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Showing results for tags 'Organisational Performance'.
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Content ArticleLast week a think-tank report drew newspaper headlines with the claim that the NHS ranked second from bottom across "a series of major health outcomes" compared with other international systems. Does the NHS really perform so badly internationally, and is there a real problem with our health outcomes? Mark Dayan looks at the evidence.
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- Organisational Performance
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Content ArticleHealth policy-making and reform require, first and foremost, a sound understanding of how a health system is performing. To assist countries in this process, the Health Systems Performance Assessment Framework for Universal Health Coverage offers a comprehensive attempt at guiding the collection and analysis of health system data in relation to policy goals and 21st century challenges. This book is grounded in the premise that any whole-of-sector assessment exercise should collect information on and examine the performance of both the functions of the health system as well as its performance goals. Thus, it follows through each of the health system functions (i.e., health system governance, financing, resource generation and service delivery), outlining their purpose, the sub-functions needed to fulfil that purpose, and assessment areas to evaluate how well a function performs. This innovative framework conceptually links health system functions to intermediate and final health system goals. As a result, policy-makers will be better able to determine and analyse possible origins or impact of poor performance on a particular health system outcome.
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Content ArticleInfection prevention and control (IPC) programmes and practices play a vital role to ensure outbreak preparedness and control, including patient safety and quality of care, which remain essential components of universal health coverage across health systems worldwide. However, detailed IPC evaluations using standardised validated tools, such as the WHO IPC self-assessment framework (IPCAF), are limited. Tomczyk et al. have conducted the first WHO global survey to assess implementation of these programmes in healthcare facilities. IPC professionals were invited through global outreach and national coordinated efforts to complete the online WHO IPC assessment framework (IPCAF). The study found that despite an overall high IPCAF score globally, important gaps in IPC facility implementation and core components across income levels hinder IPC progress. Increased support for more effective and sustainable IPC programmes is crucial to reduce risks posed by outbreaks to global health security and to ensure patient and health worker safety.
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- Infection control
- Healthcare associated infection
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Content ArticleHertfordshire Partnership University NHS Foundation Trust's Quality Account has been designed to report on the quality of their services in line with regulations. The aim in this report is to describe in a balanced and accessible way of how the Trust provides high-quality clinical care to service users, the local population and commissioners.
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- Quality improvement
- Organisation / service factors
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Content ArticleThe Competition and Markets Authority (CMA) has published an open letter calling for all hospitals to comply with the Private Healthcare Market Investigation Order. The Order entered into force on 1 October 2014 and requires the performance measures of private healthcare facilities, and the performance measures and fees of consultants providing privately-funded healthcare services to be published by the Private Healthcare Information Network (PHIN).The CMA has asked PHIN and its members to provide a detailed roadmap outlining how the Order will be complete by June 2026. Over the next few months there will be opportunities for all interested parties to contribute to this roadmap, including consultant representative groups, insurers and other stakeholders.
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- Private sector
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Content Article
Ministry of Justice Annual Report and Accounts 2020‑21
Patient Safety Learning posted an article in Legal matters
The Ministry of Justice and its agencies deliver prison, probation and youth custody services; administer criminal, civil and family courts and tribunals; and support victims, children, families and vulnerable adults.- Posted
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News Article
‘Advice to GPs’ will count towards elective care target
Patient Safety Learning posted a news article in News
Avoiding GP referrals by providing ‘advice and guidance’ will contribute significantly towards NHS performance on the government’s elective care targets, according to draft NHS plans seen by HSJ. Under the elective recovery plan, hospital specialists are being asked to offer more advice when GPs are deciding whether to refer a patient for an outpatient appointment, which would avoid some patients being added to waiting lists. This is aimed at reducing instances where GPs may want to be risk averse and refer a patient when they might be unsure whether a secondary referral is needed. New documents seen by HSJ, shared in draft by NHSE last week, reveal this avoided activity will be counted in assessing if the service or individual trusts have hit key government targets to increase activity. NHS England has agreed with government to carry out 10% more ‘clock-stop’ activity in 2022-23 than was taking place pre-covid, but this is “after accounting for the impact of an improved care offer through system transformation, and advice and guidance”. Read full story (paywalled) Source: HSJ, 28 February 2022 -
Content Article
NHS England: Productive Ward (9 June 2020)
Patient Safety Learning posted an article in Other
The Productive Ward focuses on improving ward processes and environments to help nurses and therapists spend more time on patient care, thereby improving safety and efficiency. Productive Ward will allow healthcare teams to redesign the way they work, eliminating waste and releasing staff time to invest in patient care. Teams are enabled to maximise quality, reduce harm, develop more efficient processes, and ensure that patients feel safe and well cared for.- Posted
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- Hospital ward
- Staff factors
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Content ArticleThis report by the Health Foundation examines shifts in public attitudes towards health, the NHS and social care caused by the Covid-19 pandemic. It highlights key findings from the first wave of the Health Foundation's new programme of polling research, delivered in partnership with Ipsos, that will track public views on health and social care every six months.
