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.