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Found 26 results
  1. Content Article
    Little is known as to whether the effects of physician sex on patients’ clinical outcomes vary by patient sex. This study examined whether the association between physician sex and hospital outcomes varied between female and male patients hospitalised with medical conditions. The findings indicate that patients have lower mortality and readmission rates when treated by female physicians, and the benefit of receiving treatments from female physicians is larger for female patients than for male patients.
  2. Content Article
    Hospitals with high mortality and readmission rates for patients with heart failure (HF) might also perform poorly in other quality concepts. Wang et al. sought to evaluate the association between hospital performance on mortality and readmission with hospital performance rates of safety adverse events. They found that patients admitted with HF to hospitals with high 30-day all-cause mortality and readmission rates had a higher risk of in-hospital adverse events. There may be common quality issues among these 3 measure concepts in these hospitals that produce poor performance for patients with HF.
  3. Content Article
    This study from Jalilian et al., published in the BMJ, evaluated the length of stay difference and its economic implications between hospital patients and virtual ward patients. It found that the use of a 40-bed virtual ward was clinically effective in terms of survival for patients not needing readmission and allowed for the freeing of three hospital beds per day. However, the cost for each day freed from hospital stay was three-quarters larger than the one for a single-day hospital bed. This raises concerns about the deployment of large-scale virtual wards without the existence of policies and plans for their cost-effective management.
  4. News Article
    Researchers have found the costs of treating patients in a 40-bed virtual ward were double that of traditional inpatient care. The study’s authors said the findings should raise concerns over a flagship NHS England policy, which has driven the establishment of 10,000 virtual ward beds. Virtual wards, sometimes described as “hospital at home”, are cited as a safe way to reduce pressure on hospitals, by reducing length of stay and enabling quicker recovery. The study at Wrightington Wigan and Leigh Teaching Hospitals, in Greater Manchester, found a clear reduction in length of stay but also found higher rates of readmission. The authors said this led to additional costs, with the cost of a bed day in the virtual ward estimated at £1,077, compared to £536 in a general inpatient hospital bed. “This raises concerns [over] the deployment of large-scale virtual wards without the existence of policies and plans for their cost-effective management. This evidence should be taken into consideration by [the] NHS in planning the next large deployment of virtual wards within the UK… “Virtual wards must be cost effective if they are to replace traditional inpatient care, the costs must be comparable or lower than the costs of hospital stay to be economically sustainable in the medium to long terms.” To break even, the paper said the virtual ward would need to double its throughput, but warned this would risk lowering the standard of care. Read full story (paywalled) Source: HSJ, 25 January 2024
  5. News Article
    Thousands of patients are being readmitted to NHS mental health units in England every year soon after being discharged, raising concerns about poor care, bed shortages and increased risk of suicide. Experts say being discharged prematurely can be upsetting, set back the patient’s chances of making a full recovery and be “disastrous” for their health. Figures from NHS mental health trusts in England show that last year almost 5,000 people – children and adults – were readmitted to a mental health facility within a month of leaving. The Labour MP Dr Rosena Allin-Khan said the “alarming” data, which she obtained under freedom of information laws, showed too many patients were not receiving enough help to recover. Allin-Khan said: “With record waiting lists and mental health beds in short supply, it is alarming that many patients are being discharged only to be readmitted within days. Every patient expects to receive full and appropriate mental health support, so it is concerning that in many cases patients are being discharged prematurely. “Being discharged too soon can have a disastrous impact, stunting progress towards a full recovery, ultimately causing further damage to a patient’s mental health.” Read full story Source: The Guardian, 12 January 2024
  6. News Article
    Extra beds squeezed into hospitals as part of winter planning are crowding out space for rehab, pushing up length of stay and knock-on costs, and increasing the chance of readmission, NHS leaders have been warned. Systems and trusts were encouraged to staff thousands of additional ward beds in the run-up to last winter to try to ease emergency care pressures, and government and NHS England have since asked for many of them to be kept open through the year. However, many of the additional beds are not in proper ward spaces, instead being located in gyms and other areas used for physiotherapy and other rehab. This followed on from some rehab areas already being lost during the pandemic, to be used for beds or storage. NHSE has sent out a warning about the issue, following a commitment by ministers earlier this year. However, senior figures in physio and older people’s care remain concerned the spaces will not be restored without checks and enforcement, especially as acute trusts remain under pressure to increase general bed space.
