The future of pathology services

"The report also looks at the changes digital and genomic technology is bringing in pathology, and what they mean for services, and how we can get the most benefit out of them."

The future of pathology services
S Karakusevic, N Edwards, R Lewis, M Dayan
Nuffield Trust
June 2016

Read more here.

Large-scale general practice in England: what can we learn from the literature?

"Traditional general practice is changing. Three-quarters of practices are now working collaboratively in larger-scale organisations – albeit with varying degrees of ambition and organisational integration. Policy-makers and practitioners have high hopes for these organisations and their potential to transform services both within primary care and beyond. But can we be confident that they can live up to these expectations?"

Large-scale general practice in England: what can we learn from the literature?
L Pettigrew, N Mays, S Kumpunen, R Rosen, R Posaner
Nuffield Trust
September 2016

Read more here.

Lessons for large-scale general practice

"This study examines the factors affecting the evolution and impact of large-scale general practice on staff, patients, the wider health economy and the quality of care. The study combines an extensive literature review and national surveys with an in-depth mixed-methods evaluation of contrasting, large-scale general practice organisations that includes detailed case studies."

Is bigger better? Lessons for large-scale general practice
R Rosen, S Kumpunen, N Curry, A Davies, L Pettigrew, L Kossarova
Nuffield Trust
July 2016

Read more here.

Sustainability and Transformation Plans: what we know so far

"So far, the plans are not sufficient to close the funding gap, but, if implemented well and combined with high-quality local efficiency improvement, they would go some way to doing so and would demonstrate the capability of the NHS and social care system to deliver. This paper points to some important trends, ideas to be explored and issues that need to be resolved in order to ensure success."

Sustainability and Transformation Plans: what we know so far
N Edwards
Nuffield Trust
September 2016

Read more here.

Understanding patient flow in hospitals

"Previous Nuffield Trust work has argued that although the target can be over-emphasised, struggles in meeting it are associated with deeper problems in the capacity to move patients into hospital wards. This briefing draws on theories about congestion to look at why this has become more difficult, and what can be done about it. It aims to be useful to the hospital managers and people involved in Sustainability and Transformation Plans who tackle these problems on the front line, as well as to the policymakers who oversee them."

Understanding patient flow in hospitals
S Karakusevic, N Edwards
Nuffield Trust
October 2016

Read more here.

Thames Valley & Milton Keynes Strategic Clinical Networks commissioning guidance

Thames Valley & Milton Keynes Strategic Clinical Networks have produced commissioning guidance with recommendations for action and best practice case studies for cancer, cardiovascular health, children, end of life care, long term conditions, maternity, mental health and neurological conditions. Although locally focused, the guides may have wide spread interest. 

Access the guides here.

A guide to enabling the spread of person and community-centred approaches for health and wellbeing

"This guide outlines how behavioural science can help spread the take-up of person- and community- centred approaches to health and wellbeing. It is aimed at people who champion these approaches in health and social care, in other statutory bodies and in community-based organisations."

Spreading change: A guide to enabling the spread of person- and community-centred approaches for health and wellbeing
H Burd, M Hallsworth, The Behavioural Insights Team
Nesta and the Health Foundation
September 2016

Read more here.

A guide to enabling behaviour change for health and wellbeing using person- and community-centred approaches

"This guide is for people who support those living with long-term conditions, their carers, families or communities. It summarises practical ways to support people to self manage effectively using person and community-centred approaches. Many of these activities are useful also for people who work to prevent the development of long-term conditions in the first place."

Supporting self-management: a guide to enabling behaviour change for health and wellbeing using person and community centred approaches
H Burd, M Hallsworth, The Behavioural Insights Team
Nesta and the Health Foundation
September 2016

Read more here.

User feedback in maternity services

This report looks at what maternity services are doing locally to collect, analyse and act on user feedback. It describes the challenges of adopting the different approaches and highlights the features of organisations that are successful in user feedback activities.

User feedback in maternity services
L Wenzel, J Jabbal
The King's Fund
October 2016

Read more here.

Deficits in the NHS 2016

This briefing draws on data from our quarterly monitoring reports, secondary research and interviews with health care leaders to consider commissioner and provider finances in the round and to provide an overview of the factors that have led to the NHS going into deficit. It goes on to outline some of the strategies being employed to restore financial balance, before drawing together our thoughts on the implications of these strategies for the NHS this year and in the longer term.

Deficits in the NHS 2016
 P Dunn, H McKenna, R Murray
The King's Fund
July 2016

Read more here.

Understanding dementia memory services across London

This reports details the results of the clinical audit carried out on London dementia memory services by the Dementia CN’s Effective diagnosis work stream.

The audit found substantial variation between services, and the report provides recommendations to address this and improve practice.

Understanding dementia memory services across London
June 2016
London Clinical Networks

Read more here.

Tooling up and gearing up mental health in primary care

This document supports people to improve access and understand the key components of good primary care mental health training and education. It provides: 1.) Workforce training and education framework; 2.) competency checklist; 3.) summary of education and training in London.

Tooling up and gearing up mental health in primary care
London Clinical Networks
August 2016

Read more here.

Delayed Transfer of Care Pan London Review

This report has been prepared by the NHS England Delayed Transfer of Care Programme and provides an overview of the causes of delayed transfers of care across London, and the characteristics of a good model for reducing these.

NHS England: Delayed Transfer of Care Pan London Review
A Bjorkstrand, Lead for Delayed Transfer of Care Project
March 2016

Read more here.

Improving the quality of care in the last days of life: medication

"This document identifies best practice in the way medications should be managed in the last days of life. It sets out practical, high level, evidence-based recommendations to help guide those responsible for care to review their processes and consider ways to make change where necessary."

Improving the quality of care in the last days of life: A practical guide to getting the medications right
London Clinical Networks
April 2016

Read more here.

