosnyak, T Bontempo, A Enns, C Fourie, F Ismail, A Lo
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207288.w2926

Read more here.

Improving the acute care of COPD patients across Gloucestershire

"The aim of the scheme was to improve compliance with the BTS [British Thoracic Society] guidelines and CQUIN [Commissioning for Quality and Innovation] scheme for patients admitted with an exacerbation of COPD."

Improving the acute care of COPD patients across Gloucestershire: a quality improvement project
C Miller, C Cushley, K Redler, C Mitchell, EA Day, H Mansfield, A Nye
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u208427.w3338

Read more here.

Improving fluid balance monitoring on the wards

"This study highlighted that understanding and use of fluid balance monitoring can be improved for nurses, health care assistants (HCAs), and doctors. These improvements allow better documentation and safer patient care."

Improving fluid balance monitoring on the wards
S Jeyapala, A Gerth, A Patel, N Syed
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209890.w4102

Read more here.

"SHOUT" to improve the quality of care delivered to patients with acute kidney injury

"Our results suggest that using the twin approaches of improving awareness, and small changes to systemic factors such as modification of the admission proforma, can lead to significant enhancements in the quality of care of patients with AKI."

"SHOUT" to improve the quality of care delivered to patients with acute kidney injury at Great Western Hospital
P Brady et al.
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207938.w3198

Read more here.

Are patients with newly diagnosed breast cancer getting appropriate DEXA scans

"We have achieved a large improvement in the quality of assessment of bone quality in breast cancer patients. Moreover, we have demonstrated the importance of the dissemination of information and education within a multidisciplinary setting."

Are patients with newly diagnosed breast cancer getting appropriate DEXA scans? A District General Hospital experience
H Dong, P Dayananda, SA Preece, A Carmichael
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209414.w3856

Read more here.

Experience based co-design reduces formal complaints on an acute mental health ward

"An acute mental health triage ward at Oxleas NHS Foundation Trust was attracting high levels of formal service user and family complaints. The Trust used experience based co-design to examine the issues and redesign procedures. This resulted in an immediate eradication of formal complaints for a period of 23 months."

Experience based co-design reduces formal complaints on an acute mental health ward
N Springham, G Robert
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209153.w3970

Read more here.

Intensive care discharges: improving the quality of clinical handover

"This project demonstrated how modifying system factors, such as a standardised template, could effectively modify individuals’ practices. Simple changes to the design of an intensive care discharge summary have been shown to greatly improve the quality of handover information, with the aim of improved continuity and quality of care."

Intensive care discharges: improving the quality of clinical handover through changes to discharge documentation
W Hall, P Keane, S Wang, F Debell, A Allana, P Karia
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209711.w4036

Read more here.

Models of Care for High-Need, High-Cost Patients

"This brief analyzes experts’ reviews of evidence about care models designed to improve outcomes and reduce costs for patients with complex needs. It finds that successful models have several common attributes"

Models of Care for High-Need, High-Cost Patients: An Evidence Synthesis
D McCarthy, J Ryan, S Klein
The Commonwealth Fund
October 2015

Read more here.

Making choice work well in NHS adult hearing services: resources for commissioners

"Information and resources to help commissioners of NHS audiology services implement choice that works well for patients."

Making choice work well in NHS adult hearing services: resources for commissioners
Monitor
November 2015

Read more here.

Supplement case studies: So how efficient are you?

"Trusts up and down the country are finding out where they stand in diagnostics – and starting to make improvements."

Supplement case studies: So how efficient are you?
C Reed
Health Service Journal
October 2015

Read more here.

Costing report: menopause diagnosis and management

"This report focuses on the recommendations that are considered to have the greatest resource impact nationally, and therefore need the most additional resources to implement or can potentially generate the biggest savings. They are:

- decrease the number of follicle-stimulating hormone (FSH) tests in women 
- increase use of transdermal hormone replacement therapy (HRT). "

Costing report: menopause diagnosis and management 
Implementing the NICE guideline on menopause (NG23)
NICE
November 2015

Read more here.

Implementing the NICE guideline on social care of older people with social care needs and multiple long-term conditions

"The guideline covers how health and social care for older people with multiple long-term conditions should be planned and delivered. It addresses how those responsible for commissioning, managing and providing health and social care should work together to deliver safe, high-quality services."

Costing statement:Implementing the NICE guideline on social care of older people with social care needs and multiple long-term conditions (NG22)
NICE
November 2015

Read more here.

Cost and risk management in critical care: reducing the use of colloids

"In the past, colloid fluid therapy was used as the primary resuscitation fluid in critically ill people. Increasing evidence ... suggests that crystalloid fluids are equivalent in effectiveness and cost considerably less. This project aimed to reduce colloid use by removing them from the clinical area and making them available by consultant prescription only."

Cost and risk management in critical care: reducing the use of colloids
City Hospitals Sunderland NHS Foundation Trust

NICE Quality and Productivity case study

November 2015

Read more here. 

Supply chain management and collaboration: cardiology device procurement

"This initiative helps organisations within a large geographical area (in this case the South West) to smooth price differentials while maintaining choice for clinicians and focusing strongly on quality. This case study describes a collaborative approach across 10 interested NHS acute trusts in the region for procuring cardiology products."

Supply chain management and collaboration: cardiology device procurement
Avon,Gloucestershire,Wiltshire, and Somerset Cardiac & Stroke Network
NICE Quality and Productivity case study

November 2015

Read more here. 

We're no closer to knowing if 'commissioning' is worthwhile or not

"Richard Taunt and Clare Allcock explore how the introduction of outcomes based commissioning could end decades of speculation over the impact of the commissioning culture"

We're no closer to knowing if 'commissioning' is worthwhile or not
R Taunt, C Allcock
Health Service Journal
October 2015

Read more here.

Quick guides: transforming urgent and emergency care services in England

"NHS England and partners have published a series of quick guides to support local health and care systems. The guides provide practical tips, case studies and links to useful documents, which can be used to implement solutions to commonly experienced issues. Use the information to manage upcoming winter pressures and plan for 2016 and beyond."

• Better use of care at home 
• Clinical input to care homes 
• Identifying local care home placements
• Improving hospital discharge into the care sector 
• Technology in care homes
• Sharing patient information 

Quick guide: Transforming urgent and emergency care services in England
NHS England
2015

All six guides can be accessed here.

Paper-free at the Point of Care

"Providers are being invited to complete a Digital Maturity Self-assessment in order to establish the baseline position regarding the effective use of information, technology and systems by health and care professionals at the point-of-care." 

Paper-free at the Point of Care: Completing the Digital Maturity Self-assessment (Five Year Forward View)
NHS National Information Board
November 2015

Read more here.

