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Showing results for tags 'Quality improvement'.
Found 757 results
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Content ArticleThere is increasing interest and belief in applying quality improvement (QI) to help solve our most complex challenges in healthcare, yet little published literature to help leaders develop a business case and evaluate return on investment from QI. This is even more pronounced in fields such as mental health and community health services. This paper from Amar Shah and Steven Course presents a framework to help identify, understand and evaluate return on investment from large-scale application of QI in healthcare providers. The framework has been developed at East London NHS Foundation Trust (ELFT), a provider of predominantly mental health and community health services to a population of 1.5 million people, which has been undertaking QI at scale since 2014. This paper presents case studies and examples from ELFT to illustrate return on investment from QI at multiple levels: improving outcomes for patients and service users, improving the experience of staff, improving productivity and efficiency, avoiding costs, reducing costs and increasing revenue.
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Content ArticleThis article explores political barriers to integrated care, arguing that improving the US healthcare system requires the pursuit of three aims: improving the experience of care, improving the health of populations and reducing per capita costs of health care.
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Content ArticleThis study in the Journal of Health Organization and Management aimed to explore factors shaping the implementation of five new care model (NCM) initiatives in the North East of England. The study findings demonstrate that all five pilot sites experienced, and were subject to, unrealistic pressure placed upon them to deliver outcomes.
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Content ArticleNeonatal intensive care unit (NICU) admission among term neonates is associated with significant morbidity and mortality, as well as high healthcare costs. This study in the Journal of Clinical Medicine aimed to identify and quantify risk factors and causes of NICU admission of term neonates. The study looked at NICU admission for term babies at a maternity unit in Israel. The authors suggest that a comprehensive NICU admission risk assessment that uses an integrated statistical approach may be used to build a risk calculation algorithm for this group of neonates prior to delivery.
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Content ArticleThe Commission on Young Lives (COYL) was set up in September 2021, to propose a new settlement to prevent marginalised children and young people from falling into violence, exploitation and the criminal justice system, and to support them to thrive. Its national action plan will include ambitious practical, affordable proposals that government, councils, police, social services and communities can put into place. This detailed report by COYL examines the state of children and young people's mental health, describing the current situation as "a profound crisis." It examines the impact of the pandemic on young people's mental health, as well highlighting the lack of capacity and inequalities present in children and young people's mental health services. It then looks in detail at factors that contribute to mental health issues in children and young people and prevent marginalised groups from accessing mental health support.
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Content ArticleThe Care Quality Commission (CQC) has introduced a new assessment framework that it will use to set out its view of quality and make judgements about health services. The framework is being introduced in phases, and the CQC has published it before it comes into use so that providers and other stakeholders can start to become familiar with it.
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Content ArticleThe Peer Network for Advancing Equity through Quality and Safety is a year-long program offered by the Center for Health Equity at the American Medical Association (AMA) in collaboration with the Brigham & Women’s Hospital (BWH) and The Joint Commission (TJC). It is designed to help health systems apply an equity lens to all aspects of quality and safety practices and improve health outcomes for historically marginalised populations. This article covers the program's strategic plan, goals and activities and includes embedded videos containing an introduction to the program and a simulated case review.
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Content ArticleHow can NHS provider organisations and systems reliably and sustainably improve care? Historically, most improvement interventions have been discrete, small-scale efforts run by individual teams, often without reference to what else is taking place in their trust. However, it is now widely accepted that a patchwork of local interventions is unlikely to deliver sustained improvement or efficiencies on the scale that policymakers and local leaders want. This report by the Health Foundation outlines learning from the evaluation of the NHS partnership with Virginia Mason Institute, which examined how five NHS trusts in England attempted to build a culture of continuous improvement.
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Content ArticleThis study in BMJ Open Quality examines aspects of workplace culture, employee motivation and leadership behaviours that support continuous learning and improvement, in an effort to measure the transition to high reliability. It reports on the development of two scales (trust in team members and trust in leadership) in a US children’s hospital which was seeking to assess progressive movement towards a ‘culture of safety'. The scales were designed to measure two cultural conditions fostered by the five high reliability principles and a composite measure on local learning activities.