London acute neurology services: A case for change

This document describes why neurological services must change how patients are managed upon entering the health system through emergency and urgent care routes.

London acute neurology services: A case for change
London Clinical Networks
January 2015

Read more here.

Excellence in anticoagulant care

This document defines and describes the components of an excellent anticoagulation service.
A consensus view on what constitutes an excellent anticoagulation service for patients with atrial fibrillation (AF) will support providers and commissioners in ensuring the provision of best quality practice for their local populations.

Excellence in anticoagulant care

London Clinical Networks

August 2016

Read more here.

Type 1 diabetes London commissioning pack

This comprehensive commissioning pack aims to ensure excellent type 1 diabetes services for all Londoners. There are three parts:

• Service specification – Aimed at commissioners, this document details the care to be commissioned for adults with type 1 diabetes, including an overview of diabetes, elements of an excellent service plus commissioning recommendations.
• Clinical management: Optimal pathway – Aimed at providers, this document details the expected clinical care for type 1 diabetes.
• Implementation guide – This document provides the tools for both commissioners and providers to measure, analyse and develop improvement plans for their local diabetes service. It includes a summary of expectations and self assessments for commissioners and providers, performance targets and a sample patient reported outcome measures (PROM) form to collate patient feedback. It also highlights the type 1 care consultation tool (developed by Health Innovation Network and King’s Health Partners), which can be used in the management of people with type 1 diabetes.

Diabetes commissioning pack
London Clinical Networks
September 2016

Access the pack here.

The multispecialty community provider (MCP) emerging care model and contract framework

"This document defines what being a multispecialty community provider (MCP) means by assembling features from the 14 MCP vanguards into a common framework. In turn, the 14 will be adopting or adapting the framework for their diverse local communities, as they progress from their current status as aspirant MCPs towards full maturity."

The multispecialty community provider (MCP) emerging care model and contract framework 
NHS England
July 2016

Read more here.

CQC New Care Models: Information for providers

"The purpose of this Q&A is to provide advice and guidance to health and care organisations that already are, or thinking of becoming, involved in delivering a new care model. It talks through a number of common questions about regulatory considerations of new care models, and how CQC is aiming to support providers through this process."

New Care Models: Information for providers
CQC
July 2016

Read more here.

Oversight of new care models: your questions answered

"The new care models programme is delivering a key element of the Five Year Forward View and we're working to support innovative change. With our national partners and a number of vanguards, we're identifying potential issues and developing and testing solutions for providers."

Oversight of new care models: your questions answered
NHS Improvement
August 2016

Read more here.

NHS England New care models – FAQs

NHS England have released a new FAQ answering questions about the new care model (vanguard)

Access them here.

The state of maternity services in England

"Improving people’s experiences of maternity care therefore requires providers to hear and respond to user feedback, and to ensure that staff feel supported to provide the best quality care."

The state of maternity services in England: Policy briefing
G Paparella
Picker Institute
July 2016

Read more here.

Under the scan: patients’ views of X-rays and scans in the UK

"The survey findings highlight the current lack of capacity in UK radiology services to deliver X-ray and scan results for all patients within 28 days."

Under the scan: patients’ views of X-rays and scans in the UK

The Patients Association and The Royal College of Radiologists

August 2016

Read more here. 

Understanding pressures in general practice

"This report looks at patient factors, system factors and supply-side issues to see what lies behind this increasing pressure on general practice. It finds that despite GPs being at the heart of the health care system, a lack of nationally available, real-time data has made their changing workload largely invisible to commissioners and policy-makers."

Understanding pressures in general practice
B Baird, A Charles, M Honeyman, D Maguire, P Das
The King's Fund
May 2016

Read more here.

Strategic quality improvement

"The King’s Fund was commissioned by Oxleas NHS Foundation Trust to work with their Quality Board to facilitate an assessment of its existing approaches to quality improvement and to develop a strategy for future work. This case study details the approach and philosophy behind this work, which involved working with the trust’s five directorates to develop their ability to appraise their own approach to quality improvement with a view to improving performance, achieving better clinical outcomes and building further on the trust’s capacity as a learning organisation."

Strategic quality improvement: An action learning approach
V Nath
The King's Fund
May 2016

Read more here.

NHS finances outside the EU

"In this briefing we explore what the UK leaving the EU might mean for funding of the NHS in England. We then outline the current state of finances for NHS providers in 2015/16, what this implies for the total Department of Health budget, and the scale of the financial challenge facing the health service for the near future."

NHS finances outside the EU: Health Foundation analysis of the impact on NHS finances of the UK leaving the European Union
The Health Foundation
July 2016

Read more here.

A healthier life for all: The case for cross-government action

"Health experts and politicians have come together in A healthier life for all: the case for cross-government action to call on the government to tackle the drivers of poor health by making health improvement an objective in all policy areas – in recognition that it is fundamental to a prosperous and sustainable society."

A healthier life for all: The case for cross-government action
The Health Foundation and the All-Party Parliamentary Health Group
July 2016

Read more here.

Hooked on Health Care: Designing Strategies for Better Health

"As dependency on health care services continues to grow in developed nations, there is an increased need to examine the prevailing model and its focus on treatment rather than the wider determinants of health. With participants from a range of disciplines, including, public health policy, business, and urban planning, Salzburg Global Fellows explored the value of wellbeing, the roles of businesses, government and civil society actors in promoting health, and health justice."

Hooked on Health Care: Designing Strategies for Better Health
E Spencelayh
The Health Foundation, Salzberg Global Seminar
July 2016

Read more here.

A clear road ahead: Creating a coherent quality strategy for the English NHS

"A clear road ahead sets out a practical and feasible set of actions for policymakers to safeguard and improve care within current priorities, as well as support the development of the NHS for years to come."

A clear road ahead: Creating a coherent quality strategy for the English NHS
A Molloy, S Martin, T Gardner, S Leatherman
The Health Foundation
July 2016

Read more here.

