Clinical audit in commissioning

The Health care Quality Improvement Partnership has published Using Clinical audit in commissioning healthcare services.

This guide outlines how clinical audits can be used by commissioners to assure both quality and drive continuous improvement in patient care. It examines the strengths and limitations of clinical audit outputs for monitoring and assurance as well as considering how clinical audit can drive quality improvement as demonstrated through case studies and practical guidance.

Mental health in primary care

This event hosted by The kings Fund in partnership with the Royal College of Psychiatrists and NHS Clinical Commissioners showcased some of the best practice taking place across England in integrating mental health and primary care, demonstrating the benefits for both the mental health and primary care workforce and providing more joined-up and holistic care for patients and service users.

The presentations are available to view here

New models of care in practice

The NHS Confederation has published briefings on new models of care and how they are working in practice:

Driving improvement: case studies from eight NHS trusts

Reviewing the culture of NHS trusts and addressing disconnects between clinicians and managers within the organisation is key to improving care, a new CQC report has revealed. | Care Quality Commission | via National Health Executive

street-1435744_1920

The CQC has published ‘Driving improvement: case studies from eight NHS trusts’.

The document examines how a number of different trusts improved care and subsequently their CQC rating by making simple changes to how services were run.

During its study, the inspectorate found that engaging with staff and allowing for open and honest conversations was vital to making improvements to care delivery.

The CQC also discovered that successful trusts tended to make their chief executives and senior staff more visible by having them spend more time on the ‘shop floor’ – meeting staff and setting up regular channels of communication. The report also highlights the increasing challenges faced by trusts.

Read more at National Health Executive

Full report: ‘Driving improvement: case studies from eight NHS trusts’.

Referring wisely

The Royal College of Physicians has published Referring wisely.

This document provides a framework for both generalist and specialist physicians to use in their day-to-day work, to guide and rationalise their approach and treatment.  The report aims to start a conversation between physicians about the referral processes they use each day and seeks to aid the streamlining of such processes in the long term.

 

Improving hospital-based end of life care processes and outcomes

A systematic review was undertaken to examine the quantity and quality of data-based research aimed at improving the (a) processes and (b) outcomes associated with delivering end-of-life care in hospital settings | BMC Palliative Care

arrows-1229845_960_720

A total of 416 papers met eligibility criteria. The number increased by 13% each year (p < 0.001). Most studies were descriptive (n = 351, 85%), with fewer measurement (n = 17) and intervention studies (n = 48; 10%). Only 18 intervention studies (4%) met EPOC design criteria. Most reported benefits for end-of-life processes including end-of-life discussions and documentation (9/11). Impact on end-of-life outcomes was mixed, with some benefit for psychosocial distress, satisfaction and concordance in care (3/7).

More methodologically robust studies are needed to evaluate the impact of interventions on end-of-life processes, including whether changes in processes translate to improved end-of-life outcomes. Interventions which target both the patient and substitute decision maker in an effort to achieve these changes would be beneficial.

Full reference: Waller, A. et al. (2017) Improving hospital-based end of life care processes and outcomes: a systematic review of research output, quality and effectiveness. BMC Palliative Care. Published: 19 May 2017