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News Article
Little evidence that penalties are getting US hospitals to improve
Patient Safety Learning posted a news article in News
The US federal government has penalised 764 hospitals — including more than three dozen it simultaneously rates as among the best in the country — for having the highest numbers of patient infections and potentially avoidable complications. The penalties — a 1% reduction in Medicare payments over 12 months — are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. The punishments, which the Affordable Care Act requires be assessed on the worst-performing 25% of general hospitals each year, are intended to make hospitals focus on reducing bedsores, hip fractures, blood clots, and the cohort of infections that before Covid-19 were the biggest scourges in hospitals. Those include surgical infections, urinary tract infections from catheters, and antibiotic-resistant germs like MRSA. This year’s list of penalised hospitals includes Cedars-Sinai Medical Center in Los Angeles; Northwestern Memorial Hospital in Chicago; a Cleveland Clinic hospital in Avon, Ohio; a Mayo Clinic hospital in Red Wing, Minnesota; and a Mayo hospital in Phoenix. Paradoxically, all those hospitals have five stars, the best rating, on Medicare’s Care Compare website. Eight years into the Hospital-Acquired Condition Reduction Program, 2,046 hospitals have been penalised at least once, a KHN analysis shows. But researchers have found little evidence that the penalties are getting hospitals to improve their efforts to avert bedsores, falls, infections, and other accidents. “Unfortunately, pretty much in every regard, the program has been a failure,” said Andrew Ryan, a professor of health care management at the University of Michigan’s School of Public Health, who has published extensively on the programme. “It’s very hard to capture patient safety with the surveillance methods we currently have,” he said. One problem, he added, is “you’re kind of asking hospitals to call out events that are going to have them lose money, so the incentives are really messed up for hospitals to fully disclose” patient injuries. Academic medical centers say the reason nearly half of them are penalised each year is that they are more diligent in finding and reporting infections. Read full story Source: Kaiser Health News, 8 February 2022- Posted
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Content ArticleIn this opinion piece for The Hill, the authors argue that urgent action is needed to prevent huge amounts of avoidable harm in the American healthcare system. They point to successful strategies under the Obama administration to demonstrate that the right political will can both improve patient safety and save money. They highlight actions that policy makers, official bodies and patients should take to promote the patient safety agenda.
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- USA
- Patient safety strategy
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Content ArticleQuality is complex and difficult to define, and institutions and organisations often have their own definitions, measurements and assurance processes. The Care Excellence Framework (CEF), developed and used at University Hospitals of North Midlands NHS Trust, is a unique, integrated framework of measurement, clinical observation, patient and staff interviews and benchmarking. It also has an internal accreditation system that provides assurance from ward to board based on the five Care Quality Commission (CQC) domains and reflects CQC standards. The CEF has been established in its existing form since autumn 2016 and has been used in all areas of the organisation. This article provides an overview of the development and use of the CEF in an acute care setting, demonstrates how the framework acts as an internal accreditation system, and shows how it can encourage staff to undertake effective change and transform care from ordinary to excellent.
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- Competency framework
- Quality improvement
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Content ArticlePatient safety standards are critical for the establishment and assessment of patient safety programmes within hospitals. This third edition of the Patient safety assessment manual provides an updated set of standards and assessment criteria that reflect current best practice and WHO guidance. The manual will support the implementation of patient safety assessments and improvement programmes within hospitals as part of the Patient Safety Friendly Hospital Framework to ensure that patient safety is prioritised and facilities and staff implement best practices. The manual is a key tool for use by professional associations regulatory accrediting or oversight bodies and ministries of health to improve patient safety.
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Content ArticleWaiting is a feature of public healthcare systems but must be managed to avoid adverse impacts on patients. The NHS sets performance standards for waiting times for elective and cancer care. Its performance against these was deteriorating before the COVID-19 pandemic and has worsened since it began. Millions of patients’ care was disrupted, meaning backlogs increased. This report looks in detail at backlogs and waiting times for elective and cancer care in the NHS in England. It explains how the current increased backlogs and waiting times have arisen, including the impact of the COVID-19 pandemic. The report sets out: how waiting times performance for elective and cancer care are tracked in the NHS, and how long patients have been waiting relative to the performance standards; the causes of increasing longer waits before the pandemic and the disruption caused by the pandemic; and the steps the Department and NHSE&I have already taken to address the increasing backlogs and waiting times, and the constraints and challenges the NHS faces in making a full recovery.
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- Cancer
- Lack of resources
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Content ArticleAt the moment, we’ve got maternity scandals day in, day out, which are pure evidence of the fact that our maternity units are just not up to scratch. They’re unsafe for mothers, unsafe for babies, and that is not acceptable. Suzanne White, a former radiographer and a clinical negligence lawyer for the past 25 years, looks at the maternity safety scandals across the NHS and considers if any lessons have been learnt.
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- Maternity
- Investigation
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Content ArticleThis publication by National Voices, the leading coalition of health and social care charities in England, highlights the factors currently affecting timely access to care for people living with ill health, disability or impairment. It calls for system leaders to prioritise rebuilding timely access to health and care, and to take an approach that considers the whole system and its context and the whole person and their circumstances.
