Search the hub
Showing results for tags 'Evaluation'.
Found 70 results
-
Content ArticleThe transition of older adults from the emergency department (ED) to home remains a potential area of preventable harm. Through a human-centred design process, the authors developed a patient-centred intervention aimed at improving communication and coordination between ED staff and patients. The intervention included a new electronic health record (EHR)-based template for physicians to enter discharge instructions, a redesigned after-visit-summary (AVS), enhanced nurse training for patient teach-back, and EHR-embedded tips for nurses at the time of follow-up call. The research objective was to evaluate this patient-centred ED discharge process redesign from multiple perspectives. The authors used A SEIPS 3.0 model to evaluate the intervention, in particular work system barriers and facilitators in the three subprocesses of the redesigned ED discharge process: physician writing discharge instructions, nurse/patient communication at discharge, and nurse/patient communication at follow-up call. The authors used multiple methods to collect quantitative and qualitative data from the perspectives of patients, and ED physicians and nurses. Overall, the redesigned patient-centred discharge process was perceived positively by ED physicians and advanced practice providers, ED nurses, and patients. All three groups identified work system facilitators regarding the intervention, in particular the usability of the AVS. Work system barriers pointed to areas for future improvement of the intervention, such as adding prepopulated information to the AVS. Using a human-centred design process, the authors improved ED discharge for older adults. The SEIPS-based research and evaluation fit with the learning health system concept as it provides input for future work system and patient safety improvement.
-
Content ArticleThe rapid evolution of digital health technologies offers new opportunities for healthcare systems while also increasing pressure on public budgets. Governments and insurers face growing challenges in determining what to fund and at what price. Health technology assessment (HTA) remains a critical tool for informing these decisions, and several OECD countries are exploring ways to adapt their approaches to the fast-changing and diverse landscape of digital medical devices. The absence of a common taxonomy, coupled with the rapid pace of technological advancement, further complicates evaluation, prompting interest in more harmonised HTA approaches. This paper explores how France, Germany, Israel, Korea, Spain, and the United Kingdom are adapting HTA to evaluate certain types of digital medical devices for coverage and pricing decisions. Through desk research and interviews, it describes HTA approaches, focusing on relevant pathways, technology remits, and evaluation methods. Drawing on practical experiences, it highlights key challenges and potential learning opportunities. The findings contribute to ongoing discussions on adapting HTA frameworks to improve the assessment and integration of digital medical devices into healthcare systems.
-
EventuntilThis webinar from GovConnect will look at: Developing a successful Virtual Ward CUH Virtual Ward @ home (Cambridge University Hospitals) Challenges CUH faced and why they implemented Virtual Wards The journey so far and working with stakeholders What equipment is needed? Platform/technology selection Daily management: referral, on-boarding, care plan Performance and pathways Patient experience Challenges and obstacles Next steps Agenda Welcome and introduction with moderator Dr Iain Goodhart Developing a Virtual Ward @ home with Gemma Czech, Clinical Nurse Lead for Virtual Wards at Cambridge University Hospitals NHS Foundation Trust Outcomes, performance and next steps for CUH Virtual Ward @ home with Andy Bailey, Operations Manager Virtual Wards, Cambridge University Hospitals NHS Foundation Trust will cover how Interactive panel discussion Register for the webinar
-
Content ArticleThe Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 aimed to: minimise burdens on public, independent and third sector employers and ensure businesses in UK are not placed at competitive disadvantage relative to EU counterparts offer good standards of protection to healthcare workers from risk of sharps injury at work see a fall in sharps injury numbers. This post implementation review (PIR) aimed to assess the success of these objectives. It found that: stakeholder consultation provided evidence of the increasing use of safer sharps across all healthcare sectors. evidence from RCN research and HSE inspections indicates that risks to healthcare workers from sharps injuries remains high. The policy conclusion from this evidence is that the Regulations are still required, and that the Regulations’ objectives cannot be met with a system that imposes less burden to business.
-
Content ArticleThe role of Patient Safety Specialist was introduced by the NHS in England in 2019, as part of wider plans designed to help improve patient safety. There are currently several hundred Specialists in place. All NHS organisations in England are required to identify at least one Patient Safety Specialist, and they will play a key role in delivering the NHS Patient Safety Strategy. The This Institute wants a detailed understanding of the background to the Patient Safety Specialist role and its implementation to date. This study aims to offer insights into the challenges and opportunities associated with delivering improvement though a designated role like the Patient Safety Specialist. The study aims to highlight ways to support Patient Safety Specialists and provide recommendations to NHS England about future policy and strategy around their role.
