Developing an organisation-wide approach to improvement

The Improvement Journey. Why organisation-wide improvement in health care matters, and how to get started | The Health Foundation

This new report from The Health Foundation is a practical guide to developing an organisation-wide approach to improvement. It shows why this approach is critical to becoming a high performing organisation and delivering the NHS Long Term Plan.

Drawing on learning and insights from the Health Foundation’s work in quality improvement and beyond, the report shows how a sustained approach requires corporate leadership and investment in infrastructure, staff capability and culture over the long-term.

Key points

  • Building an organisation-wide approach to improvement is a journey that can take several years.
  • An essential early step is securing the support and commitment of the board for a long-term programme, including their willingness to finance the skills and infrastructure development needed to implement it.
  • The report includes case studies of three English NHS trusts with an outstanding CQC rating that have implemented an organisational approach to improvement.

Full report available at The Health Foundation

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Image source: http://www.health.org.uk
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General practice ‘tech manifesto’

The Royal College of General Practitioners has published its new ‘tech manifesto’ calling for a robust and joined-up IT system across the NHS.

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The manifesto recognises the potential of genomics, AI, digital medicine and robotics to potentially revolutionise patient care and improve patient safety but that widespread improvement will only be possible once robust, secure IT systems are in place for all GP practices and all areas of the NHS have access to computer networks which seamlessly link up the patient journey.

Related to this, the Health Secretary has announced plans to upgrade every hospital, GP practice and community care service to full fibre optic connectivity.

Read the Tech manifesto

NHS staff and parents to gain access to crucial child health information

NHS Digital | April 2019 | NHS staff and parents to gain access to crucial child health information

A new live service which enable access to important child health information at the point of care for health professionals has been launched by the NHS.

The service, the National Events Management Service, securely publishes information on key health interventions for children. Parents and health professionals can securely receive information digitally and use it to inform decisions on care and treatment, the service is the result of collaboration between NHS Digital and NHS England with IT suppliers.

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The service shows which preventative interventions a child has received; improving the speed of diagnosis and treatment by giving health visitors and parents access to the same information sources at the same time.

The service has initially launched in North East London in partnership with North East London Foundation Trust (NELFT) and their health visiting and child health services. IT suppliers which already support the Trust have connected their products to the new service.

Full details from  NHS Digital

 

WHO Guideline: recommendations on digital interventions for health system strengthening

World Health Organization | April 2019 | WHO Guideline: recommendations on digital interventions for health system strengthening

WHO (World Health Organization) has recommended 10 ways in which countries can use digital health technology, accessible via mobile phones, tablets and computers, to improve people’s health and essential services. The document Recommendations on digital interventions for health system strengthening

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Image source: apps.who.int

The key aim of this guideline is to present recommendations based on a critical evaluation of the evidence on emerging digital health interventions that are contributing to health system improvements, based on an assessment of the benefits, harms, acceptability, feasibility, resource use and equity considerations. For the purposes of this version of the guideline, the recommendations examine the extent to which digital health interventions available via mobile devices are able to address health system challenges at different layers of coverage along the pathway to universal health coverage (UHC). By reviewing the evidence of different digital interventions, as well as assessing the risks against comparative options, this guideline aims to equip health policy-makers and other stakeholders with recommendations and implementation considerations for making informed investments into digital health interventions.

This guideline urges readers to recognize that digital health interventions are not a substitute for functioning health systems, and that there are significant limitations to what digital health is able to address.

  • birth notification via mobile devices
  • death notification via mobile devices
  • stock notification and commodity management via mobile devices
  • client -to-provider telemedicine
  • provider-to-provider telemedicine
  • targeted client communication via mobile devices
  • digital tracking of patients’/clients’ health status and services via mobile devices
  • health worker decision support via mobile devices
  • provision of training and educational content to health workers via mobile devices (mobile learning-mLearning)  (Source: WHO)

Full details from WHO

Using a therapeutic companion robot for dementia symptoms in long-term care

Moyle, W. et al. | Using a therapeutic companion robot for dementia symptoms in long-term care: reflections from a cluster-RCT | Aging & Mental Health | Vol. 23 issue 3 | p329-336

Objectives: We undertook a cluster-randomised controlled trial exploring the effect of a therapeutic companion robot (PARO) compared to a look-alike plush toy and usual care on dementia symptoms of long-term care residents. Complementing the reported quantitative outcomes , this paper provides critical reflection and commentary on individual participant responses to PARO, observed through video recordings , with a view to informing clinical practice and research.

Method: A descriptive, qualitative design with five participants selected from the PARO intervention arm of the trial. The trial is registered with the Australian New Zealand Clinical Trials Registry

Results: The five participants and their responses to PARO are presented in terms of three issues: i.) Different pre-intervention clinical presentations and different responses; ii.) Same individual, different response – the need for continual assessment and review; and iii.) The ethics of giving and retrieving PARO. Implications for clinical practice and future research are discussed in relation to each issue.

Conclusion: The findings suggest that one approach does not fit all, and that there is considerable variation in responses to PARO. A number of recommendations are discussed to aid the delivery of psychosocial interventions with PARO in practice, as well as to guide future research.

Full detail at Aging & Mental Health

Use of mobile applications in the management of overweight and obesity

Alnuaimi A, Rawaf S, Hassounah S et al. | Use of mobile applications in the management of overweight and obesity in primary and secondary care | Journal of the Royal Society of Medicine | 5 April 2019

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This systematic review involved searching electronic databases for studies on the use of mobile app-based interventions in the management of overweight and obesity among adults over 18 years of age in a primary and secondary care setting. The results of the review revealed that mobile apps are effective tools for weight loss management and sustaining such loss when compared to standard interventions.

However, further research is needed to consider the sustained benefits and the applicability of mobile app-based interventions for large-scale population coverage.

Full document at Sage Journals

NHS App pilot research findings

This report presents the findings of research carried out during the pilot phase of the NHS App roll out. The research was used to test and improve the user experience of the NHS App, and to plan effective support for GP practices as the app is rolled out across England | via NHS Digital

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In late 2017, it was decided that the NHS would develop an app that all patients in England could use to carry out a series of important tasks, such as booking GP appointments and ordering repeat prescriptions. Since then a team of staff from NHS Digital and NHS England has been working to develop, build and test the NHS App.

This report contains the findings from the pilot phase, drawn from analytics and what was found during research with users and GP practices.

Full report at NHS Digital