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Showing results for tags 'Care coordination'.
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News Article
111 First to go live imminently amid ‘vehement’ opposition in some EDs
Patient Safety Learning posted a news article in News
Emergency care leaders are warning it will take up to six more months to determine whether pilots of a radical change to accident and emergency are working, even though it is due to go live nationally next week, HSJ has learned. HSJ understands the new “111 First” system — where walk-in patients not in medical emergencies call 111 to “book” urgent care — is set to “go live” across England from next week following pilots in acute trusts which have been run since the summer. From 1 December, people will be able to call NHS 111 from anywhere in the country and have urgent care “booked” for them if needed, it is understood. NHS England has been pursuing the 111 First model to help reduce overcrowding and the risk of nosocomial infections in A&Es. The service is also intended to be able to book them into GP practice appointments. Well-placed sources confirmed most acute trusts have now implemented some form of 111 First and the model is set to be part of their standard operations when the national system “goes live” next week. A national advertising campaign is expected to promote the approach. But the Royal College of Emergency Care Medicine said there was a “vocal minority” of clinicians who are “vehemently against” 111 First as they believe it will increase demand in emergency departments. Read full story (paywalled) Source: HSJ, 25 November 2020 -
Content ArticleKey findings: Wide variability in the fidelity of the RED intervention. Engaged leadership and multidisciplinary implementation teams were keys to success. Common challenges included obtaining timely follow-up appointments, transmitting discharge summaries to outpatient clinicians, and leveraging information technology. Eight out of 10 hospitals reported improvement in 30-day readmission rates after RED implementation. The authors concluded that a supportive hospital culture is essential for successful RED implementation. A flexible implementation strategy can be used to implement RED and reduce readmissions.
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Centre for Perioperative Care: What is perioperative care?
Patient Safety Learning posted an article in Surgery
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News ArticleSerious patient safety and wellbeing concerns about the latest hospital discharge guidance have been raised to HSJ by senior clinicians and charities. Senior geriatricians warned that the guidance could prompt an increase in “urgent readmissions”, “permanent disability” and “excess mortality”, while charities said families could be left with “unsustainable caring responsibilities” because of the new rules. The government guidance, Hospital Discharge Service: policy and operating model, published in August, said clinicians should consider discharging patients when they were “medically optimised” rather than “medically fit”. It said 95% of these patients would return straight home with additional social care and rehabilitation support if needed. Many of the concerns raised surround the retention of the “criteria to reside”. This was originally agreed in March when there was a push from NHS England to free up acute beds over fears hospitals would become overwhelmed with covid admissions as the pandemic hit the UK. The criteria has, however, been maintained in the new guidance, despite a significant fall in infections and deaths from the virus. Rachel Power, chief executive of The Patients Association charity, warned: “This guidance makes it clear that the NHS is still having to take drastic emergency action in the face of covid-19, that will continue to take a heavy toll on patients. It is clear that many patients will be rushed home who would normally have had a longer period of hospital care.” Read full story (paywalled) Source: HSJ, 8 September 2020
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Hancock extends emergency patient data sharing rules
Patient Safety Learning posted a news article in News
Matt Hancock has extended four national data sharing orders which allow GPs and NHS organisations to share confidential patient information, as part of the ongoing response to the COVID-19 pandemic. The data sharing instructions were initially put in place in March when the pandemic broke out in earnest, and they were due to expire at the end of September. Under the arrangement GPs, NHS providers, NHS Digital, NHS England/Improvement, local authorities and the UK Biobank can share information about patients’ treatment and medical history - if doing so would help their response to COVID-19. The data sharing instructions have now been extended until 31 March next year. According to the Department of Health and Social Care’s update which notified organisations of the extension, NHS entities can share information for reasons such as helping to support the NHS Test and Trace service, identifying further patients at risk of COVID-19, and understanding information about patient access to health and adult social care services. Read full story (paywalled) Source: HSJ, 20 August 2020 -
News Article
Social care at breaking point in England after 'lost decade'
Patient Safety Learning posted a news article in News
Policymakers’ failure to tackle chronically underfunded social care has resulted in a “lost decade” and a system now at breaking point, according to a new report. A team led by Jon Glasby, a professor of health and social care at the University of Birmingham, says that without swift government intervention including urgent funding changes England’s adult social care system could quickly become unsustainable. Adult social care includes residential care homes and help with eating, washing, dressing and shopping. The paper says the impact has been particularly felt in services for older people. Those for working-age people have been less affected. It suggests that despite the legitimate needs of other groups “it is hard to interpret this other than as the product of ageist attitudes and assumptions about the role and needs of older people”. Read full story Source: The Guardian, 9 August 2020 -
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Covid aftercare piles pressure on ‘understaffed’ community services
Patient Safety Learning posted a news article in News