-
Content ArticleInconsistent and poorly coordinated systems of tracheostomy care commonly result in frustrations, delays, and harm. The Safer Tracheostomy Care in Adults bundle was a programme of 18 interventions implemented across 20 hospitals in England between August 2016 and January 2018. These interventions were designed to improve the quality and safety of care for patients who have had tracheostomies. This evaluation report outlines why the interventions were needed and assesses their impact, including an estimated reduction in total hospital length of stay per tracheostomy admission of 33.02 days, corresponding to a potential reduction of over £27,000 per admission. Hospitals that implemented the Safer Tracheostomy Care initiative interventions saw improvements across a number of quality, safety and efficiency for patients who had tracheostomies, these improvements included: reduced length of stay in hospital reduced incident severity reductions in anxiety and depression. The level of these improvements varied across hospitals, as did the type of interventions implemented. The hospitals also had different characteristics and populations which they served.
-
Content ArticleThe Covid-19 pandemic had an adverse impact on the detection and management of cardiovascular disease (CVD) risk factors including hypertension. In June 2022, nearly two million fewer people with hypertension were recorded as being treated to target, compared with the previous year. As a result, NHS England commissioned the AHSN Network to deliver a new national Blood Pressure Optimisation (BPO) programme building on its portfolio of work around cardiovascular disease. This report lays out: evidence about the impact of the BPO programme how it has been received by frontline staff how it has been implemented nationally.
-
News ArticleThe Health and Social Care Select Committee have commissioned an Expert Panel to consider the Government’s progress against accepted recommendations from public inquiries and reviews on patient safety. The Panel will consider a range of recommendations made by public inquiries and reviews on both patient safety and whistleblowing and subsequently select a number of these for evaluation. The Panel will in its final report provide a rating of the Government’s progress against each of these recommendations. Panel members are: Professor Dame Jane Dacre (Chair). Sir Robert Francis KC Anita Charlesworth Professor Stephen Peckham Sir David Pearson Professor Emma Cave Read full story Source: House of Commons Health and Social Care Select Committee, 24 October 2023
-
Content ArticleThe number of patients who die from post-surgical complications in low- and middle-income countries is shockingly high. In Africa alone, more than 600,000 people die each year after surgery, mostly from causes that are relatively easy to treat. This blog by Pierre Barker, Chief Scientific Officer at the Institute for Healthcare Improvement (IHI) looks at a method for reducing post-surgical death called the '5Rs for rescue': Risk stratification Recognise deterioration Respond Reassess Reflect/Redesign He describes how the IHI will test how to support the reliable implementation of the '5Rs for Rescue', which aims to reduce mortality by 25%.
-
Content ArticleThe Learning Together Evaluation framework for Patient and Public Engagement (PPE) in research is an adaptable tool which can be used to plan and to evaluate patient engagement before, during and at the end of a project. The Learning Together Framework can be used in multiple ways with the purpose of mutual learning and understanding by all partners. It is rooted in seven guiding principles of patient engagement defined by the patient-oriented research community: Relationship building Co-building Equity, diversity and inclusion Support and barrier removal Transparency Sustainability Transformation
-
Content ArticleThis long read by the Nuffield Trust looks at priority areas where further development and action could help improve the effectiveness of virtual wards. It outlines different models for virtual wards and looks at how to ensure effective system oversight. It also highlights the need to ensure the workforce is equipped to run virtual wards effectively and safely.
-
EventuntilHealth and care, and academic environments can have specific expectations that influence the evaluation of public involvement. These expectations may shape why the evaluation takes place and the approaches deemed ‘valid’. The hosts of this ‘Necessary Conversation’ argue that these environments and the approaches that they tend to favour, can lead to public contributors being absent from the conversation about what matters. Lynn Laidlaw leads this session with Niccola Hutchinson-Pascal and others to be confirmed. Lynn will be asking who is pushing the impact and evaluation agenda, where does the power lie, and what are the different forms of impact that exist? Sign up for this event
-
News ArticleThe US Food and Drug Administration (FDA) has approved convalescent plasma for emergency use in hospital patients with COVID-19. The announcement on 23 August said that the FDA had concluded that plasma from recovered patients “may be effective” in treating the virus and that the “potential benefits of the product outweigh the known and potential risks.” The move came despite the absence of results from randomised controlled trials, with only a preprint paper on the effects on hospitalised COVID-19 patients being published to date. Experts have warned that although these early findings show promise there is not enough evidence to show that it works. Plasma from recovered patients was approved on a case by case basis by the FDA for people critically ill with COVID-19 in March. Since then more than 70 000 patients have been treated with plasma. Emergency use approval allows clinicians to use unapproved medical products to diagnose, treat, or prevent serious or life threatening diseases or conditions when there are no adequate, approved, and available alternatives. The FDA’s commissioner, Stephen Hahn, said, “I am committed to releasing safe and potentially helpful treatments for covid-19 as quickly as possible in order to save lives. We’re encouraged by the early promising data that we’ve seen about convalescent plasma. The data from studies conducted this year shows that plasma from patients who’ve recovered from covid-19 has the potential to help treat those who are suffering from the effects of getting this terrible virus.” But Martin Landray, professor of medicine and epidemiology at the University of Oxford and lead researcher for the RECOVERY trial, which is comparing treatments for COVID-19, including convalescent plasma for hospital patients, urged caution. He said, “There is a huge gap between theory and proven benefit. That is why randomised clinical trials are so important. At present, we simply don’t know if it works." Read full story Source: BMJ, 25 August 2020