How to build up the actionable knowledge base

"We demonstrate the utility of a method known as ‘best fit framework synthesis’ (BFFS) in offering a ubiquitous and versatile means by which to collect, analyse and evaluate improvement work in healthcare."

How to build up the actionable knowledge base: the role of ‘best fit’ framework synthesis for studies of improvement in healthcare
A Booth, C Carroll
BMJ Quality and Safety 2015;24:700-708 doi:10.1136/bmjqs-2014-003642

Read more here.

Routine failures in the process for blood testing and the communication of results to patients in primary care in the UK

"A number of potential failures in testing and communicating results to patients were identified, and some specific ideas for improving existing systems emerged. These included same-day phlebotomy sessions, use of modern technology methods to proactively communicate routine results and targeted training for receptionists handling sensitive data."

Routine failures in the process for blood testing and the communication of results to patients in primary care in the UK: a qualitative exploration of patient and provider perspectives
I Litchfield, L Bentham, A Hill, RJ McManus, R Lilford, S Greenfield
BMJ Quality and Safety 2015;24:681-690 doi:10.1136/bmjqs-2014-003690

Read more here.

Test result communication in primary care

"Our study has shown that the potential for error in the TRC [test result communication] process is large yet seemingly unrecognised in general practice. Staff have yet to introduce technological solutions with the result that the robustness of the system hinges on patients who may be unaware of their responsibility to retrieve results and in many cases act as the system fail-safe."

Test result communication in primary care: a survey of current practice
I Litchfield, L Bentham, R Lilford, RJ McManus, A Hill, S Greenfield
BMJ Quality and Safety 2015;24:691–699. doi:10.1136/bmjqs-2014-003712

Read more here.

Atlas of Variation 2015 Opportunity Locator tool

"The Atlas of Variation Opportunities Locator is a companion tools to the NHS Atlas of Variation 2015. It uses the same data and maps but allows local commissioners to select and view the CCG and Local Authority maps for their own local population across a wide range of disease areas contained in the Atlas."

Atlas of Variation 2015 Opportunity Locator tool
NHS RightCare
2015

Access the locator tool here.

Closer to critical? QualityWatch annual statement 2015

"Our third annual statement, Closer to critical?, aims to help policy-makers, healthcare leaders, patient groups and others make sense of quality across health and social care, primarily in England. We observe that while there are many areas of excellent care, there are also increasingly clear signals that in some areas quality is deteriorating."

Closer to critical? QualityWatch annual statement 2015
The Health Foundation, Nuffield Trust
November 2015

Read more here.

Mental health under pressure

"There is a clear need for mental health services to focus on using evidence to improve practice and reduce variations in care. However, it is essential that this is underpinned by stable funding, with no more cuts to budgets." 

Mental health under pressure
H Gilburt
The King's Fund
November 2015

Read more here.

Place-based systems of care

"This paper argues that providers of services should establish place-based ‘systems of care’ in which they work together to improve health and care for the populations they serve. This means organisations collaborating to manage the common resources available to them."

Place-based systems of care: A way forward for the NHS in England
C Ham, H Alderwick
The King's Fund
November 2015

Read more here.

Need to nuture: Outcomes-based commissioning in the NHS

"This paper examines what outcomes-based commissioning means, the evidence to support it, progress to date on introducing the approach in England, and the optimum role of national policy in response to it."

Need to nuture: Outcomes-based commissioning in the NHS
The Health Foundation
September 2015

Read more here.

Context for successful quality improvement

"Building on a series of thought pieces – published by the Health Foundation in Perspectives on context – this study combines the ideas of receptive and non-receptive contexts for change (as outlined by Pettigrew et al), with a psychological perspective and the proposition that social context is the key facilitator of quality improvement."

Context for successful quality improvement
N Fulop, G Robert
The Health Foundation
October 2015

Read more here.

Indicators of quality of care in general practices in England

"In the summer of 2015 the Health Foundation was asked by the Secretary of State for Health to review indicators of the quality of care provided by general practices in England. We looked at how indicators could be developed to generate meaningful information that supports improvements to care and helps the public choose which practice might best meet their needs."

Indicators of quality of care in general practices in England: An independent review for the Secretary of State for Health
J Dixon, E Spencelayh, A Howells, A Mandel, F Gille
The Health Foundation
October 2015

Read more here.

The habits of an improver: Thinking about learning for improvement in health care

"The habits of an improver has been written to promote discussion and as a possible model for all those seeking to take decisions about the best balance of attitudes, skills and knowledge in initial training and continuing professional development for improvement across the NHS and with our international friends and partners."

The habits of an improver: Thinking about learning for improvement in health care
B Lucas, H Nacer
The Health Foundation
October 2015

Read more here.

On targets: How targets can be most effective in the English NHS

"This report does not set out to determine whether targets, as a concept, are good or
bad, but focuses on how targets can be most effective for improving quality of care. It
builds on the evidence base regarding the impact of targets to identify good practice in
designing new or improved targets, and considers how policymakers can apply these
lessons to the challenges facing the NHS."

On targets: How targets can be most effective in the English NHS
N Berry, T Gardner, I Anderson
The Health Foundation
October 2015

Read more here.

Closer to critical? QualityWatch

"Our third annual statement, Closer to critical?, aims to help policy-makers, healthcare leaders, patient groups and others make sense of quality across health and social care, primarily in England. We observe that while there are many areas of excellent care, there are also increasingly clear signals that in some areas quality is deteriorating."

Closer to critical? QualityWatch annual statement 2015
The Health Foundation, Nuffield Trust
November 2015

Read more here.

Transforming healthcare in England’s core cities

"The report demonstrates how commissioners in Nottingham, Leeds, Sheffield, Bristol, Newcastle, Birmingham, Liverpool and Manchester are addressing profound health challenges. It also highlights how clinically-led commissioning is making it possible to deliver healthcare focused on the needs of specific populations."

Transforming healthcare in England’s core cities 
NHS Clinical Commissioners
September 2015

Read more here.

Three things the NHS must do to manage clinical risk

"Every hospital admission or discharge should have an explicit understanding and agreement of risk. Unless we support clinicians to take only appropriate, managed risk, we will not succeed in truly integrating care"

Three things the NHS must do to manage clinical risk
J Inglesfield
Health Service Journal
October 2015

Read more here.

The state of health care and adult social care in England 2014/15

"Many services have responded well, despite the increasing pressures, and managed to improve or maintain quality."

The state of health care and adult social care in England 2014/15
Care Quality Commission
October 2015

Read more here.

Investing in prevention and early intervention

"These documents aim to raise awareness of the prioritisation frameworks and associated tools and resources which are used by the NHS and local authorities. They help to make the case for investment in prevention or early intervention, to prioritise investment (and disinvestment) or to improve the use of existing resources invested."