The aftercare of COVID-19 patients will have significant financial implications for ‘understaffed’ community services, NHS England has been warned. This month the national commissioner released guidance for the care of patients once they have recovered from an immediate covid infection and been discharged from hospital. It said community health services will need to provide “ongoing health support that rehabilitates [covid patients] both physically and mentally”. The document said this would result in increased demand for home oxygen services, pulmonary rehabilitation, diagnostics and for many therapies such as speech and language, occupational, physio, dieticians and mental health support. One GP heavily involved in community rehab told HSJ: “There is a lot detailed information about what people might experience in recovery, but it doesn’t say what should actually happen. “We have seen people discharged from hospital that don’t know anything about their follow-up and the community [health sector] hasn’t got any instructions of what they should be doing or what services have even reopened. This guidance needs to go a step further and rapidly say what is expected so local commissioners can put that in place.” Read full story Source: HSJ, 10 June 2020 -
News Article
Ministers to set up ‘dedicated team’ to aid NHS recovery
Patient Safety Learning posted a news article in News
The government said it will set up ‘dedicated team’ to look for innovative ways for the NHS to continue treating people for coronavirus, while also providing care for non-covid health issues. In its pandemic recovery strategy published today, the government also said step-down and community care will be “bolstered” to support earlier discharge from acute hospitals. The 60-page document contained little new information about plans for NHS services, but said: “The government will seek innovative operating models for the UK’s health and care settings, to strengthen them for the long term and make them safer for patients and staff in a world where COVID-19 continues to be a risk. “For example, this might include using more telemedicine and remote monitoring to give patients hospital-level care from the comfort and safety of their own homes. Capacity in community care and step-down services will also be bolstered, to help ensure patients can be discharged from acute hospitals at the right time for them". To this end, the government will establish a dedicated team to see how the NHS and health infrastructure can be supported for the COVID-19 recovery process and thereafter. Read full story Source: 12 May 2020 -
News Article
NHS data sharing failure ‘exasperating and could cause error’
Patient Safety Learning posted a news article in News
Significant concerns about the NHS’ refusal to share data with councils have emerged in a letter from a leading council chief executive and clinical commissioning group accountable officer. Steven Pleasant, chief executive of Tameside Metropolitan Borough Council and accountable officer of Tameside and Glossop CCG, said the failures are “becoming increasingly exasperating”, in a letter intended for the Ministry of Housing, Communities and Local Government’s shielding sounding board. Steven said he understands NHS Digital has decided the most recent version of the list cannot be shared with councils even though it is being shared with police, fire, voluntary organisations and companies offering logistical support. “I am sure that you will appreciate that this is counterproductive and frustrating given that local authorities are leading and coordinating the response to the most vulnerable in communities,” he wrote. He also raised concerns about how the NHS’ shielded patients team is passing on to councils information about people needing additional support — for instance, if the recipient’s food parcel stock is running low, requiring the council to step in. Welfare concerns and medication information could also need to be passed on. Mr Pleasant said although his council had asked for this information to be provided via email, staff “have been told by the NHS shielding team that they do not have permission to do this and that details can only be provided verbally over the phone”. “We believe this significantly increases the chances of error and presents significant risk… around incorrect information being captured,” he wrote. Read full story Source: HSJ, 21 April 2020 -
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News Article
Coronavirus pressures 'put organ transplants at risk'
Patient Safety Learning posted a news article in News
The UK's organ transplant network could be forced to shut down as a result of the coronavirus outbreak, the body that runs the scheme is warning. One factor is the pressure on intensive care beds, according to NHS Blood and Transplant (NHSBT). But there is also the risk to transplant patients, who have their immune systems suppressed so their bodies don't reject new organs. This is a dilemma for those like Ana-Rose Thorpe, from Manchester, who is waiting for a liver transplant. Now aged 29, Ana-Rose has lived with hepatitis almost her entire life after contracting it as a baby. The disease has taken its toll and now her liver is failing and she is in desperate need of a transplant. "Having to go into hospital while there are coronavirus patients there is very worrying," she says. "Whilst my body could withstand the transplant, the longer I'm not being monitored, not being seen as often as I was, the longer I leave it, I could just get sicker and sicker. "I feel like it's patients that are already on the transplant list, patients waiting for other operations, we have just been swept aside." "It's my life - it is a matter of life and death," Ana-Rose says. Read full story Source: BBC News, 9 April 2020 -
Content ArticleFollowing a review of the events that led up to Amy’s death Great Ormond Street Hospital have already made changes to practice: They have improved the way clinical information is shared between different specialist teams, to make sure staff have as comprehensive a picture as possible when making complex decisions about a patient’s treatment. They now use a single log-in electronic patient record system which means staff can quickly access clinical information about a patient and have the right information at the right time, rather than routinely having to use multiple systems. They have improved consultant availability. This means there is more consultant time for each patient being looked after in our paediatric intensive care unit. They have introduced a new process to make sure the care of patients, like Amy, who have both complex spinal and heart conditions is routinely considered by the hospital’s specialist joint cardiology committee.