Staffing matters; funding counts

"Policymakers need to look at how targeted and aligned policies covering the effective use of temporary staff, retention of existing employees and international recruitment can be used to address current shortages in staffing and skills in order to buy time, while a more long-term sustainable approach is introduced."

Staffing matters; funding counts: Workforce profile and trends in the English NHS
J Buchan, I Seccombe, A Charlesworth
The Health Foundation
July 2016

Read more here.

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

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

Read more here.

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

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

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

Read more here.

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

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

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

Read more here.

Patients and families as teachers: a collaborative learning model for medical error disclosure and prevention

"An educational paradigm that includes patients as teachers and collaborative learners with clinicians in patient safety is feasible, valued by clinicians and P/F and promising for P/F-centred medical error disclosure and prevention training."

Patients and families as teachers: a mixed methods assessment of a collaborative learning model for medical error disclosure and prevention
T Langer, W Martinez, DM Browning, P Varrin, B Sarnoff Lee, SK Bell
BMJ Quality and Safety 2016;25:615-625 doi:10.1136/bmjqs-2015-004292

Read more here.

Progressing patient and public involvement in healthcare improvement

"Our findings point to a need to re-evaluate methods and approaches for involving patients and the public in all aspects of healthcare and in healthcare improvement. Partnership working has long been the explicit stated goal of involvement. However, current involvement practices at a national and local level often involve a narrow group of individuals in involvement activities, with little consideration given to including a broader demographic of the population."

From tokenism to empowerment: progressing patient and public involvement in healthcare improvement
J Ocloo, R Matthews
BMJ Quality and Safety 2016;25:626-632 doi:10.1136/bmjqs-2015-004839

Read more here.

Radiologist-initiated double reading of abdominal CT

"A 14% rate of clinically important changes made during double reading may justify quality assurance of radiological interpretation. Using expert second readers and a targeted selection of urgent cases and radiologists reading outside their specialty may increase the yield of discrepant cases."
Radiologist-initiated double reading of abdominal CT: retrospective analysis of the clinical importance of changes to radiology reports
PM Lauritzen et al.
BMJ Quality and Safety 2016;25:595-603 doi:10.1136/bmjqs-2015-004536

Read more here.

Plans to accelerate innovation in health systems are less than IDEAL

"An adapted IDEAL framework offers a pathway for prospective longitudinal evaluation of the Vanguard test bed sites and similar complex and emergent innovations. Adopting a common analytical framework will encourage iterative development, reporting and evaluation of innovations from the outset and before more widespread and rigorous testing is pursued."
Plans to accelerate innovation in health systems are less than IDEAL
PM Wilson, R Boaden, G Harvey
BMJ Quality and Safety 2016;25:572-576 doi:10.1136/bmjqs-2015-004605

Read more here.

Uptake, outcomes, and costs of implementing non-invasive prenatal testing for Down’s syndrome into NHS maternity care

"Implementation of NIPT [non-invasive prenatal testing] as a contingent test within a public sector Down’s syndrome screening programme can improve quality of care, choices for women, and overall performance within the current budget."

Uptake, outcomes, and costs of implementing non-invasive prenatal testing for Down’s syndrome into NHS maternity care: prospective cohort study in eight diverse maternity units
LS Chitty
BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i3426

Read more here.

Implementing an active foot disease pathway for people with diabetes in South Tees

"A regional referral pathway for active foot disease was set up in April 2015 for 8 NHS Trusts across north east England, which sets out when patients should be referred, who they should be referred to and how they should be referred.

It has helped to ensure that all patients with diabetes requiring care for active foot disease are referred correctly and seen in a timely manner, and is consistent with the recently updated NICE guideline on diabetic foot problems (NG19), which recommends that robust protocols and clear local pathways are in place for the continued and integrated care of people across all settings."

Implementing an active foot disease pathway for people with diabetes in South Tees
Diabetes Care Centre, The James Cook University Hospital
NICE Shared Learning example
July 2016

Read more here.

Talk Cardio Pulmonary Resuscitation Project

"The aim of this project, entitled ‘TalkCPR’, is to improve communication and dialogue between patients and their healthcare professionals about Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions."

Talk Cardio Pulmonary Resuscitation Project
Velindre NHS Trust
NICE Shared Learning example

May 2016

Read more here. 

Cardiovascular disease integrated care pilot to improve patient outcomes closer to home

"Within the context of a growing elderly population and better survival of people with CVD conditions, this project aimed to support patients to remain in the community for as long as is clinically possible, avoid hospital admissions and reduce length of stay."

Cardiovascular disease: integrated care pilot to improve patient outcomes closer to home
British Heart Foundation
NICE Quality and Productivity case study
May 2016

Read more here.

Coproduction of healthcare service

"In our efforts to improve healthcare service, we have often inadvertently approached the work as though healthcare was a ‘good’ produced by healthcare professionals. Recognising that healthcare service is a ‘service’ coproduced by patients and health professionals invites four clusters of opportunity for action."

Coproduction of healthcare service
M Batalden, P Batalden, P Margolis, M Seid, G Armstrong, L Opipari-Arrigan, H Hartung
BMJ Qual Saf 2016;25:509-517 doi:10.1136/bmjqs-2015-004315

Read more here.

Are reductions in emergency department length of stay associated with improvements in quality of care?

"We sought to determine whether patients seen in hospitals who had reduced overall emergency department (ED) length of stay (LOS) in the 2 years following the introduction of the Ontario Emergency Room Wait Time Strategy were more likely to experience improvements in other measures of ED quality of care for three important conditions."

Are reductions in emergency department length of stay associated with improvements in quality of care? A difference-in-differences analysis
MJ Vermeulen et al.
BMJ Qual Saf 2016;25:489-498 doi:10.1136/bmjqs-2015-004189

Read more here.