  7. Content Article
    Standard operating procedures (SOPs) should improve safety in the operating theatre, but controlled studies evaluating the effect of staff-led implementation are needed. Morgan et al. evaluated three team process measures (compliance with WHO surgical safety checklist, non-technical skills and technical performance) and three clinical outcome measures (length of hospital stay, complications and readmissions) before and after a 3-month staff-led development of SOPs.  They found that SOPs when developed and introduced by frontline staff do not necessarily improve operative processes or outcomes. The inherent tension in improvement work between giving staff ownership of improvement and maintaining control of direction needs to be managed, to ensure staff are engaged but invest energy in appropriate change.
  8. Content Article
    This report from the National Asthma and Chronic Obstructive Pulmonary Disease Audit Programme (NACAP) shows what happened after people were admitted to hospital with an asthma attack or COPD exacerbation between 2018 and 2020. The data show that many people are being readmitted to hospital within three months of going home and that some, particularly with COPD, are dying within three months of their exacerbation.
  9. News Article
    Those recovering from Covid-19 are to be given devices which can help spot dips in their blood oxygen-levels while they recover at home. The NHS is trialling the use of oximeters, combined with an app, which will make it easier to spot whether people need to be re-admitted to hospital. The new oximeter service is being tested with more than 150 patients in sites on Watford, Hertfordshire and north London. Clinicians in ‘virtual wards’ are able to track patients’ vital signs – including temperature, heart rate and blood oxygen saturation – in near real-time, receiving alerts if they suggest a patient is deteriorating so that further assessments and care can be arranged. Health and Social Care Secretary, Matt Hancock, said: “While we restore face to face NHS services too, new innovations will ensure patients can benefit from the comfort of home, with the reassurance that they can be fast tracked to support from the NHS should they need. NHS at Home will help keep people safe and out of hospital while providing the best possible care.” Read full story Source: Digital Health, 5 June 2020
  10. News Article
    From July, hospitals will be able to refer patients who would benefit from extra guidance around new prescribed medicines to their community pharmacy. Patients will be digitally referred to their pharmacy after discharge from hospital. The NHS Discharge Medicines Service will help patients get the maximum benefits from new medicines they’ve been prescribed by giving them the opportunity to ask questions to pharmacists and ensuring any concerns are identified as early as possible. This is part of the Health Secretary’s ‘Pharmacy First’ approach to ease wider pressures on A&Es and general practice. Read full story Source: Department of Health and Social Care, 23 February 2020
  11. News Article
    A major NHS hospital is under such pressure that it has decided to discharge people early even though it admits that patients may be harmed and doctors think the policy is unwise. The Royal Cornwall Hospitals NHS trust has told staff to help it reduce the severe overcrowding it has been facing in recent weeks by discharging patients despite the risks involved. In a memo sent on 8 January, three trust bosses said the Royal Cornwall hospital in Truro, which is also known as Treliske hospital and has the county’s only A&E department, “has been under significant pressure for the last two weeks and it is vital that we are able to see and admit our acutely unwell patients through our emergency department and on to our wards”. The memo added: “One of these mitigations was to look at the level of risk that clinicians are taking when discharging patients from Treliske hospital either to home or to community services, recognising that this may be earlier than some clinicians would like and may cause a level of concern. “It was agreed, however, that this would be a proportionate risk that we as a health community were prepared to take on the understanding that there is a possibility that some of these patients will be readmitted or possibly come to harm.” Read full story Source: 14 January 2020
  12. Content Article
    Out-of-hours discharge from the intensive care unit (ICU) to the ward is associated with increased in-hospital mortality and ICU readmission. This study in the journal Critical Care Medicine was part of the REcovery FoLlowing intensive CarE Treatment mixed methods study. It aimed to map the discharge process and describe the consequences of out-of-hours discharge to inform practice changes to reduce the impact of discharge at night. The study identified significant limitations in out-of-hours care provision following overnight discharge from ICU. The authors recommend changes to help make daytime discharge more likely, and new systems to ensure patient safety where night time discharge is unavoidable.
  13. Content Article
    This report from the Queen's Nursing Institute’s International Community Nursing Observatory (ICNO) describes the role of district nursing in ensuring continuity of care and preventing unnecessary hospital admissions. It highlights the advanced skills in assessment, diagnosis and patient management of District Nurse Team Leaders - skills that could be used to provide safe and effective care for people at home.
  14. Content Article
    The aim of this study from Hutchinson et al. was to explore the reasons for and experiences of patients who make an unplanned return visit to the emergency department.
