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.
Horner, D. (2017) Emergency Medicine Journal. 34(5) pp. 331-334.
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.
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
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
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.”
The improved platform aims to make it easier to see uptake of pharmaceutical products and medical innovations within the NHS | NHS Efficiency
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.
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.
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.
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.