How safe is primary care?

"Improving patient safety is at the forefront of policy and practice. While considerable progress has been made in understanding the frequency, causes and consequences of error in hospitals, less is known about the safety of primary care."

How safe is primary care? A systematic review
S Singh Panesar et al.
BMJ Qual Saf 2016;25:544-553 doi:10.1136/bmjqs-2015-004178

Read more here.

Outpatient services and primary care: scoping review, substudies and international comparisons

"There is little conclusive evidence on the cost-effectiveness of the provision of more care in the community. In developing new models of care for the NHS, it should not be assumed that community-based care will be cheaper than conventional hospital-based care. Possible reasons care in the community may be more expensive include supply-induced demand and addressing unmet need through new forms of care and through loss of efficiency gained from concentrating services in hospitals."

Outpatient services and primary care: scoping review, substudies and international comparisons 
E Winpenny, C Miani, E Pitchforth, S Ball, E Nolte, S King, et al.
Health Services Delivery Research 2016;4(15)

Read more here.

Stopping Over-Medication of People with Learning Disabilities

"The goal is to improve the quality of life of people with a learning disability by reducing the potential harm of inappropriate psychotropic drugs that may be used wholly inappropriately, as a “chemical restraint” to control challenging behaviour, in place of other more appropriate treatment options. It is time for action, it is time for you to lead a medication review of all people with a learning disability, with a view to implementing a planned supervised dose reduction and stopping of inappropriate psychotropic drugs"

Stopping Over-Medication of People with Learning Disabilities (toolkit): Reducing inappropriate psychotropic drugs in people with a learning disability in general practice and hospitals in 2016
NHS England
June 2016

Access the toolkit here.

Commissioning for Value Focus Packs

"These focus packs provide more detailed information on those highest spending programmes previously covered by the earlier Commissioning for Value packs. The areas covered are: cancer; the CVD family of conditions including renal, stroke and diabetes; maternity and early years; mental health and dementia; musculoskeletal and trauma; neurology; and respiratory. The packs include a wider range of outcome measures and information on the most common procedures and diagnoses for the condition in question. They help CCGs begin work on phase two of the RightCare approach ‘What to Change’ by using indicative data to identify improvement opportunities."

There are two Commissioning for Value focus packs available for each CCG:

• Cancer, Mental health and dementia, MSK and trauma – May 2016
• CVD, Neurological, Respiratory, Maternity – April 2016

Find out more and access the packs here.

Dementia and housing: An assessment tool for local commissioning

"Commissioned by Public Health England ... this self-assessment tool focuses on local commissioning processes and decision-making. The main principle being applied in this tool is that all available assets and resources need to be combined, both to create the conditions that reduce the risk of developing dementia, and to develop a framework of support to help those with dementia, their families and carers, to have as good a quality of life as possible."

Dementia and housing: An assessment tool for local commissioning
Housing Learning & Improvement Network
May 2016

Read more here.

Sustaining Improvement. IHI White Paper

"This white paper presents a framework that health care organizations can use to sustain improvements in the safety, effectiveness, and efficiency of patient care. The key to sustaining improvement is to focus on the daily work of frontline managers, supported by a high-performance management system that prescribes standard tasks and responsibilities for managers at all levels of the organization."

Sustaining Improvement. IHI White Paper

R Scoville, K Little, J Rakover, K Luther, K Mate 

Cambridge, Massachusetts: Institute for Healthcare Improvement

2016

Read more here (requires registration).  

Methods for Reducing Sepsis Mortality in Emergency Departments and Inpatient Units

"In 2011, North Shore-LIJ Health System (now Northwell Health) launched a strategic partnership with the Institute for Healthcare Improvement to accelerate the pace of sepsis improvement, focusing initially on sepsis recognition and treatment in emergency departments (EDs). The health system reduced overall sepsis mortality by approximately 50 percent in a six-year period (2008-2013; sustained through 2014) "

Methods for Reducing Sepsis Mortality in Emergency Departments and Inpatient Units
ME Doerfler  et al.
Joint Commission Journal on Quality and Patient Safety. 2015 May;41(5):205-211.

Read more here (registration required).

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

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

Read more here.

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

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

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

Read more here.

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

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

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

Read more here.

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

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

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

Read more here.

Improving maternal confidence in neonatal care through a checklist intervention

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

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

Read more here.

Improving the management of iron deficiency in ambulatory heart failure patients

"In an attempt to improve patient and physician satisfaction we piloted an ambulatory outpatient service to deliver iv iron. We demonstrated that this service was feasible and more efficient as less time was required waiting for a bed or spent in hospital and was less costly."

Improving the management of iron deficiency in ambulatory heart failure patients
C Hayward, H Patel, C Allen, A Vazir
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u209822.w4076

Read more here.

Improving physical health for people taking antipsychotic medication

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

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

Read more here.

Reducing blood culture contamination rates in an Emergency Department

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

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

Read more here.

Improving the quality of handover in a liaison psychiatry team

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

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

Read more here.

Public health and prevention (Quality Watch)

"Against a backdrop of substantial changes to the way public health services in England are commissioned and increasing funding constraints on local government, this QualityWatch report provides an overview of public health outcomes in recent years."

Focus on: Public health and prevention (Quality Watch)
A Davies, E Keeble, T Bhatia, E Fisher
The Health Foundation, Nuffield Trust
April 2016

Read more here.

Building Q: Learning from designing a large scale improvement community

"The report identifies lessons for anyone seeking to support improvement work across organisations or through networks, as well as those engaged in designing initiatives with many diverse stakeholders. It draws on a variety of sources including the independent real-time evaluation of Q undertaken by RAND Europe."

Building Q: Learning from designing a large scale improvement community
P Pereira, H O'Malley
The Health Foundation
May 2016

Read more here.