-
News ArticleThe Health Research Authority has launched a new strategy to ensure information about all health and social care research – including COVID-19 research - is made publicly available to benefit patients, researchers and policy makers. The COVID-19 pandemic has highlighted the importance of sharing details of research taking place - to understand the virus and find the tests, treatments and vaccines - so that results can inform best quality care and preventive measures. This also means researchers do not duplicate efforts and can build on each other’s work while the public can see what research is going on. Now the new Make it Public strategy aims to build on this good practice and make it easy for researchers to be transparent about their work. The strategy, delivered by the HRA in partnership with NHS Research Scotland (NRS), Health and Care Research Wales and Health and Social Care Northern Ireland, is about making transparency ‘the norm’ in research and making information more visible to the public. New measures set out in the strategy – will improve transparency and openness in health and social care studies, by: expecting researchers to plan how they will let research participants know about the findings of the study from the beginning introducing additional monitoring to check that researchers are reporting results and to collect information about study findings making information on individual research projects – and their transparency performance - available to the public introducing a system to consider past transparency performance when reviewing new studies for approval and in the future introducing sanctions.
-
Content ArticleA glimpse of moving and powerful Rounds discussions that took place at the Massachusetts General Hospital Cancer Center and at Emerson Hospital in Concord, MA, USA
-
Content ArticleFor some time now I've been looking to find out more about mental health services in Trieste, Italy. Then I met Vincenzo Passante Spaccapietra, co-host of the Place of Safety? podcast series. This has enabled me to learn more about the closure of the mental institutions in Trieste, Italy, and the work of Franco Basaglia. I was keen to find out what really took place, what this really means in practice and how we can adopt this model in the UK. We were delighted to have become involved and to have recorded a couple of podcasts. I recommend this resource to everyone interested in safe, compassionate, patient led mental health care. "Many voices are not heard in British mental health care (and beyond), significant flaws are overlooked. If you are not satisfied with the status quo or just curious, follow us!" Here's a sample of some of the podcasts: Episode 33 - Basaglia's International Legacy: From Asylum to Community... review Episode 8 - Lived experience in Trieste, a mental health system without psychiatric hospitals, with Marilena and Arturo Episode 25 - Clinical Psychology vs Psychotherapy in Italy and the UK Episode 18 - The Trieste model cannot be exported to the UK because... let's unpack the main objections Episode 27 - Substance dependency, colonialism and sexism with Dr Sonia Soans (@PSYfem) Episode 26 - From the horse's mouth...patient & nurse teaching together as equals Listen to all the podcasts from link below.
-
News Article
Chaos and panic': Lancet editor says NHS was left unprepared for Covid-19
Patient Safety Learning posted a news article in News
The NHS could have prevented “chaos and panic” had the system not been left wholly unprepared for the pandemic, the editor of the BMJ has said. Numerous warnings were issued but these were not heeded, Richard Horton wrote in the Lancet. He cited an example from his journal on 20 January, pointing to a global epidemic: “Preparedness plans should be readied for deployment at short notice, including securing supply chains of pharmaceuticals, personal protective equipment, hospital supplies and the necessary human resources to deal with the consequences of a global outbreak of this magnitude.” Horton wrote that the government’s Contain-Delay-Mitigate-Research plan had failed. “It failed, in part, because ministers didn’t follow WHO’s advice to ‘test, test, test’ every suspected case. They didn’t isolate and quarantine. They didn’t contact trace." “These basic principles of public health and infectious disease control were ignored, for reasons that remain opaque. The result has been chaos and panic across the NHS.” Read full story Source: Guardian, 28 March 2020 -
Content ArticleThe aim of the study was to create a core outcome set (COS), an agreed set of outcomes that could be measured, and report in all studies an evaluation of the introduction and evaluation of novel surgical techniques. The authors used data from several different sources such as innovation-specific literature, policy/regulatory body documents, and surgeon interviews. The results included 7,972 verbatim outcomes that were identified which were categorized into 32 domains. The researchers conclude the COS could be used to help encourage safer surgical innovation.
-
Content ArticleConsumer-focused digital healthcare apps are widely used for health maintenance. This scoping review from Millenson et al. examined evidence on interactive direct-to-consumer diagnostic applications and found a lack of robustness on evaluation methods.
