Exploring the perspectives of patients with dementia about the hospital environment

Hung, L. et al. International Journal of Older People Nursing. Published online: 18 April 2017

Background: Recognising demographic changes and importance of the environment in influencing the care experience of patients with dementia, there is a need for developing the knowledge base to improve hospital environments. Involving patients in the development of the hospital environment can be a way to create more responsive services. To date, few studies have involved the direct voice of patients with dementia about their experiences of the hospital environment.

Conclusions: Patient participants persuasively articulated the supportive and unsupportive elements in the environment that affected their well-being and care experiences. They provided useful insights and pointed out practical solutions for improvement. Action research offers patients not only opportunities to voice their opinion, but also possibilities to contribute to hospital service development.

Read the full article here

Towards evidence-based emergency medicine

Horner, D. (2017) Emergency Medicine Journal. 34(5) pp. 331-334.

Image source: BEstBETS

Best Evidence Topic reports (BETs) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews, but rather contain the best (highest level) evidence that can be practically obtained by busy practicing clinicians. The search strategies used to find the best evidence are reported in detail to allow clinicians to update searches whenever necessary. Each BET is based on a clinical scenario and ends with a clinical bottom line which indicates, in the light of the evidence found, what the reporting clinician would do if faced with the same scenario again.

The BETs published below were first reported at the Critical Appraisal Journal Club at the Manchester Royal Infirmary or placed on the BestBETs website. Each BET has been constructed in the four stages that have been described elsewhere. The BETs shown here together with those published previously and those currently under construction can be seen at http://www.bestbets.org. Two BETs are included in this issue of the journal.

Read the full abstract here

WHO surgical safety checklist cuts post-surgical deaths by 22%

McCarthy, M. (2017) BMJ. 357:j1935

Hospitals that completed a quality improvement programme designed to implement the World Health Organization’s surgical safety checklist saw a 22% lower 30 day post-surgery mortality than hospitals that did not complete the programme, a US study has found.

The WHO checklist requires surgical teams to take such steps as confirming the patient’s identity, scheduled procedure, and surgical site at the outset; reviewing the procedure’s risks before incision; and completing instrument and sponge counts and discussing postoperative care before the patient leaves the operating room

Read the full BMJ analysis here

The original research article is available to download here

Implementing shared decision making in the NHS

Shared decision making requires a shift in attitudes at all levels but can become part of routine practice with the right support, say Natalie Joseph-Williams and colleagues | BMJ

Adoption of shared decision making into routine practice has been remarkably slow, despite 40 years of research and considerable policy support. In 2010, the Health Foundation in the UK commissioned the MAGIC (Making Good Decisions in Collaboration) programme to design, test, and identify the best ways to embed shared decision making into routine primary and secondary care using quality improvement methods

The learning from MAGIC derives from a variety of sources, including facilitated shared learning events, clinic and consultation observations, interviews with clinicians and patients, patient and public involvement panels, focus groups, and questionnaires. We assessed progress using “plan do study act” data collection tools,monthly project team meetings (including researchers, clinical teams, healthcare organisations, and patient representatives), and an independent evaluation report of phase 1. Here, we draw on our learning from the three year programme and subsequent experience to summarise the key challenges of implementing shared decision making and to offer some practical solutions

Read the full article here

Quality Improvement Program Reduces Respiratory-Related Events

According to data presented at the 2017 annual meeting of the Society for Technology in Anesthesia, implementation of a hospital-based quality improvement program (QIP) was shown to reduce respiratory-related events after only one year | Clinical Anesthesiology

Although the program did not lead to changes in PSI-11 (Patient Safety Indicator 11), ICU transfers or mortality, continuous monitoring with capnography and pulse oximetry was associated with reductions in postoperative respiratory failure, cardiac arrest/resuscitation events and length of stay from a respiratory event.

