Information Governance in local quality improvement

This guide describes how Information Governance laws and principles apply to the use of personal data in local or regional multi-agency healthcare quality improvement studies such as clinical audit, productivity reviews, intervention testing, and service evaluation.

It is designed to assist clinicians, Quality Improvement specialists, support staff and service users who lead, take part in, or review, local and regional quality improvement studies such as clinical audits, with the application of IG law to their work.

Information governance in local quality improvement is available to download here

Promoting Evidence-Based Practice at a Primary Stroke Center

Promoting a culture of evidence-based practice within a health care facility is a priority for health care leaders and nursing professionals; however, tangible methods to promote translation of evidence to bedside practice are lacking | Dimensions of Critical Care Nursing

Objectives: The purpose of this quality improvement project was to design and implement a nursing education intervention demonstrating to the bedside nurse how current evidence-based guidelines are used when creating standardized stroke order sets at a primary stroke center, thereby increasing confidence in the use of standardized order sets at the point of care and supporting evidence-based culture within the health care facility.

Discussion: This nurse education strategy increased RNs’ confidence in ability to explain the path from evidence to bedside nursing care by demonstrating how evidence-based clinical practice guidelines provide current evidence used to create standardized order sets. Although further evaluation of the intervention’s effectiveness is needed, this educational intervention has the potential for generalization to different types of standardized order sets to increase nurse confidence in utilization of evidence-based practice.

Full reference: Case, C.A. (2017) Promoting Evidence-Based Practice at a Primary Stroke Center: A Nurse Education Strategy. Dimensions of Critical Care Nursing. 36(4) pp. 244–252

Effective events for local quality improvement following national clinical audit

This guide aims to contain everything needed to plan, organise and deliver effective quality improvement workshops – and how to follow up and maintain momentum | HQIP

Image source: HQIP

Event planning should be straight forward and rewarding, but at times can also be time consuming and complex. You’ll find helpful ideas, checklists, useful website links, templates and case studies.

This guide is produced by the Inflammatory Bowel Disease (IBD) National Clinical Audit (NCA) team and HQIP and based around learnings from a series of local events held by the IBD team to drive quality improvement following national audit.

Download the full guide 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

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

 

Collaboration with an infection control team for patients with infection after spine surgery

Kobayashi, K. et al. American Journal of Infection Control. Published online: 22 February 2017

Highlights: 

• The risk of infection after spine surgery has increased due to aging of society.
• An infection control team (ICT) manages infected cases at our hospital.
• The ICT guided use of antibiotics in 30 cases and investigated infection in 10.
• The bacteria detection rate was 88% (35/40 patients) in cases treated by the ICT.
• Early assistance from the ICT is a key to preventing onset of MRSA infection.

Read the full abstract here

Productivity, Technology and the NHS

Productivity, Technology and the NHS, looks at the NHS in England approach to productivity improvement half-way through the implementation of NHS Engand’s ‘Five Year Forward View | Newchurch

Image source: Newchurch

A core component of NHS England’s Five Year Forward View (5YFV), which underpinned the subsequent financial settlement agreed with the Government, was that NHS  productivity would improve by 2.4% a year for each of the five years up to 2020/21. The 5YFV went further suggesting that its implementation could even result in sustained improvements of 3% a year in the longer term, a proposition which must have assumed sustained improvement in workforce productivity, given that staff costs make up some 70% of NHS expenditure. This proposition always looked ambitious and subsequent analyses of the NHS’s long-term productivity performance have served to underline the size of the challenge. However the Carter Review, published 12 months ago, underlined the scale of the potential improvements that could be made in the NHS’s dominant acute sector.

A key contributor to achieving the rate of productivity improvement underpinning the 5FYV, reinforced by Carter’s conclusions, was the adoption of new digital technologies. This faith in the impact of digital technology is despite the evidence of the last 20 years that would cast considerable doubt as to the productivity impact of the digital technologies programmes that the NHS in England and its predecessors have implemented.

An analysis of current performance and future plans at the national, Sustainability and Transformation Plan and trust level suggests that the NHS as a system gives little priority to productivity improvement. Furthermore current plans for the development and implementation of digital technologies are unlikely to have any significant impact on productivity, certainly within the lifetime of the 5YFV.

Read the full overview here

Read the full report here