Investing in prevention and early intervention
Public Health England
October 2015

Read more here.

Health service review: Shropshire (Future Fit)

Future Fit is a programme overseeing plans for service improvement for health services across Shropshire. They have compiled rapid reviews of the evidence for planned care, long term conditions and frailty, and acute and episodic care, all of which can be viewed here.

Health service review - Dorset Vision

Dorset Clinical Commissioning Group have a website detailing the extensive review of their services which have been taking place.

It can be access at: www.dorsetsvision.nhs.uk

Two particular documents of note on the website are:

• The Compendium of clinical evidence combines quality standards and clinical evidence to form recommendations for changes in practice and service delivery.
• The Case examples on models of care outlines examples of models of care which are delivering improved services.

Improving productivity in elective care

"This report concentrates on potential improvements in the operational management of elective patient pathways within the direct control of NHS providers and identifies a mechanism whereby clinicians and managers can work together to maximise provision of care."

Improving productivity in elective care
Monitor
October 2015

Read more here.

Focus on: People with mental ill health and hospital use

"At any time, one in six adults has a mental health condition and one in 100 has a severe mental illness. Our new research explores what differences in hospital use can tell us about the quality of physical health care for people with mental ill health."

Focus on: People with mental ill health and hospital use
H Dorning, A Davies, I Blunt
The Health Foundation, Nuffield Trust
October 2015

Read more here.

Improving UK health care

"Our Strategy sets out a new direction – we will be more grounded in the practical implications of policy-making, working closely with NHS staff and policy-makers to identify solutions to the challenges facing the NHS."

Improving UK health care: Nuffield Trust strategy 2015-2020
Nuffield Trust
October 2015

Read more here.

How is the NHS performing? October 2015

"The NHS is now entering seriously dangerous financial territory which will have ramifications for patients and for all levels of NHS management."

How is the NHS performing?:Quarterly Monitoring Report
J Appleby, J Thompson, J Jabbal
King's Fund
October 2015

Read more here.

Health and Care Quality Systems in practice: A guide for local leaders

"This publication is intended as a practical guide for people who have leadership and oversight responsibility for the quality of services in their communities."

Health and Care Quality Systems in practice: A guide for local leaders
Local Government Association, Centre for Public Scrutiny, Think Local Act Personal 
September 2015

Read more here.

Development of a cost-effectiveness model for optimisation of the screening interval in diabetic retinopathy screening

"The study found that annual screening of all patients for STDR [sight-threatening diabetic retinopathy] was not cost-effective. Screening this entire cohort every 3 years was most likely to be cost-effective."

Development of a cost-effectiveness model for optimisation of the screening interval in diabetic retinopathy screening
PH Scanlon, SJ Aldington, J Leal , R Luengo-Fernandez, J Oke , S Sivaprasad , et al.
Health Technology Assessment 2015;19(74)

Read more here.

Access, quality, and costs of care at physician owned hospitals in the United States

"Using a comprehensive list of POHs [physician owned hospitals] across the United States and contemporary data, we found no evidence that POHs systematically avoid poorer patients or those from ethnic and racial minority groups. POHs also performed equally to non-POHs on a wide array of measures of quality of care, costs, and payments for care. These findings indicate a need to re-examine existing public policies that target all hospitals with physician owners."

Access, quality, and costs of care at physician owned hospitals in the United States: observational study
DM Blumenthal, EJ Orav, AB Jena, DM Dudzinski, ST Le,  AK Jha, KT Li
BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h4466


Read more here.

HSJ Commissioning supplement: The right services at the right time

"Commissioning within the NHS is being shaped by a variety of factors, ranging from technology to the third sector. This week’s supplement, produced in association with Skills for Health, IMS Health and the British Red Cross, looks at:

• workforce planning 
• gaining value from data 
• benefitting from third sector organisations" 

HSJ Commissioning supplement: The right services at the right time
How data, workforce planning and the voluntary sector are shaping NHS commissioning
September 2015

Read more here.

Improving the completion of Quality Improvement projects amongst psychiatry core trainees

"Through the implementation and development of training sessions and simple, low cost and sustainable interventions over a 10 month period, two thirds of core trainees and over a half of the advanced psychiatry trainees in the School are now participating in 28 individual QI projects and QI project methodology is to become embedded in the core psychiatry training course. "

Improving the completion of Quality Improvement projects amongst psychiatry core trainees
L Ewins
BMJ Quality Improvement Report 2015;4: doi:10.1136/bmjquality.u205682.w2554

Read more here.

Training in General Surgery Ward Call: A Resident-Student Buddy System

"There is a paucity of literature regarding medical student experiences of after hours hospital ward call. It was observed at our institution that medical students had minimal experience in ward call, yet were required to undertake such shifts as interns after graduation. We implemented a buddy system in which a medical student shadowed a general surgery resident for a ward call shift."

Training in General Surgery Ward Call: A Resident-Student Buddy System
A Maurice, A Hann
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u202587.w3786

Read more here.

A multifaceted approach to prevention of delirium on intensive care

"Delirium is a frequent complication of critical illness with an increased risk of death which is difficult to treat effectively. We describe a seven year quality improvement programme that aimed to reduce rates of delirium on intensive care (ICU)."

A multifaceted approach to prevention of delirium on intensive care
J Hanison, D Conway
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209656.w4000
 Programme

Read more here.

Development and Implementation of a Catheter Associated Urinary Tract Infection 'Toolkit'

"This quality improvement project saw the development, testing and introduction within NHS Tayside of an evidenced based bundle of care. This was to standardise and drive quality care delivery for the insertion and maintenance of urethral urinary catheters with the intention of reducing catheter associated urinary tract infections in our patients." 

Development and Implementation of a Catheter Associated Urinary Tract Infection (CAUTI) 'Toolkit'
M Tatham, G Macfarlane, M MacRae, V Tully, K Craig
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u205441.w3668

Read more here.

Improving induction of labour - a quality improvement project

"Induction of labour (IOL) in maternity care is often not an area of priority in maternity services, which often results in protracted delays, a poor patient experience, and patient complaints. Caesarean section (CS) rates among women undergoing IOL at this inner city district general hospital were noted to be higher than other units nationwide."

Improving induction of labour - a quality improvement project addressing Caesarean section rates and length of process in women undergoing induction of labour
S O'Dwyer, C Raniolo, J Roper, M Gupta
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u203804.w4027

Read more here.

Moving healthcare closer to home

"Support for providers and commissioners to make evidence-based appraisals of how the benefits compare with the costs of various approaches to move care closer to home."