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- Secondary impact
- Pandemic
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Content ArticleState of Care is the Care Quality Commission's annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve. It highlights people's experiences of care, including the impact of the pandemic, health inequalities, the challenges for people with a learning disability, the rising demand for mental health care, workforce stress and burnout, access to services, and the challenges for systems.
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- Health inequalities
- Health Disparities
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News Article
Scotland records worst A&E waiting times performance yet
Patient Safety Learning posted a news article in News
The percentage of patients visiting A&E who are seen within four hours has hit a “terrifying” new low in Scotland, latest figures show, with ministers urged to “get a grip” on the growing crisis. The figure has been declining since the summer amid high demand, staffing shortages and a lack of patient flow through hospitals. In the week to 3 October, just 71.3% of patients were seen within four hours, a five percentage point drop on the previous week, according to a data published by Public Health Scotland. The figure is the lowest since records began in 2015, with the Scottish Government target set at 95%. With 25,000 visits to A&E in that week, it means more than 7,000 patients waited longer than four hours. Some 1,782 people waited more than eight hours, while a record 591 patients waited longer than 12 hours. Last week, Scotland’s Health Secretary, Humza Yousaf, warned that Scotland’s NHS faces an “incredibly difficult winter” despite announcing a £300 million funding boost. But opposition parties have now accused him of “overseeing a scandalous situation” and leaving A&E departments “beyond breaking point”. Read full story Source: The Scotsman, 12 October 2021- Posted
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- Accident and Emergency
- Long waiting list
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Content ArticleThis blog for the High Reliability Organizing website looks at the implications of 'preoccupation with failure' for individuals and organisations. The author highlights examples of how preoccupation with failure, as first described by Karl Weick and Kathleen Sutcliffe, can improve outcomes and reduce costs in healthcare organisations and in other sectors. She identifies barriers to organisations engaging with the process, including reluctance to look for 'hidden failures' and poor communication.
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- Communication
- Personal reflection
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Content ArticleThis cross-sectional study in BMJ Quality & Safety examines the association of hospital nursing skill mix with patient mortality and quality of care. The study analysed patient discharge data, hospital characteristics and nurse and patient survey data from adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. The authors found that a bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. They suggest that having a higher proportion of assistive nursing personnel without professional nurse qualifications reduces the skill mix and may: contribute to preventable deaths erode quality and safety of hospital care contribute to hospital nurse shortages.
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Content ArticleThis paper by Biophorum, a membership organisation for the biopharmaceutical industry, looks at how companies in the sector can adopt a human performance approach to operations. It highlights the need to move away from a focus on reducing human error and towards integrating fundamental systems changes that will enhance human performance.
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- Organisational Performance
- Risk management
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Content ArticleThe pandemic has severely disrupted cancer services in England with major consequences for survival rates for lung, breast and colorectal cancer. This paper from the Institute for Public Policy Research examines the impact of the pandemic on cancer pathways, highlighting widespread disruption across screening, referrals, diagnostic and treatment services. The authors also highlight that the 'missing patient' backlog is difficult to predict and that there is a lack of qualified staff to increase capacity and aid service recovery.
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- Cancer
- Secondary impact
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Content ArticleLong waiting times and growing waiting lists for hospital treatment have been a problem for some time, but the COVID-19 pandemic has exacerbated the issue and waiting lists have grown rapidly. This analysis of waiting list data by The King's Fund shows a clear relationship between longer waiting lists and deprivation, with those living in the most deprived areas nearly twice as likely to wait more than a year for treatment compared to those living in the least deprived areas.
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- Health inequalities
- Secondary impact
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Content ArticleWhile the NHS delivered a remarkable amount of elective treatment during the pandemic, the pressure of caring for large numbers of patients seriously unwell with COVID-19 has led to the waiting list for elective care reaching the highest level since current records began. This analysis from The Health Foundation looks in detail at the impact of the pandemic on the waiting list for elective care in England. It highlights that: 6 million fewer people completed elective care pathways between January 2020 and July 2021 than would have been expected based on pre-pandemic numbers the backlog of elective care is not evenly distributed across England patients living in socioeconomically deprived areas faced more disruption and delays than those in England’s least deprived areas. It also looks at the difficulty in predicting how long the backlog will take to clear and how much it will cost. One unknown factor that complicates this task is 'missing' patients - those who did not or could not seek care during the pandemic. These patients may present at a healthcare setting requiring more urgent, intensive treatment as a result of missing out on earlier intervention.
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- Secondary impact
- Organisational Performance
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Content ArticleThis article published in Patient Safety discusses the role of patients and families in supporting a culture of safety. It looks at the concept of 'preoccupation with failure', a feature of high reliability organisations (HROs) and examines how patients can contribute to safety by being engaged in this process. The authors discuss a case study in which a patient contributes to safety improvements by sharing specific concerns. They draw out the importance of encouraging and empowering patients and their families to raise issues.
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- Patient engagement
- Quality improvement
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