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My role as a lead therapist for eating disorders
Dr Joanna Silver posted an article in Stories from the front line
In my current role I oversee the therapy programme for the Eating Disorders Unit (EDU) and see in-patients, day-patients and out-patients for individual and group therapy. I work with both adults and children with eating disorders, depression and anxiety, and use evidence-based therapies including cognitive behavioural therapy (CBT). A case study Lucy* is a 25-year-old interior designer who is seeking treatment for anorexia. She was an inpatient on our EDU. Throughout the whole admission there is a strong focus on patient safety. One of Lucy’s goals was to gain weight to a safer weight, but the increases were very gradual to avoid refeeding syndrome. At the beginning of her stay and all throughout we carried out regular risk assessments to check her risk to herself and also to others. Lucy had her bloods monitored throughout and was regularly observed for physical symptoms. In terms of the therapy, our focus was looking at the role that anorexia played in Lucy’s life. To do this we did a collaborative formulation which was continually evolving. This helped Lucy to make more sense of her illness and understand what it meant to her. Lucy was able to articulate that her anorexia made her feel ‘special’ and also was a way of managing difficult feelings such as feeling upset and angry by her parents’ divorce. Lucy was also able to identify that feelings were not spoken about in her family, so she did not have the ability to identify and name feelings. Lucy did very well in therapy managing both the physical and mental challenge of gaining weight. Over time, Lucy found different ways of managing her feelings such as talking to others, distracting herself and writing a journal. An essential part of our work is relapse management and ensuring that patients learn from their ‘blips’ instead of viewing them as failings. Key learning points I am flexible in tailoring treatment to patients’ needs and it is important to build a warm and trusting therapeutic relationship with patients. As part of my role I work closely with the multidisciplinary team and regularly present to other healthcare professionals about the complexities of treating people with eating disorders and related conditions and to ensure the patient's safety is always met. Here are some of my suggestions when treating children and adults with eating disorders: It is important to remember that whilst sometimes people with eating disorders can look very emaciated and frail, at other times they can be a normal weight and look well. It is therefore vital that health professionals do not solely use weight to diagnose an eating disorder. People with eating disorders often have a great deal of shame and so may not readily disclose their symptoms and instead may present with physical problems such as bowel problems. It is helpful if health professionals ask question such as "do you ever restrict your food" or "do you ever experience guilt after eating". Treatment for an eating disorder involves monitoring both the physical and psychological health of the patient. In order to ensure the physical safety of patients, tasks include monitoring electrolyte levels, assessing for risk and assessing patients nutritional and fluid levels. Eating disorders are complex mental illnesses in which patients use food in different ways to cope with difficult feelings. Health professionals should aim to build a positive therapeutic relationship with patients and should have a non-judgmental and accepting attitude towards them. *Name and details of patient have been changed to preserve confidentiality. -
Community Post"There is an aspect of information exchange that has attracted less attention and fewer resources: that patients are experts in their experience and know much more than clinicians about their own health and the needs and goals important to them." From: https://catalyst.nejm.org/information-asymmetry-untapped-patient/ Such an important point to see patients as knowledge hubs on their own care experiences.
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AHSN: Improving safety in care homes
Patient Safety Learning posted an article in AHSNs
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Content ArticleWhat will I learn? History of sepsis guidance Oxford AHSN approach to implementation of the guidance Care bundles (resource) Regional pathway for sepsis How to measure surveillance Limitations of coding sepsis Patient outcomes
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Social prescribing - What's in a name?
Claire Cox posted an article in Social prescribing
This video is 2 minutes long and gives a brief overview of what social prescribing is and its benefits. -
Content ArticleFind out in this short video how to use the Model Hospital tool, which was designed to support NHS trusts to identify productivity opportunities and provide the best patient care in the most efficient way. The Model Hospital is broken down into six sections offering different perspectives from which to review hospital activity: board-level oversight clinical service lines corporate services people care settings clinical support services.
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Content ArticleThis case study outlines: Aims, objectives and scope Method and approach Measurement plan Learning points Plans to spread the learning and adoption
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Content ArticleDeveloped by Agency for Healthcare Research and Quality (AHRQ) and the US Department of Defense, TeamSTEPPS® offers core strategies for use in a variety of healthcare environments coupled with approaches for distinct areas of care such as dental, long term care and office practice. The program collectively offers free training modules, webinars, train the trainer strategies and a bibliography of research describing how the tools have been used.
