Revalidation and appraisal of General Practitioners

The General Medical Council has published Sir Keith Pearson’s review of revalidation Taking Revalidation Forward: improving the process of relicensing for doctors

 

The report highlights evidence that patients expect there to be systems in place for checking that doctors continue to be safe to practise, but they are not generally aware of the important role they can play in this process.  The report includes recommendations for easing the burden on doctors engaging in the revalidation and appraisal process.

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Artificial Intelligence & Digital Diagnosis

How artificial intelligence could provide some respite for the NHS | The Conversation

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Earlier this month, the  NHS announced plans to trial an artificially intelligent mobile health app to a million people in London. The aim is to help diagnose and treat patients by engaging them in a real time text message conversation which will complement the NHS 111 phone based service.

The NHS app is simple to use and has been likened to using the social messaging service WhatsApp – but with one crucial difference: the conversation takes place with a computer, not a person. Once the app is downloaded, users log their basic health information, and then start explaining their symptoms. The robotic “responder” will say things like: “I just need a few details from you before we get started,” and “nearly there” to keep the conversation going.

Read more via The Conversation

Effects of smartphone-based memory training

Seo Jin Oh et. al. Effects of smartphone-based memory training for older adults with subjective memory complaints: a randomized controlled trial. Aging & Mental Health.  Published online: 10 Jan 2017

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Objectives: We explored whether newly developed application (Smartphone-based brain Anti-aging and memory Reinforcement Training, SMART) improved memory performance in older adults with subjective memory complaints (SMC).

Method: A total of 53 adults (range: 50-68 years; 52.8% female) were randomized into either one of two intervention groups [SMART (n = 18) vs. Fit Brains® (n = 19)] or a wait-list group (n = 16). Participants in the intervention groups underwent 15-20 minutes of training per day, five days per week for 8 weeks. We used objective cognitive measures to evaluate changes with respect to four domains: attention, memory, working memory (WM), and response inhibition. In addition, we included self-report questionnaires to assess levels of SMC, depression, and anxiety.

Results: Total WM quotient [t(17) = 6.27, p < .001] as well as auditory-verbal WM score [t(17) = 4.45, p < .001] increased significantly in the SMART group but not in the control groups. Self-reports of memory contentment, however, increased in the Fit Brains® group only [t(18) = 2.12, p < .05).

Conclusion: Use of an 8-week smartphone-based memory training program may improve WM function in older adults. However, objective improvement in performance does not necessarily lead to decreased SMC.

Swimming together or sinking alone Health, care and the art of systems leadership

Swimming together or sinking alone Health, care and the art of systems leadership | Richard Vize | Institute of Healthcare Management

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The Institute of Healthcare Management have published this report based on revealing interviews with senior leaders in health and local government on what is really happening as managers grapple with the Sustainability and Transformation Plan (STP) process.

It aims to help leaders understand the values, culture and skills they need to survive and thrive as the NHS tries to change from organisations working in silos to local health and care networks focussed on the needs of patients.

Under the Sustainability and Transformation Plan process announced in December 2015, health and local government leaders are coming together locally to take on two big challenges – shaping services around local needs, and doing so in a way which is financially sustainable.

Barriers between primary, secondary and community care are becoming ever more permeable and, for the first time since the creation of the NHS in 1948, local government is a major partner in shaping and delivering care.

The report analyses the difficulties these new, highly pressured networks are experiencing, and identifies how healthcare managers need to think and act differently to make systems leadership a success.

Read the full report here

Diaries for critical care patients

Teece, A. BMJ Evidence-Based Nursing blog. Published online: 8 January 2017

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Critical care nurses have a duty to provide rehabilitative care (NICE, 2009). So how can nurses make a positive impact on their patients’ psychological recovery? Patient diaries are increasing in popularity in the UK after originating in Scandinavia. The subject of a recent Cochrane review (Ullman et al., 2015), the evidence base for diaries and guidance for those completing them remains scanty. However, the premise is simple and low cost. Nurses complete entries throughout the patient’s critical care admission, describing events and the environment in layman’s terms. The diary is given to the patient after discharge, often at a follow-up clinic where further support can be accessed. The aim is, simply, to fill in memory gaps and encourage discussion.

Read the full blog post here

Effectiveness of an improvement programme to prevent interruptions during medication administration

Dall’Oglio, I. et al. (2017) BMJ Open. 7:e013285

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Objective: To assess the effectiveness of an improvement programme to reduce the number of interruptions during the medication administration process in a paediatric hospital.

Intervention: The interventions included a yellow sash worn by nurses during medication cycles, a yellow-taped floor area indicating the ‘No interruption area’, visual notices in the medication areas, education sessions for healthcare providers and families, patient and parent information material.

Conclusions: This bundle of interventions proved to be an effective improvement programme to prevent interruptions during medication administration in a paediatric context.

Read the full abstract and article here 

Eight Years of Decreased MRSA Infections Associated With Veterans Affairs Prevention Initiative

Evans, M.E. et al. American Journal of Infection Control. 45(1) pp. 13-16

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Background: Declines in methicillin-resistant Staphylococcus aureus (MRSA) health care associated infections (HAIs) were previously reported in Veterans Affairs acute care (2012), spinal cord injury (SCIU) (2011), and long-term-care facilities (LTCFs) (2012). Here we report continuing declines in infection rates in these settings through September 2015.

Conclusions: MRSA HAI rates declined significantly in acute care, SCIUs, and LTCFs over 8 years of the Veterans Affairs MRSA Prevention Initiative.

Read the full article here