Development of a Safe Staffing App

"An ‘App’ was developed which is a simple, easy to use tool which allows managers and staff to see an accurate, live staffing position from ward to board.  The app is pre-programmed with agreed planned staffing for each shift for every ward. At handover the nurse in charge inputs actual staffing numbers and relevant information into the ward mobile device."

Development of a Safe Staffing App
Nottingham University Hospitals NHS Trust
NICE Shared learning example
April 2016

Read more here.

Implementing MDI with carbohydrate counting for children at diagnosis of type 1 diabetes

"It was agreed within the team to improve glycaemic control in this first week of diagnosis we needed to start using carbohydrate counting and insulin correction doses at diagnosis. Therefore, in January 2015, in all newly-diagnosed children and teenagers, we started MDI with carbohydrate counting education, and insulin correction doses from the first time insulin is given."

Implementing multiple daily injection insulin regimens (MDI) with carbohydrate counting for children and young people at diagnosis of type 1 diabetes: education provided by the Children’s Diabetes Service for patients, families and staff
Oxford Health NHS Foundation Trust
NICE Shared learning example
April 2016

Read more here.

Abdominal drainage versus no drainage post-gastrectomy for gastric cancer

"This Cochrane review concludes that there is no convincing evidence to support the routine use of abdominal drains in patients under-going gastrectomy for gastric cancer"

Abdominal drainage versus no drainage post-gastrectomy for gastric cancer

The UK Cochrane Centre and NICE
Quality and Productivity case study

April 2016

Read more here. 

Secular trends and evaluation of complex interventions

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

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

Read more here.

User road testing of a draft version of SQUIRE 2.0

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

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

Read more here.

Sleep deprivation and starvation in hospitalised patients

"In our personal experience as surgeons at a busy tertiary hospital, the goal of avoiding unnecessary malnutrition and sleep deprivation in our patients has all too often been forgotten or prioritised far behind other more technical goals of surgical care. But keeping a patient strong and rested is a critical goal towards the same end."

Sleep deprivation and starvation in hospitalised patients: how medical care can harm patients
T Xu, C Wick, MA Makary
BMJ Qual Saf 2016;25:311-314 doi:10.1136/bmjqs-2015-004395

Read more here.

Half-life of a printed handoff document

"In this report, we identify a very high potential for inaccurate information in printed handoff documents. If a handoff document is printed at the start of a night shift, it is reasonable to assume that within 6 h the document will contain inaccuracies on half of the patients. The field most likely to contain inaccuracies is the medication lists, followed by code status."

Half-life of a printed handoff document

G Rosenbluth, R Jacolbia, D Milev, AD Auerbach

BMJ Quality and Safety, 2016;25:324-328 doi:10.1136/bmjqs-2015-004585

Read more here. 

Catalyst or distraction? The evolution of devolution in the English NHS

"Focusing primarily on devolution in the NHS, the report considers the potential implications for health and care outcomes in England and how policy could best evolve. It draws on analysis of the Devolution Deals agreed to date, relevant literature, and international experience with a focus on four European decentralised health systems."

Catalyst or distraction?: The evolution of devolution in the English NHS
F Dormon, H Butcher, R Taunt
The Health Foundation
April 2016

Read more here.

Developing a Complex Care Case Management Service within Primary Care

"Analysis of the Slough CCG patient population demonstrated that 5% (7,500) of people consume 43% of healthcare resources.  In an attempt to realise cost savings and improve quality of service, efforts were made to target those at higher risk of an emergency admission or A&E attendance."

Slough CCG: Developing a Complex Care Case Management Service within Primary Care
S Saran, A Thompson, R Chana
RightCare
February 2016

Read more here.

Management of urinary incontinence in women

"Regular teaching sessions in primary care using NICE guidance on the management of urinary incontinence in women and regular multidisciplinary team reviews improve clinical outcomes. Compliance with NICE guidance results in reduced referral to secondary care." 

Management of urinary incontinence in women (Quality and Productivity case study)
Royal Cornwall Hospitals NHS Trust
NICE
February 2016

Read more here.

Electronic blood transfusion: Improving safety and efficiency of transfusion systems

"Transfusion errors are an important, avoidable, serious hazard. Wrong transfusion is one of the two leading causes of death from transfusion reported to Serious Hazards of Transfusion (SHOT) in the United Kingdom (SHOT steering committee 2011). The initiative ‘re-engineers’ hospital transfusion services using new technology."

Electronic blood transfusion: Improving safety and efficiency of transfusion systems (Quality and Productivity case study)
Oxford University Hospitals
NICE
February 2016

Read more here.

Routine 72-96 hour replacement of peripheral venous catheters - Do not do

"This Cochrane systematic review concluded that there is insufficient evidence to support the routine replacement of patients’ peripheral intravenous catheters every 72 to 96 hours. Clinical teams should inspect catheter insertion sites for signs of infection at each shift change and adopt a policy of replacing catheters only when clinically indicated. Such a policy would lead to significant cost savings and prevent unnecessary discomfort for patients associated with routine catheter replacement."

Routine 72-96 hour replacement of peripheral venous catheters (Quality and Productivity case study)
The UK Cochrane Centre and NICE
March 2016

Read more here.

Fetal and umbilical doppler ultrasound in normal pregnancy - Do not do

"Existing data do not provide robust enough evidence that the use of routine umbilical artery Doppler ultrasound, or combination of umbilical and uterine artery Doppler ultrasound in low risk or unselected populations benefits either mother or baby. Until further research can support new practices, Doppler ultrasound examination should be reserved for use in high-risk pregnancies (Alfirevic et al, 2013)."

Fetal and umbilical doppler ultrasound in normal pregnancy (Quality and Productivity case study)
The UK Cochrane Centre and NICE
March 2016


Read more here.