  15. News Article
    Nearly a third of people who were discharged from hospitals in England after being treated for COVID-19 were readmitted within five months – and almost one in eight died, a study suggests. The research, which is still to be peer-reviewed, also found a higher risk of problems developing in a range of organs after hospital discharge in those younger than 70 and ethnic minority individuals. “There’s been so much talk about all these people dying from Covid … but death is not the only outcome that matters,” said Dr Charlotte Summers, a lecturer in intensive care medicine at the University of Cambridge who was not involved in this study. “The idea that we have that level of increased risk in people – particularly young people – it means we’ve got a lot of work to do.” There is no consensus on the scale and impact of “long Covid”, but scientists have described emerging evidence as concerning. According to recent figures provided by the Office for National Statistics (ONS), a fifth of people in England still have coronavirus symptoms five weeks after being infected, half of whom continue to experience problems for at least 12 weeks. Read full story Source: The Guardian, 18 January 2021
  16. News Article
    To lower hospital readmission rates for patients with chronic obstructive pulmonary disease (COPD), UB pharmacy researcher David Jacobs has received a $962,000 award from the US National Heart, Lung, and Blood Institute to develop a real-time readmission risk-prediction algorithm. Through a five-year Mentored Patient-Oriented Research Career Development Award, Jacobs will combine social information with rich clinical data to build predictive models that will be integrated into patient-centric interventions and tested in clinical practices. If successful, the research will help clinicians provide individualized treatment at the transition from hospital to home for COPD patients, who experience high rates of early hospital readmission, says Jacobs. “Each year, 7.8 million hospital-discharged patients are readmitted, costing the United States $17 billion,” says Jacobs, assistant professor of pharmacy practice, School of Pharmacy and Pharmaceutical Sciences. “High readmission rates are linked to several quality-of-care and patient-safety factors, such as medication-related problems, inaccurate information transfer, and lack of care coordination with primary care,” he says. “Our focus will be to apply innovative informatic techniques to the development of risk prediction models for hospital readmissions that ultimately personalizes care management interventions.” Read full story Source: UBNow, 21 May 2021
  17. Content Article
    This cross-sectional study in JAMA Network Open looked at patients in the USA with pneumonia who are admitted to hospitals with higher risk-standardised readmission rates. It aimed to assess whether these patients have higher rates of adverse events. The authors found that patients with pneumonia admitted to hospitals with high all-cause readmission rates were more likely to develop adverse events during hospitalisation. This strengthens the evidence that readmission rates reflect the quality of hospital care for pneumonia.
  18. Content Article
    The Re-Engineered Discharge (Project RED) programme is a nationally recognised best practice centered on delivering a patient-tailored hospital discharge plan demonstrated to reduce all-cause 30-day readmissions and improve safety during care transitions. In this study, Mitchell et al. implemented the RED in 10 hospitals to study the implementation process.
  19. Content Article
    Building on published patient safety research literature, this paper from the OECD, aims to broaden the existing knowledge base on safety lapses occurring in primary and ambulatory care settings.
  20. Content Article
    This study assesses the association of increased bed occupancy with changes in the percentage of overnight patients discharged from hospital on a given day and their subsequent 30-day readmission rate. Longitudinal panel data methods are used to analyse secondary care records (n = 4,193,590) for 136 non-specialist Trusts between April 2014 and February 2016.
  21. Content Article
    The Agency for Healthcare Research and Quality (AHRQ) created On-Time Preventable Hospital and Emergency Department Visits to help nursing homes with electronic medical records identify residents at risk for events that could lead to a hospital visit. The tools are designed to help a multidisciplinary nursing home team prevent hospital and emergency department visits that can be avoided with good preventive care.
  22. Content Article
    This guide published by the Agency for Healthcare Research & Quality (AHRQ) is a tested, evidence-based resource to help hospitals in the United States work as partners with patients and families to improve quality and safety.
  23. Content Article
    Cataract removal and implantation of an artificial lens is the most common surgical procedure undertaken by the NHS. Insertion of an incorrect intraocular lens was the most commonly reported never event in England between April 2016 and March 2017. A never event is a serious incident that is entirely preventable. Read the Healthcare Safety Investigation Branch's report on the insertion of an incorrect intraocular lens.
  24. Content Article
    Readmissions to hospital are increasingly being used as an indicator of quality of care. However, this approach is valid only when we know what proportion of readmissions are avoidable. The authors conducted a systematic review of studies that measured the proportion of readmissions deemed avoidable. This study, published in Canadian Medical Association Journal, examined how such readmissions were measured and estimated their prevalence.
  25. Content Article
    Interventions information related to the patient’s medication and hospital stay is provided to the community pharmacists on discharge from hospital, who undertake a two-part service involving medicines reconciliation and a medicine use review. To investigate the association of this discharge medicines review (DMR) service with hospital readmission, a data linking process was undertaken across six national databases. The objective of this research, published by BMJ Open, was to evaluate the association of the DMR community pharmacy service with hospital readmissions through linking National Health Service data sets.
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