Moving healthcare closer to home

Monitor

September 2015

Read more here.

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

Read more here.

A patient-initiated voluntary online survey of adverse medical events

"This large voluntary survey of medical harm highlights the potential efficacy of patient-initiated surveys for providing meaningful feedback and for guiding improvements in patient care."

A patient-initiated voluntary online survey of adverse medical events: the perspective of 696 injured patients and families
FS Southwick, NM Cranley, JA Hallisy
BMJ Quality and Safety 2015;24:620-629 doi:10.1136/bmjqs-2015-003980

Read more here.

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes

"We propose that an integration of empowerment evaluation with quality improvement approaches is likely to enhance the quality of healthcare delivery by increasing the ability of practitioners to improve as well as implement well"

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes
A Wandersman, KA Alia, B Cook, R Ramaswamy
BMJ Quality and Safety 2015;24:645-652 doi:10.1136/bmjqs-2014-003525

Read more here.

NHS Atlas of Variation in Healthcare 2015

"Improving value across the NHS landscape is the central aim of providing the information in Atlas 3.0. As in maps of health, these maps of healthcare show us where to focus efforts to improve health and healthcare while holding the line on costs."

NHS Atlas of Variation in Healthcare 2015: Reducing unwarranted variation to

increase value and improve quality

NHS England

September 2015

Access the Atlas here. 

Communications in health care improvement - a toolkit

"This toolkit is for health care professionals working in improvement who want to understand and use communications to better plan, implement and spread their work."

Communications in health care improvement - a toolkit
The Health Foundation

Read more here.

A dietetic-led coeliac service incorporating group education

"This example describes our service redesign to increase patient capacity within existing dietetic provision, whilst also aiming to improve service quality."

A dietetic-led coeliac service incorporating group education
Gloucestershire Hospitals NHS Foundation Trust
NICE Shared Learning example
September 2015

Read more here.

Integrated care clinical Pharmacist GSTT@home service

"The ICCPs have made a significant impact in the overall quality of care that the GSTT @home service patients have received, and have also had a positive effect on the overall medicines optimisation of the service in general."

Integrated care clinical Pharmacist GSTT@home service
Guys & St Thomas NHS Foundation Trust (Community Health Services) NHS Specialist Pharmacy services

NICE Shared Learning examples
September 2015

Read more here.

Tobacco return on investment tool

"The tool evaluates a portfolio of tobacco control interventions and models the economic returns that can be expected in different payback timescales. Different interventions, including pharmacotherapies and support and advice, can be mixed and matched to see which intervention portfolio or package provides the best 'value for money', compared with 'no-services' or any other specified package."

Tobacco return on investment tool

NICE

August 2015

Read more here. 

Improving the management of sepsis by implementing the 'Sepsis Six'

"Overall, we found there to a be a steady improvement in the delivery of the Sepsis Six bundle in septic patients with 63% of patients receiving appropriate care within one hour, compared to 29% prior to our interventions. However this did not translate to an improvement in patient mortality."

Improving the management of sepsis in a district general hospital by implementing the 'Sepsis Six' recommendations
P Kumar, M Jordan, J Caesar, S Miller
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207871.w4032

Read more here.

Improving the efficacy of elderly patients' hospital discharge

"After several months of sustained effort, the average time to complete eDANs fell by over an hour resulting in discharge medication dispensed earlier in the day and improved patient safety."

Improving the efficacy of elderly patients' hospital discharge through multi-professional safety briefings and behavioural change
J Corrado, K Topley, A Cracknell
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209431.w3871

Read more here.

Simple interventions can greatly improve clinical documentation

"In conclusion, simple, cost effective measures in streamlining medical notes, improves the quality of documentation, facilitates the filing and ultimately improves patient care."

Simple interventions can greatly improve clinical documentation: a quality improvement project of record keeping on the surgical wards at a district general hospital
P Glen, N Earl, F Gooding, E Lucas, N Sangha, S Ramcharitar
BMJ Quality Improvement 2015;4: doi:10.1136/bmjquality.u208191.w3260

Read more here.

Improving patient outcomes with technology and social media in paediatric diabetes

"The digital initiatives at Southport and Ormskirk Hospital NHS Trust provide strong evidence that the effective use of information technology and social media can significantly improve patient outcomes."

Improving patient outcomes with technology and social media in paediatric diabetes
S May Ng
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209396.w3846

Read more here.

Improving the productivity and efficiency of vascular surgery and radiology multidisciplinary meetings

"The changes made to the process have resulted in a real reduction in the time spent preparing each weekly meeting. As a result of careful and thoughtful improvement cycles, it has been possible to increase the proportion of patients discussed at each meeting by approximately two thirds."

Improving the productivity and efficiency of vascular surgery and radiology multidisciplinary meetings
Gary Dobson, Declan Neeson
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u208416.w3332
Programme

Read more here.

Improving the recording of surgical drain output

"We have demonstrated that the introduction of a simple and well-designed drain chart can significantly improve the documentation of drain output, thereby improving patient safety and discharge efficiency."

Improving the recording of surgical drain output
Nicholas Lyons, Paul Heron, Rob Bethune
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209264.w3964

Read more here.

Improving paediatric prescribing practice in a district general hospital

"A driver diagram identified three components contributing to prescribing errors and relevant tests of change were developed. The three primary drivers included education and communication, practical prescribing changes, and medicine reconciliation."

Improving paediatric prescribing practice in a district general hospital through implementation of a quality improvement programme
P Donnelly, S Lawson, C Watterson
BMJ Quality Improvement Report2015;4: doi:10.1136/bmjquality.u206996.w3769

 

Read more here.

Improving efficiency management of radiopharmaceutical materials

"The high cost of radiopharmaceuticals is a significant part of the annual budget of PET/CT unit and nuclear medicine department in general. In fact, it is a valuable target for quality improvement projects that aims to reduce the percentage of wastes and improves resource management at work site."

Improving efficiency management of radiopharmaceutical materials at a nuclear medicine department
A Al Ahmed, K Al-Surimi
BMJ Quality Improvement Reports, 2015;4: doi:10.1136/bmjquality.u208970.w3709

Read more here.

Atrial fibrillation care improvement collaborative

"Interdepartmental collaboration and care standardization offer opportunities to improve quality of care and reduce costs for patients with atrial fibrillation. These patients are able to avoid inpatient hospitalization, benefit from a new anticoagulation option, and follow up more closely with their primary care providers in order to address long term care plans."

 Atrial fibrillation care improvement collaborative
P Robelia, S Kopecky, T Thacher
BMJ Quality Improvement Reports, 2015;4: doi:10.1136/bmjquality.u208947.w3629

Read more here.