-
Content ArticleThe State of Care is the Care Quality Commission (CQC) 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. The care that people received in 2019/20 was mostly of good quality. But while the quality of care was largely maintained compared with the previous year, there was generally no improvement overall. And in the space of a few short months since then, the pandemic has placed the severest of challenges on the whole health and care system in England. Quality of care before the pandemic The care that people received in 2019/20 was mostly of good quality However, while quality was largely maintained compared with the previous year, there was no improvement overall Before the arrival of the coronavirus pandemic, we remained concerned about a number of issues: the poorer quality of care that is harder to plan for the need for care to be delivered in a more joined-up way the continued fragility of adult social care provision the struggles of the poorest services to make any improvement significant gaps in access to good quality care, especially mental health care persistent inequalities in some aspects of care The impact of the coronavirus pandemic As the pandemic gathered pace, health and care staff across all roles and services showed resilience under unprecedented pressures and adapted quickly to work in different ways to keep people safe. In hospitals and care homes, staff worked long hours in difficult circumstances to care for people who were very sick with COVID-19 and, despite their efforts to protect people, tragically they saw many of those they cared for die. Some staff also had to deal with the loss of colleagues to COVID. A key challenge for providers has been maintaining a safe environment – managing the need to socially distance or isolate people due to COVID-19. Good infection prevention and control practice has been vital. The crisis has accelerated innovation that had previously proved difficult to mainstream, such as GP practices moving rapidly to remote consultations. The changes have proved beneficial to, and popular with, many. But many of these innovations exclude people who do not have good digital access, and some have been rushed into place during the pandemic. The pandemic has had a major impact on elective care and urgent services such as cancer and cardiac services, and there is huge pent-up demand for care and treatment that has been postponed. The pandemic is having a disproportionate effect on some groups of people, and is shining a light on existing inequality in the health and social care system. It is vital that we understand how we can use this knowledge to move towards fairer and more equitable care, where nobody’s needs go unmet. It is important that the learning and innovation that has been seen during the pandemic is used to develop health and social care for the future. New approaches to care, developed in response to the pandemic and shown to have potential, must be fully evaluated before they become established practice.
-
Content Article
Airway Device Evaluation Project Team (ADEPT)
Claire Cox posted an article in Keeping patients safe
The aim of the Airway Device Evaluation Project Team (ADEPT) is to establish a process by which the airway-management community within the profession could lead a process of formal device/equipment evaluation. There is increasing number of airway management devices being introduced into clinical practice with little or no evidence of their clinical efficacy or safety. While there are several national and international regulations governing which products can come on to the market and be legitimately sold, there has hitherto been no formal professional guidance relating to how products should be selected (purchased). ADEPT has formulated such advice, emphasising evidence based principles and defined a minimum level of evidence needed to make a pragmatic decision about the purchase or selection of an airway device. ADEPT advises that this definition should form the basis of a professional standard, guiding those with responsibility for selecting airway devices. This paper, published by Anaesthesia journal, describes how widespread adoption of this professional standard can act as a driver to create an infrastructure in which the required evidence can be obtained. -
Content ArticleMindful organising is a key integrating concept in resolving the organisational accident. Mindful organising is both the unique source of critical information about the normal operation, as well as the key recipient of intelligence about the operation, ensuring that operational actions are always informed by the most current, relevant information about potential risks no matter how remote. Highlights of the paper: Principles of mindful organising are operationalised in a Mindful Governance model. The model is grounded in two cases studies in contrasting aviation organisations. The case studies led to the development of three prototype web applications.
-
Content Article
How does the NHS in England work? An alternative guide (2017)
Claire Cox posted an article in Health care
This animation by The Kings fund, presents a whistle-stop tour of how the NHS works in 2017 and how it is changing. -
Content ArticleIn the light of the current national guidance to reduce the number of inpatient learning disability beds, a review was completed of the quality of lives of the people who had been former inpatients in Cornwall at the time of closure of the learning disability inpatient facilities almost 10 years before transforming care. This study highlights that people with complex concerns with a history of placement breakdowns and past institutionalisation can be settled successfully and safely in local communities. However, it is difficult for many of them to achieve a satisfactory quality of life long term. The obligation for this lies with service providers to provide adequate support to overcome that difficulty.
-
Content ArticleWith the widespread adoption of electronic health records (EHRs), there is an increased focus on addressing the challenges of EHR usability; that is, the extent to which the technology enables users to achieve their goals effectively, efficiently, and satisfactorily. Poor usability is associated with clinician job dissatisfaction and burnout and could have patient safety consequences. Using EHR surveillance data collected by the ONC, researchers from the MedStar Health National Center for Human Factors analysed over 350 reports regarding EHR issues that violated the federal certification programme. They found that roughly 40% of ONC-certified EHRs had the potential for patient harm.