Alcohol Care Teams: to reduce acute hospital admissions and improve quality of care

"The principal component of this initiative is for a multidisciplinary Alcohol care team in each district hospital, led by a consultant with designated sessions, who will collaborate across hospitals and primary care, to develop a coordinated alcohol treatment and prevention programme. This team would organise systematic interventions and alcohol specialist nurses."

Alcohol Care Teams: to reduce acute hospital admissions and improve quality of care (Quality and Productivity case study)
The British Society of Gastroenterology and the Royal Bolton Hospital NHS Foundation Trust
NICE
March 2016

Read more here.

Mechanical thrombectomy for large vessel occlusion stroke: improving clinical outcomes and reducing cost

"There have been significant cost-saving benefits to the NHS and social care providers from reduced hospital bed stay and reduced disability. There is no additional burden to the NHS because the majority of patients are admitted directly to the Stroke Unit after the procedure without the need for ITU support." 

Mechanical thrombectomy for large vessel occlusion stroke: improving clinical outcomes and reducing cost (Quality and Productivity case study)
Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust
NICE
March 2016

Read more here.

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

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

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

Read more here.

Behavioural factors in person and community-centred approaches for health and wellbeing

"This report provides health and care audiences with a framework for understanding the drivers of behaviour, plus five factors that show how different behavioural mechanisms interact and play out. These factors seek to provide approaches that can help those grappling with how to encourage behaviour change for health to happen. These approaches can be hard-wired into the design of services, programmes, community initiatives, and indeed to the very lives of the people who engage with them."

Making the change: Behavioural factors in person and community-centred approaches for health and wellbeing
H Burd, M Hallsworth, The Behavioural Insights Team
March 2016

Read more here.

Workforce policy in the English NHS

"This report gives an overview of the components of workforce policy in the English NHS and the bodies which shape it. The report proposes ways in which workforce policy could be strengthened to improve the quality and productivity of care."

Fit for purpose?: Workforce policy in the English NHS
The Health Foundation
March 2016

Read more here.

Developing and evaluating oncology trainee education around minimization of adverse events and improved patient quality and safety

"Our study demonstrates that an online game is well accepted by junior doctors as a method to increase their quality improvement awareness. Developing effective and sustainable training for doctors is important to ensure positive patient outcomes are maintained in the hospital setting."

A mixed methods approach to developing and evaluating oncology trainee education around minimization of adverse events and improved patient quality and safety
A Janssen et al.
BMC Medical Education, 2016 16:91, DOI: 10.1186/s12909-016-0609-1  J

Read more here.

The Participative Design of an Endoscopy Facility using Lean 3P

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

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

Read more here.

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

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

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

Read more here.

PrescQIPP

PrescQIPP (QIPP Prescribing) aims "to help NHS organisations to improve medicines-related care to patients, through the provision of robust, accessible and evidence-based resources. We also provide a platform to share innovation, learning and good practice."

The PrescQIPP website includes a range of resources to support commissioners, including:

• Bulletins and briefings
• Data for benchmarking
• Webkits
• Webinars

Personalised commissioning in adult social care

"The Department of Health now needs to gain a better understanding of the different ways to commission personalised services for users, and how these lead to improvements in user outcomes."

Personalised commissioning in adult social care
Comptroller and Auditor General
House of Commons
March 2016

Read more here.

Bringing together physical and mental health

"The report identifies 10 areas where there is particular scope for improvement. These span the full range of health system activities, illustrating that change is needed across the system. Commissioners and providers can use these 10 areas as a guide to identify where some of the most significant opportunities for quality improvement and cost control lie."

Bringing together physical and mental health: A new frontier for integrated care
C Naylor, P Das, S Ross, M Honeyman, J Thompson, H Gilburt
The King's Fund
March 2016

Read more here.

A perfect storm: an impossible climate for NHS providers’ finances?

" The failure to spread good practice is not a result of those in the NHS wilfully ignoring the opportunities to improve. Rather it reflects the inherent challenges of transforming a service as complex as health care."

A perfect storm: an impossible climate for NHS providers’ finances? 
S Lafond, A Charlesworth, A Roberts
The Health Foundation
March 2016

Read more here.

Eliminating guidewire retention during ultrasound guided central venous catheter insertion

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

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

Read more here.

Improving Pre-emptive Prescribing to Relieve Patient Discomfort Occurring Out of Hours

"Junior doctors are commonly asked to prescribe simple medications for symptom relief for patients out of hours. Unfortunately, time constraints and other pressures may lead to delays before the medications are prescribed. A quality improvement project was conducted at a large university teaching hospital to establish the extent of the problem, with the aim of finding measures to improve preemptive prescribing for patients."

Improving Pre-emptive Prescribing to Relieve Patient Discomfort Occurring Out of Hours
R Williams, F Herbert, A Orme, G Casswell

BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u206301.w3757

Read more here.

Health Foundation analysis of acute hospital productivity

"The analysis shows that the productivity of acute hospitals in England has continued to deteriorate. Overall, the productivity of acute hospitals increased by only 0.3% between 2009/10 and 2014/15 – an average rate of 0.1% per year."

Acute hospital productivity: Health Foundation analysis of acute hospital productivity from 2009/10 – 2014/15
The Health Foundation
February 2016

Read more here.

Winter pressures: what's going on behind the scenes?

"NHS staff are working in a heavily resource-constrained environment and facing increasing demand for care. In this report we examined 15 key indicators of performance of the NHS in England over the most pressured time of year – winter (November to March) – focusing on 2014-2015, as well as looking back over the last five years."

Winter pressures: what's going on behind the scenes? (Quality Watch)
E Fisher, H Dorning
The Health Foundation, Nuffield Trust
February 2016

Read more here.

Realising the value of people and communities

"We intend the report to be a practical resource to support the work of commissioners, providers, communities and others seeking to find ways to empower individuals and communities in their health and care. In addition, we hope that it will help commissioners, policymakers and practitioners to understand the range of approaches available, some of the key components and their potential to improve health and wellbeing outcomes, NHS sustainability and social value."