 

Improving discharge communication between secondary and primary care

"Discharge communication is an essential component of transition from secondary to primary care. Our study identifies sub-optimal discharge communication at the OUH Trust, which is likely to be reflected in other trusts. In particular, the areas of concern include medication reconciliation and follow-up plans."
Mind the gap: Improving discharge communication between secondary and primary care
A Cresswell, M Hart, O Suchanek, T Young, L Leaver, S Hibbs
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207936.w3197

Read more here.

Improving length of stay: what can hospitals do?

"This report on length of stay by the Nuffield Trust is part of a larger project undertaken by Monitor which aims to find the best ways to improve quality of care across the health system in light of recent pressures on urgent and emergency care."
Improving length of stay: what can hospitals do?
N Edwards, R Lewis Nuffield Trust
September 2015

Read more here.

Challenging the NHS to innovate

"George Freeman, Minister for Life Sciences, explains how the NHS will make the most of research and innovation."

Challenging the NHS to innovate (speech)
Department of Health, George Freeman MP and Office for Life Sciences
Delivered on: 3 September 2015

Read more here.

Using technology to improve delivery of health and care services (speech)

"Life sciences minister George Freeman on how integrated data and technology can improve the delivery of effective health and care services."

Using technology to improve delivery of health and care services (speech)
Department of Health, National Information Board, Office for Life Sciences and George Freeman MP
Delivered on: 3 September 2015

Read more here.

Using FRAM to align work-as-imagined with work-as-done when implementing clinical guidelines

"Using FRAM to reconcile differences between work-as-imagined and work-as-done when implementing a guideline can reduce the need for clinicians to adjust performance and create workarounds, which may be detrimental to both safety and quality, once the guideline is introduced."

Where the rubber meets the road: using FRAM to align work-as-imagined with work-as-done when implementing clinical guidelines

Robyn Clay-Williams, J Hounsgaard, E Hollnage
Implementation Science 2015, 10:125  doi:10.1186/s13012-015-0317-y

Read more here.

Health Foundation Representation to the 2015 Comprehensive Spending Review

"This document contains the submission from the Health Foundation to the 2015 Comprehensive Spending Review"

Health Foundation Representation to the 2015 Comprehensive Spending Review
The Health Foundation
September 2015

Read more here.

How should we think about value in health and care?

"With this paper, we aim to articulate a new understanding of the value of engaging individuals and communities in health and care, and to discuss the challenges in progressing this."

How should we think about value in health and care?: Realising the Value
NESTA
September 2015

Read more here.

Development and evaluation of a community respiratory physiotherapy service for children with severe neurodisability

"This small study suggests that a community respiratory physiotherapy service can reduce hospital admissions and bed days for disabled children. The admissions cost savings have enabled the service to "pay for itself"."

Development and evaluation of a community respiratory physiotherapy service for children with severe neurodisability
A Wolff, H Griffin, M Flanigan, S Everest, D Thomas, W Whitehouse
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u208552.w3411

Read more here.

Improving VTE risk assessment at point of admission to a tertiary centre cardiology ward

"Recommendations for sustained improvement included: redesigning the drug chart so that the VTE risk assessment tool was linked to the VTE prophylaxis prescription box, and designating the responsibility of the initial VTE risk assessment to the on call junior doctor who receives admissions on to the ward."

Improving VTE risk assessment at point of admission to a tertiary centre cardiology ward
R Wilson
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209203.w3760

Read more here.

Ranking hospitals on avoidable death rates derived from retrospective case record review

"In conclusion, classifying the performance of English hospitals for avoidable hospital mortality based on a review of 2000 hospital deaths per year will result in both invalid and unreliable rankings."

Ranking hospitals on avoidable death rates derived from retrospective case record review: methodological observations and limitations
G Abel1, G Lyratzopoulos
BMJ Quality and Safety 2015;24:554-557 doi:10.1136/bmjqs-2015-004366

Read more here.

How effective are patient safety initiatives?

"Our study shows some improvements in preventable adverse events in the areas that were addressed during the comprehensive national safety programme. There are signs that such a programme has a positive impact on patient safety."

How effective are patient safety initiatives? A retrospective patient record review study of changes to patient safety over time
R Baines, M Langelaan, M de Bruijne, P Spreeuwenberg, C Wagner
BMJ Quality and Safety 2015;24:561-571 doi:10.1136/bmjqs-2014-003702

Read more here.

Hypokalaemia: Improving the investigation, management and therapeutic monitoring

"Through implementation of multiple interventions to improve awareness and understanding of the investigations, treatment, and monitoring of the hypokalaemic patient, we have achieved a notable improvement in management."

Hypokalaemia: Improving the investigation, management and therapeutic monitoring of hypokalaemic medical inpatients at a district general hospital
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209049.w3670
M Jordan, J Caesar

Read more here.

Improving Experience through Regular Shadowing Events

"The ImERSE (improving experience through regular shadowing events) approach could be applied to any area of health care to generate population specific improvement priorities. It can be used to promote patient and family centred care and provide a unique medical education experience."

ImERSE (Improving Experience through Regular Shadowing Events)
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206748.w2843
W Calvert, J Minford, C Platt, C Chatfield

Read more here.

Patient safety implications of general practice workload

"This discussion paper looks at fatigue among GPs – as caused by persistent and excessive workload – its potential impact on patient safety, and methods available to improve this situation in future."

Patient safety implications of general practice workload
Royal College of General Practitioners
July 2015

Read more here.

Implementation of improvement strategies in palliative care

"This review is one of the first to provide an overview of the available literature in relation to strategies used to improve the organisation of palliative care. Since most studies reported positive results, further research is needed to identify and improve the effects of strategies aiming to improve the organisation of palliative care."

Implementation of improvement strategies in palliative care: an integrative review
J van Riet Paap et al.
Implementation Science 2015, 10:103  doi:10.1186/s13012-015-0293-2

Read more here.

Local Transformation Plans for Children and Young People’s Mental Health and Wellbeing Guidance and support for local areas

"The report sets out a clear national ambition to transform the design and delivery of a local offer of services for children and young people with mental health needs."

Local Transformation Plans for Children and Young People’s Mental Health and Wellbeing Guidance and support for local areas
NHS England
August 2015

Read more here.

Access and Waiting Time Standard for Children and Young People with an Eating Disorder

"Guidance setting out commissioning standards and requirements for providing community-based eating disorder services for children and young people, with related referral to treatment pathways and access and waiting time standard."

Access and Waiting Time Standard for Children and Young People with an Eating Disorder: Commissioning Guide
National Collaborating Centre for Mental Health, NHS England.
July 2015

Read more here.