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Content ArticleThe Patient safety incident response framework (PSIRF) represents a new approach to responding to incidents. Under PSIRF, those leading the patient safety agenda within provider organisations, together with internal and external stakeholders (including patient safety partners, commissioners, NHS England, regulators, Local Healthwatch, coroners etc), decide how to respond to patient safety incidents based on the need to generate insight to inform safety improvement where it matters most. Key issues must first be identified and described as part of planning activities before an organisation agrees how it intends to respond to maximise learning and improvement. This guidance has been developed collaboratively between Stop the Pressure Programme, National Wound Care Strategy leads and members of the Patient Safety Team, with the support from the Patient Safety Incident Response Framework (PSIRF) Implementation and Working Groups.
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Content ArticleWest Suffolk is first of a small number of trusts in England that are part of a pilot programme recently launched by NHS Improvement and NHS England called the Patient Safety Incident Response Framework (PSIRF). A national initiative, it is designed to further improve the quality and safety of the care we provide through learning from patient safety incidents. PSIRF outlines how providers should respond to patient safety incidents, and how and when an investigation should be carried out. It includes the requirement for the publication of a local Patient Safety Incident Response Plan (PSIRP), which sets out how trusts will continually improve the quality and safety of the care they provide, as well as the experience which patients, families and carers have when using our services. Find out more about what West Suffolk NHS Foundation Trust are doing.
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Content ArticlePeripherally inserted central catheters (PICCs) are medical devices often used for medium-to-long-term intravenous therapy, but they are often associated with morbid and potentially lethal complications. This multi-centre study in the journal Plos One aimed to identify barriers and facilitators to implementing evidence-based appropriateness criteria to improve PICC safety and patient outcomes in a pay-for-performance model. The authors found that structured quality improvement (QI) efforts led to sustained PICC appropriateness and improved patient safety. These interventions included a multidisciplinary vascular access committee, clear targets, local champions and support from an online education toolkit.
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Content ArticleMost healthcare systems across the globe are dealing with the reality of limited resources and staffing shortages. Therefore, it is more important than ever to ensure that health care professionals spend time on doing what matters most and providing the most value for service users. Meaningful time spent face to face is a high priority for both service users and health care professionals. Paying more attention to computers than people because of the demands of burdensome documentation diverts our attention from direct care. It is a situation that is unsatisfactory for all parties. The Danish municipality of Sønderborg, a safety leader in nursing home and home-based care for more than a decade, decided to see what could be done. With improvement science already embedded in their organisation, they decided to take a deep dive into their processes as a first step. Mistakes in documentation, coordination, and communication have been identified as among the top 10 of root causes of patient safety incidents in Denmark, so it made sense to start there. Patient safety is often cited as the reason for documentation, but some research indicates that burdensome documentation is associated with increased medical errors, mistakes in documentation, and burnout among health care providers. Working from the theory that safely simplifying or streamlining documentation would free up time for direct care, Sønderborg and the Danish Society for Patient Safety embarked on an improvement journey that started with understanding the workflow of documentation that enabled staff to seek and share information from one another to plan and perform different tasks.
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Content ArticleThe National Vascular Registry, which measures the quality and outcomes of care for adult patients who undergo major vascular procedures in the NHS, has published its latest annual report. This report provides comparative information on five major emergency and elective vascular interventions between 2019 and 2021: Repair of aortic aneurysms, including elective infra-renal, ruptured infra-renal, and more complex aneurysms Lower limb bypass Lower limb angioplasty/stenting Major lower limb amputation Carotid endarterectomy The report also includes the results from an organisational audit of NHS vascular services in 2022.
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Content ArticleEstablished in 2006, the National Neonatal Audit Programme (NNAP) is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and delivered by the Royal College of Paediatrics and Child Health (RCPCH). It assesses whether babies admitted to neonatal units receive consistent high-quality care in relation to the NNAP audit measures that are aligned to a set of professionally agreed guidelines and standards. The NNAP also identifies variation in the provision of neonatal care at local unit, regional network and national levels and supports stakeholders to use audit data to stimulate improvement in care delivery and outcomes. This report summarises the key messages and national recommendations developed by the NNAP Project Board and Methodology and Dataset Group, based on NNAP data relating to babies discharged from neonatal care in England and Wales between January and December 2021.