“We implemented this program because it was the right thing to do for our patients,” said Christine O’Farrell, BSN, CPHQ, CPHRM, director of quality management for Barton Healthcare, in South Lake Tahoe, Calif., “but these data suggest that continuous monitoring with both capnography and pulse oximetry may improve quality by reducing severe respiratory adverse events and length of stay for high-risk patients.”

Read the full overview here

 

New innovation scorecard platform launched

The improved platform aims to make it easier to see uptake of pharmaceutical products and medical innovations within the NHS | NHS Efficiency 

Image source: Julie Rybarczyk – Flickr // CC BY 2.0

The scorecard reports on the use of medicines and medical technologies in the NHS in England, specifically those which have been positively appraised by the National Institute for Health and Care Excellence (NICE) since 2012.

The site now provides greater transparency and is easier to use.

Users can now:

• compare commissioning organisations’ uptake of medicines
• view information without having to download data
• share results more easily and securely
• look at overall levels of prescribing by medicine

The Innovation Scorecard is part of the government’s broader goal of supporting open data and transparency.

Read the full overview here

The Innovation Scoreboard is available through NHS Digital here

Mental health patients to benefit from new digital services

Seven areas across England are set to trail-blaze digital services for mental health patients, which will include innovative apps to improve care and online access to ‘real-time’ patient records. | NHS England

NHS England has announced funding for seven mental health trusts to enable them to pioneer digital services for mental health patients.  It is intended that all key professionals involved in a patient’s care have access to real-time records – from triage and initial assessment, through to admissions or referrals, as well as transfer between services and follow up care.

The trusts will also develop remote, mobile and assistive technologies to empower patients to manage their conditions and enable family and carers to provide the best possible support.

The trusts will have up to £70m to invest in digital services – consisting £35m with additional match funding from themselves of £35m – in order to become ‘Global Digital Exemplars for Mental Health’ helping the organisations become world-leading in the use of IT, providing knowledge and expertise to the wider NHS in order to reduce time and costs for others.

This is all part of the NHS’ plan to harness technology to improve services and become more efficient.

The hospital of tomorrow in 10 points

Abstract

Technology has advanced rapidly in recent years and is continuing to do so, with associated changes in multiple areas, including hospital structure and function. Here we describe in 10 points our vision of some of the ways in which we see our hospitals, particularly those in developed countries, evolving in the future, including increased specialization, greater use of telemedicine and robots, the changing place of the intensive care unit, improved pre-hospital and post-hospital management, and improved end-of-life care.

New technology is going to increasingly impact how we practice medicine. We must learn how best to adapt to and encompass these changes if we are to achieve maximum benefit from them for ourselves and our patients. Importantly, while the future hospital will be more advanced technologically, it will also be more advanced on a personal, humane patient care level.

Full paper: Vincent, J.L. and Creteur, J.  The hospital of tomorrow in 10 points. Critical Care (2017) 21:93

Workforce Planning and Development Tool

Look to the future to fix the workforce today: New resource launched to help you implement a new workforce development plan | Skills for Care

Developed in partnership with Oxfordshire County Council, Skills for Care is helping employers get to grips with the complexities of workforce planning with the launch of a new online tool.

This tool is designed to help your organisation plan for and implement a new workforce development plan. Complete any of the 9 sections of the tool, and you will receive a free and personalised report based on your answers, and sent direct to your inbox.

In addition to advice and guidance based on your responses, each report contains links to further resources and guidance on the skills for care website.

The tool is available online here

Funding available to scale up healthcare improvement

Scaling Up Improvement supports teams to take successful health care interventions or approaches and deliver them at scale, to improve health care in the UK | The Health Foundation

• Do you have a health care intervention or approach that has been proven to deliver better care?
• Are you ready to deliver your intervention or approach at scale?
• We’re looking for teams with approaches or interventions that have been successfully tested at a small scale, shown to improve care and are now ready to be implemented more widely.
• Apply now to receive up to £500,000 funding to support the implementation and evaluation of your project.

Guidance on making an application is available here