Evaluation of a continuous monitoring and feedback initiative to improve quality of anaesthetic care

"The results support the potential of quality monitoring and feedback interventions as quality improvement mechanisms and provide insight into the positive response of clinicians to this type of initiative, including documentation of the experiences of anaesthetists that participated as users and codesigners of the feedback."

Evaluation of a continuous monitoring and feedback initiative to improve quality of anaesthetic care: a mixed-methods quasi-experimental study 
J Benn, et al.
Health Services Delivery and Research 2015;3(32)

Read more here.

Supporting people with a learning disability: DRAFT service model for commissioners

"This Service Model is intended for a particular juncture in the transformation of services for people with a learning disability and / or autism. It builds on existing NICE guidance (such as that on challenging behaviour) and will be superseded as good practice develops and in particular once NICE service model guidance is published in 2017."

Supporting people with a learning disability and / or autism who have a mental health condition or display behaviour that challenges: DRAFT service model for commissioners of health and social care services
NHS England, Local Government Association, Association of Directors of Adult Social Sevices 
July 2015

Read more here.

New NICE Guideline: Melanoma: assessment and management

"This guideline covers the assessment and management of melanoma (a type of skin cancer) in children, young people and adults. It aims to reduce variation in practice and improve survival."

Melanoma: assessment and management - NICE guidelines [NG14] 
NICE
July 2015

Read more here.

The Impact of Primary Care Quality on Inpatient Length of Stay for People with Dementia

"For those who are discharged home or to the community setting, the QOF review may have a small negative influence on length of stay. Such modest effects suggest that the QOF review does not have a major influence on LoS for dementia hospital admissions. However, this does not mean the review is unimportant for patient care: the increasing prevalence of dementia and the constraints on capacity in the acute hospital sector may mean even modest impacts are important financially. "

The Impact of Primary Care Quality on Inpatient Length of Stay for People with Dementia: An Analysis by Discharge Destination
P Kasteridis, M Goddard, R Jacobs, R Santos, A Mason
CHE Research Paper 113
Centre for Health Economics, University of York, UK

July 2015

Read more here. 

Using Incentives To Improve Experience In Maternity, Children And Young People's Services

"The report will discuss three core recommendations, each with a number of sub-recommendations to support local, regional and national discussions on how CQUINs and other financial incentive schemes can be used to improve the quality and effectiveness of maternity, children and young people’s services." 

Using Incentives To Improve Experience In Maternity, Children And Young People's Services
P Kumalo, M Cunnington
NHS South East CSU
July 2015

Read more here.

Breast Cancer Screening, Incidence, and Mortality Across US Counties

"Our analysis shows that, when directed toward the general US population, the most prominent effect of screening mammography is overdiagnosis. Nonetheless, we do not believe that the right rate of screening mammography is zero. As is the case with screening in general, the balance of benefits and harms is likely to be most favorable when screening is directed to those at high risk, provided neither too frequently nor too rarely, and sometimes followed by watchful waiting instead of immediate active treatment."

Breast Cancer Screening, Incidence, and Mortality Across US Counties
C Harding, F Pompei, D Burmistrov, HG Welch, R Abebe, R Wilson
JAMA Intern Med. Published online July 06, 2015. doi:10.1001/jamainternmed.2015.3043

Read more here.

Making change possible: A Transformation Fund for the NHS

"To ensure that the substantive changes required can be achieved, we argue that the NHS needs dedicated funding – a Transformation Fund – to deliver the change required, aligned with more effective practical support and the right policy context for change."

Making change possible: A Transformation Fund for the NHS
R Murray et al.
The Health Foundation, The King's Fund
July 2015

Read more here.

The NHS in 2030: a people-powered and knowledge-powered health system

"The NHS has the opportunity to take advantage of two powerful and under–exploited sources of innovation that have the potential to make care better and, under the right circumstances, cheaper. These are the rapidly accelerating pace of digital technology, and the power of social innovation."

The NHS in 2030: a people-powered and knowledge-powered health system
J Bland, H Khan, J  Loder, T Symons, S Westlake
NESTA
July 2015

Read more here.

Using data and analytics to transform patient care

"Data-driven decision making has improved patient outcomes in Intermountain's cardiovascular medicine, endocrinology, surgery, obstetrics and care processes — while saving millions of dollars in procurement and in its the supply chain." 

How Intermountain Healthcare is using data and analytics to transform patient care
M Fitzgerald
MITSloan Management Review
June 2015

Read more here.

Identifying alternatives to old age psychiatry inpatient admission

"The results suggest that if enhanced community services were available, a significant minority of inpatients could be more appropriately supported in their own homes at a cost considerably lower than that currently incurred."

Identifying alternatives to old age psychiatry inpatient admission: an application of the balance of care approach to health and social care planning

S Tucker, C Brand, M Wilberforce, M Abendstern, D Challis
BMC Health Services Research 2015, 15:267  doi:10.1186/s12913-015-0913-1

Read more here.

The influence of context on the effectiveness of hospital quality improvement strategies

"Our findings suggest that some of the most relevant context factors are those close to the clinical microsystem in which the QI intervention is delivered. This provides cues for action for improvement practitioners who may include an assessment of such factors, and dedicated change processes, in their local plans for quality improvement."

The influence of context on the effectiveness of hospital quality improvement strategies: a review of systematic reviews
DS Kringos et al.
BMC Health Services Research 2015, 15:277  doi:10.1186/s12913-015-0906-0

Read more here.

Improving reporting of critical incidents through education and involvement

"This quality improvement project has resulted in increased reporting of critical incidents. This paves the way for future quality improvement projects to be performed targeting areas of concern which will help improve patient safety across various disciplines."

Improving reporting of critical incidents through education and involvement
P Donnelly
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206996.w3776

Read more here.

Four Simple Ward Based Initiatives to Reduce Unnecessary In-Hospital Patient Stay

"A six cycle prospective audit was carried out to investigate if four simple ward based initiatives could optimise patient flow through a medical ward and reduce LoS [length of stay] of inpatients awaiting social packages and placement."

Four Simple Ward Based Initiatives to Reduce Unnecessary In-Hospital Patient Stay: A Quality Improvement Project
A Shabbir, G Wali, A Steuer
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u208974.w3661

Read more here.

Using league tables to reduce missed dose medication errors on mental healthcare of older people wards

"By greatly reducing the risk of patients experiencing adverse drug events as a result of missed doses, this project has given rise to a potential cost-saving of around £34,000 per year across the wards studied. "

Using league tables to reduce missed dose medication errors on mental healthcare of older people wards
A Cottney
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u204237.w3567

Read more here.

Improving the safety of oxygen therapy

"Our quality improvement project aimed to increase the safety of oxygen therapy at University Hospitals Bristol NHS Foundation Trust. We aimed to increase the rate of oxygen prescribing and increase the percentage of nurses signing appropriately for oxygen titration and administration."