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Content Article
NHSE - Always Events®
Patient-Safety-Learning posted an article in NHS England
Always Events are defined as “those aspects of the patient and family experience that should always occur when patients interact with healthcare professionals and the health care delivery system”. NHS England has been leading an initiative for developing, implementing, and spreading an approach to reliably integrate Always Events into routine frontline services. Always Events® is a co-production quality improvement methodology which seeks to understand what really matters to patients, people who use services, their families and carers and then co-design changes to improve experience of care. Genuine partnerships between patients, service users, care providers, and clinicians are the foundation for co-designing and implementing reliable solutions that transform care experiences with the goal being an “Always Experience.” This webpage contains: information on the Always Events national programme Always Events toolkit Evaluation of Always Events Always Events film -
Content ArticleThis guideline describes good patient experience for babies, children and young people, and makes recommendations on how it can be delivered. It aims to make sure that all babies, children and young people using NHS services have the best possible experience of care. It includes recommendations on: overarching principles of care communication and information planning healthcare consent, privacy and confidentiality advocacy and support improving healthcare experience, including healthcare environments accessibility, continuity and coordination
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Content ArticleThis National Institute for Health and Care Excellence (NICE) guideline covers the components of a good experience of service use. It aims to make sure that all adults using NHS mental health services have the best possible experience of care. It includes recommendations on: access to care assessment community care assessment and referral in crisis hospital care discharge and transfer of care assessment and treatment under the Mental Health Act
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Content ArticleCornerstone is a free publication for anyone passionate about evidence-based healthcare, including Quality Improvement (QI), audit and clinical effectiveness professionals, and those who plan, deliver and receive healthcare. It is produced by the Healthcare Quality Improvement Partnership (HQIP), which was established in 2008 to increase the impact of clinical audit on healthcare quality improvement and support improved outcomes for patients.
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Content ArticleThe REACH Toolkit provides information, resources and quality improvement (QI) tools for managers and clinicians to improve patient, carer and family recognition and escalation of clinical deterioration in NSW health services. The resources can be adapted to suit local needs including initial program implementation, to review and improve current practices or to support current practice.
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Content ArticleThis editorial in BMJ Quality & Safety examines literature that looks at the negative side effects of quality improvement (QI) approaches and initiatives, arguing that QI can contribute to staff burnout, stress and reduced engagement. The authors make a number of recommendations for avoiding the negative side effects of QI.
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Content ArticleCompassionate leaders place quality of care at the heart of what they do, and respect and empower people drawing on and delivering care to achieve this together. This article sets out NHS England's vision for developing compassionate, inclusive leadership, highlighting that it results in better outcomes for everyone. It sets out the following four priorities: The NHS Leadership Academy will soon be publishing new NHS Leadership Competency Frameworks for system leaders. We support these frameworks and ask each of our professional bodies, colleges and employers to review their own systems to ensure that our leaders have the skills to lead compassionately today, with curiosity to transform our services for tomorrow. We commit to supporting compassionate, inclusive leadership and doing what we can to create the conditions for it, including addressing issues that stand in the way such as bureaucracy and misaligned policy. This leadership is crucial to developing and maintaining an open and transparent culture committed to learning and continuous improvement, that is responsive and accountable to the public. We will go further to open up the recruitment pool for future leaders and will support the recruitment and development of a diverse talent pipeline with the right skills, behaviours and values to be our leaders of today and tomorrow. We will support those leading ICSs to develop a new kind of system leadership, which inspires collaboration, diversity of thought and experience, and always puts the well-being of people drawing on and delivering services first. ICS implementation guidance on effective clinical and care professional leadership can now be found here. We will lead by example and ensure that our people have the tools to support compassionate behaviours. This will require a continuous approach to lifetime learning and a growth mindset, based on an agile and evolving way of seeing the world.
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Content ArticleIn this position statement, the National Quality Board (NQB) outlines: Key requirements for quality oversight in Integrated Care Systems (ICSs) The role of System Quality Groups (formally Quality Surveillance Groups) NQB work to support quality oversight in ICSs
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Content ArticleRestrictive practices are things that limit the rights of a person, like being able to move around freely. Restrictive Practice is used to stop a person from doing behaviours of concern. These Specialised Services Quality Dashboards (SSQD) are designed to provide assurance on the quality of care by collecting information about outcomes from healthcare providers. SSQDs are a key tool in monitoring the quality of services, enabling comparison between service providers and supporting improvements over time in the outcomes of services commissioned by NHS England.
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Content ArticleThis guidance from NHS England aims to support Integrated Care System (ICS) leaders as they develop their approach to quality management, providing clarity on how quality concerns and risks should be managed through systems. It provides an overarching approach to quality risk response and escalation, including guidance on routine, enhanced and intensive quality assurance and improvement activity.