At the heart of health: Realising the value of people and communities
S Wood, A Finnis, H Khan, J Ejbye
Nesta, The Health Foundation
February 2016

Read more here.

What the Commonwealth Fund’s 2015 international survey of general practitioners means for the UK

"The survey findings show that there are certain aspects of care where the UK performs strongly. Indeed, in some cases (such as the use of electronic medical records) the UK is an international leader. However, the survey also highlights a number of areas of concern, in particular that UK GPs find their job more stressful than any of their international counterparts."

Under pressure: What the Commonwealth Fund’s 2015 international survey of general practitioners means for the UK
S Martin, E Davies, B Gershlick
The Health Foundation
February 2016

Read more here.

Higher Quality Dementia Care

"In a programme of 3 linked studies, we investigated the impact of the QOF [quality and outcomes] dementia review on the quality of care received by those with dementia, focusing particularly on the interface between primary and secondary care."

Higher Quality Dementia Care: Policy & Research Briefing
P Kasteridis, A Mason, M Goddard, R Jacobs, R Santos
Centre for Health Economics
February 2016

Read more here.

Demand management for planned care

"This report presents a substantial review of the effectiveness of main strategies designed to alleviate demand pressures in the area of planned care. The study commences with an overview of the key ideas about the genesis of demand and capacity problems for health services."

Demand management for planned care: a realist synthesis
R Pawson, J Greenhalgh, C Brennan
Health Services and Delivery Research 2016;4(2)
DOI: http://dx.doi.org/10.3310/hsdr04020

Read more here.

What the planning guidance means for the NHS 2016/17 and beyond

"Leaders will need to work collaboratively in place-based systems of care, recognising that success in the current context depends on collective action that makes best use of a common pool of limited resources. It will be critical that organisations engage staff at all levels in achieving sustainability and delivering transformation, and focus on improving value for patients rather than crude cost-cutting."

What the planning guidance means for the NHS 2016/17 and beyond
H McKenna, P Dunn
February 2016
The King's Fund

Read more here.

Managing the supply of NHS clinical staff in England

"Ensuring there are enough clinical staff with the right skills to meet the demand for high-quality, safe healthcare is essential to the operation of the NHS. There are risks to both the quality and cost of services if the supply of clinical staff is poorly managed." 

Managing the supply of NHS clinical staff in England
Department of Health, National Audit Office
February 2016

Read more here.

The future of child health services: new models of care

"Different services and models of care for children and young people have been emerging around the UK, both within the Vanguard scheme and inspired by it. These models are emerging in response to a series of problems in current services for children and young people. This briefing describes the current state of child health and quality of care in the UK and how the emerging models are responding to these issues."

The future of child health services: new models of care
L Kossarova, D Devakumar, N Edwards
Nuffield Trust
February 2016

Read more here.

Standardizing Patient Outcomes Measurement

"If we’re to unlock the potential of value-based health care for driving improvement, outcomes measurement must accelerate. That means committing to measuring a minimum sufficient set of outcomes for every major medical condition — with well-defined methods for their collection and risk adjustment — and then standardizing those sets nationally and globally."

Standardizing Patient Outcomes Measurement
ME Porter, S Larsson, TH Lee
New England Journal of Medicine 2016; 374:504-506 DOI: 10.1056/NEJMp1511701

Read more here.

Improving acute psychiatric care for adults in England

"The Commission’s starting point is that patients with mental health problems should have the same rapid access to high quality care as patients with physical health problems. It proposes the introduction of firm targets for improvement combined with new approaches to quality, data management, innovation and investment."

Old problems, New solutions: Improving acute psychiatric care for adults in England
The Independent Commission on Acute Adult Psychiatric Care
February 2016

Read more here.

Delays and interruptions in the acute medical unit clerking process

"Interruptions and delays regularly occurred during the admission process in the study hospital which impacts adversely on patient experience and compliance with the recommended 4-h timeframe, further work is required to assess the impact on patient safety. Data obtained from this observational study were used to guide operational changes to improve the process."


Delays and interruptions in the acute medical unit clerking process: an observational study
AJ Basey, TD Kennedy, AJ Mackridge, J Krska
JRSM Open February 2016 vol. 7 no. 2 2054270415619323

Read more here.

Characteristics of morbidity and mortality conferences associated with the implementation of patient safety improvement initiatives

"This study suggests that the implementation of improvement initiatives relates to MCC [Morbidity and mortality conferences] characteristics. Recommendations for developing more effective patient safety-oriented MMCs can be proposed."

Characteristics of morbidity and mortality conferences associated with the implementation of patient safety improvement initiatives, an observational study
P François, F Prate, G Vidal-Trecan, JF Quaranta, J Labarere, E Sellier
BMC Health Services Research, 2016, 16:35 DOI: 10.1186/s12913-016-1279-8

Read more here.

Patient representatives’ views on patient information in clinical cancer trials

"The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language, structured text and illustrations to improve the informed consent process and thereby patient enrolment into clinical trials."

Patient representatives’ views on patient information in clinical cancer trials
P Dellson, M Nilbert, C Carlsson
BMC Health Services Research, 2016, 16:36 DOI: 10.1186/s12913-016-1272-2

Read more here. 

Improving the user experience of patient versions of clinical guidelines

"It is important for guideline producers to maximise the user experience of the public when they access patient versions of guidelines, particularly given the current low level of access and awareness. One size does not fit all and guideline producers need to strike a balance between keeping the patient version simple and providing sufficient information to facilitate shared decision making and empower the public. Guideline producers may find the results of this study useful in designing their own patient versions."


Improving the user experience of patient versions of clinical guidelines: user testing of a Scottish Intercollegiate Guideline Network (SIGN) patient version
N Fearns, K Graham, G Johnston, D Service
BMC Health Services Research, 2016, 16:37 DOI: 10.1186/s12913-016-1287-8


Read more here.

