Nurse and doctor roles improve A&E patient flow

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Reviewers from Australia examined three strategies to enhance patient flow through A&E. They searched four bibliographic databases for studies published between 1980 and 2014. Twenty-one studies were included. Advanced practice nursing roles, doctor-assisted triage and medical assessment units were found to improve A&E throughput and decrease A&E length of stay and ‘did not wait’ rates.

Reference: Elder E, Johnston AN, Crilly J.  Systematic review of three key strategies designed to improve patient flow through the emergency department. Emergency Medicine Australasia. 2015. 27(5): 394 – 404

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Model for improvement reduced surgical site infections

An improvement collaborative implemented a care bundle to reduce surgical site infections amongst children. Over a two year period they used the Model for Improvement to develop and implement change. Organisations were encouraged to adopt all or part of the bundle. Support was provided through webinars, discussion boards, targeted messages to leaders and in-person training. Within six months, 97% of organisations were using the bundle reliably. There was a 21% reduction in surgical site infection rates, from an average of 2.5 per 100 procedures to 1.8 per 100 procedures. The reduction was sustained over the 15 month follow-up period.

Schaffzin JK, et al. Surgical site infection reduction by the Solutions for Patient Safety Hospital Engagement Network. Pediatrics. Nov;136(5)1353-60 2015.

Using smartphone app led to lower blood pressure

This study examined a mobile phone-based self-management app for people with high blood pressure. Fifty people from Sweden used the app daily for eight weeks. They inputted self-reported blood pressure, pulse, symptoms, lifestyle activities and well-being. The app provided reminders, encouragement messages and graphs of self-reported data. The app was associated with reduced blood pressure. There were daily improvements initially which levelled out over the two month period. The app was equally effective for subgroups, regardless of their initial blood pressure.

Bengtsson U, et al. Improved blood pressure control using an interactive mobile phone support system. Journal of Clinical Hypertension. 2015.

Hospital trusts productivity in the English NHS: uncovering possible drivers of productivity variations

Centre for Health Economics (CHE)

This study looks at how NHS trusts perform in terms of how much they produce given the resources (doctors, nurses, medicines and premises) they use. It finds that on these criteria – which economists call productivity measures – there is a lot of variation between trusts and that the best and worst performers stay the same over time. It is not possible to explain away the variation in terms of the kinds of patients that are treated. These results suggest that there may be scope for making substantial savings by ensuring that all trusts perform as well as the best ones.

Medicines wastage evaluation and prescription management in homecare medicines in Nottingham University Hospitals NHS Trust

European Journal of Hospital Pharmacy

Medication waste amounted to £9430 in renal transplant and HIV homecare (HC) over 1 year (0.2% of the annual HC drug expenditure). Cost avoidance of £155,809 was identified through updating the prescription management database based on stock levels reported by patients.

Examining variations in prescribing safety in UK general practice: cross sectional study using the Clinical Practice Research Datalink

British Medical Journal

Data from a sample of 526 UK general practices showed that about 5% of patients at risk (mainly older patients) were found to have received a potentially inappropriate prescription and about 12% had no record of appropriate monitoring.