Changing an ingrained culture: Improving the safety of oxygen therapy at University Hospitals Bristol NHS Foundation Trust
M Gatter, G Dixon, J Wall, E Mew
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u203238.w1474

Read more here.

Priorities for creating a learning healthcare system based on routinely collected data

"Ongoing feedback of insights from data to patients, clinicians, managers and policymakers can be a powerful motivator for change as well as provide an evidence base for action. Many studies and systems have demonstrated that routine data can be a powerful tool when used appropriately to improve the quality of care."

Making sense of the shadows: priorities for creating a learning healthcare system based on routinely collected data
SR Deeny, A Steventon
BMJ Quality and Safety 2015;24:505-515 doi:10.1136/bmjqs-2015-004278

Read more here.

Characterising ‘near miss’ events in complex laparoscopic surgery through video analysis

"Error awareness is essential in daily surgical practice and surgical training. The current study highlights the benefits of detailed video analysis to create a database of common injury mechanisms and video clip repository that can be used in tailoring future training interventions."

Characterising ‘near miss’ events in complex laparoscopic surgery through video analysis
EM Bonrath, LE Gordon, TP Grantcharov
BMJ Quality and Safety 2015;24:516-521 doi:10.1136/bmjqs-2014-003816

Read more here.

The Global Comparators project: international comparison of 30-day in-hospital mortality by day of the week

"We show that mortality outcomes for our sample vary within each country and per day of the week in agreement with previous studies of the ‘weekend effect’."

The Global Comparators project: international comparison of 30-day in-hospital mortality by day of the week
M Ruiz, A Bottle, PP Aylin
BMJ Quality and Safety 2015;24:492-504 doi:10.1136/bmjqs-2014-003467

Read more here.

Insights on earlier adoption of medical innovations

"The aims of this piece of work are:

• To identify the key features of systems in which drugs, devices and diagnostics are assessed from trials to patients quickly, by considering a number of global ‘front-runners’;
• To understand how these systems work in practice;
• To reflect on the challenges and opportunities to effectively translate into the UK’s health system"

Insights on earlier adoption of medical innovations: An international review of emerging and effective practice in improving access to medicines and medical technology
S Wooding, G Cochrane, J Taylor, A Kamenetzky, S Sousa, S Parks
Rand Europe
July 2015

Read more here.

Home administration of intravenous diuretics to heart failure patients

"Originally a 2-year pilot programme to assess safe and effective ways for specialist nursing teams to administer intravenous (IV) diuretics to people at home or in a day-care setting, preventing hospital admissions and improving patient experience. Without this service patients would be admitted to hospital to receive IV diuretics."

Home administration of intravenous diuretics to heart failure patients: Increasing productivity and improving quality of care
Quality and Productivity case study
British Heart Foundation
June 2015

Read more here.

Template reports for radiology cancer staging: improving information

"This initiative uses templates to record tumour staging information from magnetic resonance (MR) investigations. The information provided by radiologists to clinicians is improved and standardised, allowing management decisions to be better informed and reducing the need for additional clarification. This initiative is primarily about improving quality, although there are some small productivity savings"

Template reports for radiology cancer staging: improving information to guide treatment decisions
Quality and Productivity case study
Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust
July 2015

Read more here.

Podiatry education to empower patients to self-care

"This project was designed to identify and train patients suitable for self-care, so they can be discharged from the service. This helped to ensure that podiatry care is targeted at those with the greatest need. "

Podiatry education to empower patients to self-care
Quality and productivity collection example
Community and Primary Services, Sheffield Teaching Hospitals NHS Foundation Trust
July 2015

Read more here.

How is the NHS performing? Quarterly Monitoring Report

"three-quarters of trust finance directors intend to recruit more permanent nurses in the next six months, suggesting that the NHS is continuing to prioritise quality of patient care despite rising financial pressures."

How is the NHS performing? Quarterly Monitoring Report
J Appleby, J Thompson, J Jabbal
The King's Fund
July 2015


Read more here.

Using a simple handover to improve the timing of gentamicin levels

"Prior to our intervention, the timing of gentamicin levels was poorly performed, with 42.2% of levels taken late and two episodes of missed doses were reported."

Using a simple handover to improve the timing of gentamicin levels
A Williamson, A Bradley, K Khan
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207727.w3081

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Improving the quality of handover

"This project demonstrates that replacing an ad-hoc system of handover with a multi-disciplinary, team based approach to handover improves handover quality. In addition it provides a useful guide to introducing a new handover meeting to a department and contains useful lessons on how to combat cultural barriers to change within a department."

Improving the quality of handover by addressing handover culture and introducing a new, multi-disciplinary, team-based handover meeting
H Walton, W Munro
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206069.w2989

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Services for people with neurological conditions: progress review

"Part One of this report sets out a range of data on the quality of neurological services since we reported in 2011, including waiting times and emergency admissions."

Services for people with neurological conditions: progress review
Department of Health and NHS England
National Audit Office
July 2015

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Enhanced recovery programme in gynaecology

"We describe the successful implementation of an ERP in Southend Hospital resulting with no difference in measurable morbidity and mortality, a shorter length of stay, and a high patient satisfaction scores and outcomes."

Enhanced recovery programme in gynaecology: outcomes of a hysterectomy care pathway
D Mukhopadhyay
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206142.w2524

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Mental Health Staffing Framework

"Mental Health Staffing: A Practical Guide has been developed as part of the ‘Compassion in Practice programme’ led by NHS England. It is based around standards set by the National Quality Board and is expected to inform national Mental Health programmes of work "

Mental Health Staffing Framework
Health Education West Midlands
NHS England
June 2015

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Children and young people's survey 2014

"This is the first national children’s survey conducted by CQC. It represents the experiences of nearly 19,000 children and young people who received inpatient or day case care in 137 acute NHS trusts in 2014."

Children and young people's survey 2014
Care Quality Commission
July 2015

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Unbundling recovery: Recovery, rehabilitation and reablement

"This report describes how an audit methodology used previously for surgical conditions can be used to assess whether the rehabilitation aspects of a patient's acute hospital stay could be better provided.

It shows how, with some further evidence, a locally derived tariff for recovery, rehabilitation and reablement could be developed to support service improvements."

Unbundling recovery: Recovery, rehabilitation and reablement national audit report
NHS Improving Quality
June 2015

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Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes

"This all-cause harm safety study indicates that inpatient harm has negative financial outcomes for hospitals and negative clinical outcomes for patients."

Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes
L Adler et al.
2015, Journal of Patient Safety, doi: 10.1097/PTS.0000000000000171

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Better value in the NHS

"In a time of severe financial constraint, the NHS is being asked to make productivity savings of £22 billion by 2020/21. However, this report argues that, rather than looking at efficiency and costs, the NHS should be focusing on getting better value from its budget."

Better value in the NHS: The role of changes in clinical practice
H Alderwick, R Robertson, J Appleby, P Dunn, D Maguire
The King's Fund
July 2015

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Good practice in ambulance commissioning

"The National Ambulance Commissioners Network (NACN), which is part of NHS Clinical Commissioners, brings together individuals from across the country with an interest in ambulance commissioning to share learning, provoke discussion and work together to find solutions. As part of that we have collected and brought together a number of good practice examples to contribute to the ongoing debate on finding new approaches to the provision of emergency services, and the role that clinical commissioners can play in driving those new approaches forward."

Good practice in ambulance commissioning
The National Ambulance Commissioners Network
NHS Clinical Commissioners
June 2015

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“Conversation Ready”: A Framework for Improving End-of-Life Care

"This white paper describes the Conversation Ready framework, the changes associated with the framework’s five principles that can be implemented to improve end-of-life care, examples of changes tested by organizations, and suggested measures to guide improvement."

“Conversation Ready”: A Framework for Improving End-of-Life Care (IHI White Paper)
K McCutcheon Adams, A Kabcenell, K Little, L Sokol-Hessner
Institute for Healthcare Improvement
June 2015

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Focus on: International comparisons of healthcare quality

"This report uses the data to understand what international comparisons tell us about changes in quality of healthcare in the UK between 2000 and 2013, and provides a baseline for future comparisons."

Focus on: International comparisons of healthcare quality: What can the UK learn?
L Kossarova, I Blunt, M Bardsley
QualityWatch
July 2015

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Examining the implementation of NICE guidance

"In the UK, NHS hospitals receive large amounts of evidence-based recommendations for care delivery from the National Institute for Health and Care Excellence (NICE) and other organisations. Little is known about how NHS organisations implement such guidance and best practice for doing so." 

Examining the implementation of NICE guidance: cross-sectional survey of the use of NICE interventional procedures guidance by NHS Trusts
K Lowson, M Jenks, A Filby, L Carr, B Campbell, J Powell
Implementation Science 2015, 10:93  doi:10.1186/s13012-015-0283-4

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The Budget: health and social care funding

"There are still significant opportunities to improve productivity, and the NHS must redouble its efforts to deliver better outcomes at lower cost by changing the way clinical care is delivered."

The Budget: health and social care funding
The King's Fund
July 2015

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A Medicines Optimisation Service

"The service was developed as a result of a pilot in one practice who used innovation funding to employ a pharmacist to improve their management of medicines. The idea came from the GPs who felt they were always rushed when looking at discharge medicines and this task would be more efficiently and effectively undertaken by a pharmacist. "

A Medicines Optimisation Service
Wyre Forest Clinical Commissioning Group
NICE Shared Learning example
May 2015

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Improving evidence-based management of irritable bowel syndrome across Somerset

"By identifying cost savings from reducing referrals to secondary care for patients of 16-45 years old with no red flag symptoms and likely IBS, and limiting investigations to those with a likely inflammatory pathology, we were able to fund faecal calprotectin testing for general practice and a specialist dietetic-led gastroenterology clinic"

Improving evidence-based management of irritable bowel syndrome across Somerset
Somerset Gastroenterology Flexible Healthcare Team
NICE Shared Learning example
June 2015

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A Right Care Collaboration 2015/19: Forward View

"During 2015/16, NHS Right Care will scale up its activities and will seek to develop partnerships across the major NHS bodies to develop a variations and value programme." 

A Right Care Collaboration 2015/19: Forward View
NHS Right Care
June 2015

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Medicine optimisation can cut the costs of long term conditions

"Medicines optimisation can cut waste, emergency admissions and the cost of long term conditions. But a review of rheumatoid arthritis care reveals how far it has to go"

Medicine optimisation can cut the costs of long term conditions
M Shelley
Health Service Journal Supplement
June 2015

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Improving medical handover at the weekend

"we found that a structured, well organised weekend handover meeting together with an effective electronic handover system improves the quality of medical weekend handover."

Improving medical handover at the weekend: a quality improvement project
E Michael, C Patel
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207153.w2899

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Optimising the Pre-Operative Investigative Work Up for Elective Surgical Patients

"Design and implementation of a “Pre-Admission Handbook”, for use by junior doctors and nurse practitioners in the pre-operative setting, reduced the rate of over investigation to 12% in a subsequent, prospective audit cycle of 50 patients, and has improved patient care by standardising the pre-admissions process for elective surgery"

Optimising the Pre-Operative Investigative Work Up for Elective Surgical Patients
N Hack-Adams, N King, M Ahuja, SM Higgs
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u206272.w2608

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How-to Guide: Prevent Adverse Drug Events

"This How-to Guide describes key evidence-based care components to prevent adverse drug events (ADEs) by implementing medication reconciliation at all transitions in care (at admission, transfer, and discharge), describes how to implement these interventions, and recommends measures to gauge improvement." 

How-to Guide: Prevent Adverse Drug Events (Medication Reconciliation)
Institute for Healthcare Improvement
2011

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How-to Guide: Prevent Catheter-Associated Urinary Tract Infection

"This How-to Guide describes key evidence-based care components for preventing catheter-associated urinary tract infections, describes how to implement these interventions, and recommends measures to gauge improvement."

How-to Guide: Prevent Catheter-Associated Urinary Tract Infection
Institute for Healthcare Improvement
2011

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How-to Guide: Deploy Rapid Response Teams

"This How-to Guide describes key evidence-based care components for Rapid Response Teams, describes how to implement these interventions, and recommends measures to gauge improvement."

How-to Guide: Deploy Rapid Response Teams
Institute for Healthcare Improvement
2008

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High performing hospitals: a qualitative systematic

"The objective of this study was to undertake a systematic review of qualitative literature to identify methods used to identify high performing hospitals, the factors associated with high performers, and practical strategies for improvement."

High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement
N Taylor, R Clay-Williams, E Hogden, J Braithwaite, O Groene
BMC Health Services Research 2015, 15:244  doi:10.1186/s12913-015-0879-z

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Waiting time reduction in intravitreal clinics by optimization of appointment scheduling

"This study was designed guided by the Model for Improvement framework to reduce waiting times and visit duration in the intravitreal therapy clinic, while improving patient and staff experience. In our aim to provide good quality, patient-centred care and constantly improve, we optimised the appointment profile and patient flow."

Waiting time reduction in intravitreal clinics by optimization of appointment scheduling: balancing demand and supply
M Ugarte
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u208924.w3618

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