New Commissioning for Value packs

"The information in the packs will be of particular interest to CCG clinical and management leads with responsibility for finance, performance, improvement and health outcomes; to NHS England regional team leads; and to commissioning support teams who are helping CCGs with this work."

Commissioning for Value – comprehensive data packs to support CCGs and NHS England in the regions
NHS England
January 2016

Access the packs here.

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

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

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

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

Read more here.

Analgesia in hip fractures. Do fascia-iliac blocks make any difference?

"Our experience shows a great improvement in compliance with fascia-iliac blocks in the pre-operative period. This work has also underpinned the introduction of a new hip fracture care pathway ultimately to better patient care and outcomes."

Analgesia in hip fractures. Do fascia-iliac blocks make any difference?
J Callear, K Shah
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u210130.w4147

Read more here.

Improving antibiotic prescribing practice in a respiratory ward

"This project aims to improve compliance with documentation of indication and duration of antibiotic use in line with our local antibiotic prescribing guidelines. Post-intervention results were encouraging with compliance rates increasing from 24% to 94% for indication, and from 39% to 71% for duration."

Antimicrobial stewardship: Improving antibiotic prescribing practice in a respiratory ward
JM Yeo
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u206491.w3570

Read more here.

Improving information availability in vascular surgical clinics

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

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

Read more here.

A quality improvement project to tackle under-reporting of hazards by doctors by using an anonymous telephone hotline

"The trial of the reporting answerphone demonstrated that if reporting was made easier, quicker and anonymous then reporting rates increased exponentially."

A quality improvement project to tackle under-reporting of hazards by doctors by using an anonymous telephone hotline
S Johnson
BMJ Quality Improvement Reports 2016;5: doi:10.1136/bmjquality.u208718.w3660

Read more here.

Anticipatory management communication in end-of-shift medicine and nursing handoffs

"The different frequencies for types of AMC likely reflect differences in how residents and nurses work and disparate professional cultures. But, verbal communication in both groups included important information unlikely to be captured in written handoff tools or the electronic medical record, underscoring the importance of direct communication to ensure safe handoffs."

“Mr Smith's been our problem child today…”: anticipatory management communication (AMC) in VA end-of-shift medicine and nursing handoffs
AA Bergman, ME Flanagan, PR Ebright, CM O'Brien, RM Franke
BMJ Quality and Safety 2016;25:84-91 doi:10.1136/bmjqs-2014-003694

Read more here.

Implementing Evidence-based Suicide Prevention Training in Communities

"Suicide prevention trainings are implemented to equip the public’s ability to intervene with those who are at-risk, but their implementation is not often monitored for quality. In this study, we propose a quality improvement model to improve trainer skill, demonstrate evidence of knowledge uptake, and document the quality of training workshop implementation."

Implementing Evidence-based Suicide Prevention Training in Communities: Implications for Quality Improvement
KC Osilla, R Ramchand, R Seelam, D Barnes-Proby, ML Gilbert 
Journal of Community Medicine and Health Education, 2015;5:371. doi:10.4172/2161-0711.1000371

Read more here.

Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis

"Arthritis stakeholders have proposed 28 KPIs [Key Performance Indicators] that should be used in quality improvement efforts when evaluating centralized intake for OA [osteoarthritis] and RA [rheumatoid arthritis]. The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems."

Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis
CE Barber et al.
Arthritis Research & Therapy 2015, 17:322 doi:10.1186/s13075-015-0843-7

Read more here. 

Knowledge Translation and Barriers to Imaging Optimization in the Emergency Department

"This article outlines a research agenda to promote the dissemination and implementation (also known as knowledge translation) of evidence-based interventions for emergency department (ED) imaging, i.e., clinical pathways, clinical decision instruments, and clinical practice guidelines."

Knowledge Translation and Barriers to Imaging Optimization in the Emergency Department: A Research Agenda
MA Probst
Academic Emergency Medicine 2015;22:1455–1464

Read more here.

The digital revolution: eight technologies that will change health and care

"Some of the technologies we discuss are on the horizon – others are already in our pockets, our local surgeries and hospitals. But none are systematically deployed in our health and care system. Each could represent an opportunity to achieve better outcomes or more efficient care."

The digital revolution: eight technologies that will change health and care
C Gretton, M Honeyman
The King's Fund
January 2016

Read more here.

A zero cost way to reduce missed hospital appointments

"This randomised controlled trial tested the effectiveness of the reminder message sent to outpatients. Results showed if the message included the specific cost to the NHS of not attending then the patient was more likely to attend or rearrange their appointment – rather than miss it."

A zero cost way to reduce missed hospital appointments
Department of Health
January 2016

Read more here.

Middle managers’ experience implementing healthcare innovations in practice

"If engaging in hypothesized roles promotes implementation effectiveness, then the middle manager role theory should be leveraged to develop an intervention to enable middle managers to fulfill hypothesized roles with the support of top managers; doing so may promote the implementation of innovations intended to reduce the gap between evidence and practice."

Elaborating on theory with middle managers’ experience implementing healthcare innovations in practice
SA Birken, LD DiMartino, MA Kirk, SD Lee, M McClelland, NM Albert
Implementation Science 2016, 11:2  doi:10.1186/s13012-015-0362-6

Read more here.

BRAFV600E mutation testing for thyroid cancer

"The BRAF V600E mutation test is more than 99% specific for thyroid cancer, so a positive result means that it is more than 99% likely that the patient has a malignancy and the entire thyroid can be removed in 1 operation rather than 2. This reduces the risks of complications and shortens the total time spent in hospital and recovery."

BRAFV600E mutation testing for thyroid cancer: avoiding unnecessary surgery 
NICE Quality and productivity example
Portsmouth Acute Hospitals NHS Trust
December 2015

Read more here.