Knowledge @lert for Monday 16th June

June 16, 2014 Daily News

Guidance for taking responsibility: accountable clinicians and informed patients – Academy of Medical Royal Colleges (AoMRC)

Following recommendations in the Francis Inquiry report that there is a need for a named accountable clinician for a patient’s care whilst in hospital, AoMRC was asked by the Secretary of State to see how this could be taken forward. This guidance was developed following discussion and consultation with medical royal colleges, regulatory bodies and professional bodies.

Developing a reliable and valid patient measure of safety in hospitals (PMOS): a validation study- BMJ Quality and Safety Article

Patients represent an important and as yet untapped source of information about the factors that contribute to the safety of their care. The aim of the current study is to test the reliability and validity of the Patient Measure of Safety (PMOS), a brief patient-completed questionnaire that allows hospitals to proactively identify areas of safety concern and vulnerability, and to intervene before incidents occur. Finds that the PMOS is the first patient questionnaire used to assess factors contributing to safety in hospital settings from a patient perspective. It has demonstrated acceptable reliability and validity. Such information is useful to help hospitals/units proactively improve the safety of their care.

Interventions employed to improve intrahospital handover: a systematic review – BMJ Quality and Safety Article

This paper finds that the current literature does not confirm that any methodology reliably improves the outcomes of clinical handover, although information transfer may be increased.

Improving patient care over weekends by reducing on-call work load and better time management – BMJ Quality Improvement Reports Article

The Royal College of Physicians states that “handover, particularly of temporary ‘on-call’ responsibility, has been identified as a point at which errors are likely to occur. Initial study demonstrated that on average 30-40% of time on a long day shift was spent on jobs which could have been done on the preceding Friday. The ”FRIDAYS” checklist was introduced for clinical staff (particularly junior doctors) to identify these jobs.

Updated recommendations: an assessment of NICE clinical guidelines – Implementation Science Article

Article that highlights the pressing need to standardise the reporting and presentation of updated recommendations and the research gap about the optimal way to present updates to guideline users. Furthermore, there is a need to investigate updating predictive factors.

Bill Moyes questions whether FT model remains ‘sensible’

Bill Moyes, who championed the development of foundation trusts as Monitor executive chair, has urged the NHS to reconsider “whether the model of foundation trusts is sensible”.

Right Care reading list: Priority-setting – Right Care

NHS Right Care regularly publishes reading lists on specific themes relevant to the Right Care programme. The latest one is a reading list providing the best evidence on Priority-setting/Prioritisation.

RCN publishes ‘All in it together? The Executive pay bill in England’s NHS’

The RCN has published a new report into the size of the executive pay bill in England’s NHS.

Clinicians in management: a qualitative study of managers’ use of influence strategies in hospitals – BMC Health Services Research

Combining a professional and managerial role can be challenging for doctors and nurses. This article aimed to explore influence strategies used by doctors and nurses who are managers in hospitals with a model of unitary and profession neutral management at all levels. Finds managers’ professional background may be both a resource and constraint, and also determine the influence strategies they use. Professional roles and influence strategies should be a theme in leadership development programs for health professionals.

Key concepts in consumer and community engagement (CCE) – BMC Health Services Research

Although consumer and community engagement (CCE) in health care is receiving increasing attention, research and practice in this area is hampered by the variability of concepts and terminology commonly employed. This scoping meta-review aims to identify key CCE concepts and examine terminology used to describe them. The analysis identified nine different concepts related to CCE: shared decision-making, self-management, CCE in health care systems, community-based health promotion, providing access to health care, rehabilitation, participation in research, collaboration in research design and conduct, and peer support.

Unexpectedly long hospital stays as an indicator of risk of unsafe care: an exploratory study – BMJ Open Article

Develops an outcome indicator based on the finding that complications often prolong the patient’s hospital stay. A higher percentage of patients with an unexpectedly long length of stay (UL-LOS) compared to the national average may indicate shortcomings in patient safety. This article explores the utility of the UL-LOS indicator. It finds the UL-LOS indicator is a useful addition to other patient safety indicators by revealing variation between hospitals and areas of possible patient safety improvement.

Reframing professional boundaries in healthcare: A systematic review of facilitators and barriers to task reallocation from the domain of medicine to the nursing domain – Health Policy Article

This paper finds introducing nurse practitioners in healthcare requires organisational redesign and the reframing of professional boundaries. Especially the facilitators and barriers in the analytical themes of ‘professional boundaries’ and ‘organisational environment’ should be considered when reallocating tasks. If not, these factors might hamper the cost-effectiveness of task reallocation in practice.

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review – BMJ Quality & Safety Article

Patient-centeredness is central to healthcare. Hospitals should address patients’ unique needs to improve safety and quality. Patient engagement in healthcare, which may help prevent adverse events, can be approached as an independent patient safety practice (PSP) or as part of a multifactorial PSP. This paper finds a lack of real world research supporting this development and recommends more research is required.

How nurses and their work environment affect patient experiences of the quality of care: a qualitative study – BMC Health Services Research

This paper finds that according to participants, a diverse range of elements affect patient experiences of the quality of nursing care. They believe that incorporating these elements into daily nursing practice would result in more positive patient experiences. However, nurses work in a healthcare context in which they have to reconcile cost-efficiency and accountability with their desire to provide nursing care that is based on patient needs and preferences, and they experience a conflict between these two approaches. Nurses must gain autonomy over their own practice in order to improve patient experiences.

Patient Engagement Resource Hub – Canadian Foundation for Healthcare Improvement

The Canadian Foundation for Healthcare Improvement has created this Hub, which contains a resources and tools to support patient engagement and quality improvement.

Monitor: ‘No evidence’ of poorer quality of care in small hospitals – HSJ

Small hospitals should continue to play an “important role” in the NHS, Monitor has indicated after a new study found “no evidence” of poorer quality clinical performance when compared with larger providers.

Shortage occupation list call for evidence – two weeks left to submit your evidence – NHS Employers 

The Centre for Workforce Intelligence is gathering information on current and anticipated workforce shortages in the healthcare sector in England. Have your say.

Tracheostomy care

The National Confidential Inquiry into Patient Outcome and Death has published Tracheostomy Care: On the Right Trach? This report highlights the process of care for patients who undergo a tracheostomy or a laryngectomy. The report takes a critical look at areas where the care of patients might have been improved. Remediable factors have also been identified in the clinical and the organisational care of these patients.

NICE consultations
NICE has issued the following consultation documents:

Bulletin

Health Statistics

 

Knowledge @lert for Thursday 12th June

Knowledge @lert for Tuesday 17th June