Circumnavigating the world of quality and patient safety: a compendium of highlights and perspectives

2020 ◽  
Vol 65 (1) ◽  
pp. 3-11
Author(s):  
Nancy El-Farargy
Keyword(s):  
Patient Safety ◽  
Workforce Development ◽  
Design Thinking ◽  
Hospital Admissions ◽  
Health Spending ◽  
Healthcare Improvement ◽  
Health And Social Care ◽  
Major Reform ◽  
Quality And Patient Safety ◽  
The Uk

Background In the UK, estimates suggest that approximately 10% of hospital admissions and 1–2% of primary care consultations result in some sort of adverse event. Globally, medication errors cost approximately US$42 billion annually, and 15% of total health spending in Organisation for Economic Cooperation and Development countries is used to deal with adverse events. Method Stemming from the Glasgow 2019 British Medical Journal and Institute for Healthcare Improvement International Forum on Quality and Safety in Healthcare (‘People Make Change’), a review of workforce characteristics, the psychology of change and design thinking in healthcare is presented. The concept of personalised care is also discussed. Conclusion In the last decade, the National Health Service in Scotland has undergone major reform around the integration of health and social care. In tandem with this, there have been a range of national initiatives to support patient safety and quality improvement. Moving forward, there is an increasing realisation of how service design, digital technologies and a national digitised infrastructure can improve services. Implications highlight the role of workforce development and in embedding design thinking in service organisation. This review article therefore presents an anthology of highlights and perspectives in improving healthcare quality and patient safety.

scholarly journals Flipping the Paradigm: A Qualitative Exploration of Research Translation Centres in the UK and Australia

2020 ◽  
Author(s):  
Tracy Elizabeth Robinson ◽  
Helen Skouteris ◽  
Prue Burns ◽  
Angela Melder ◽  
Cate Bailey ◽  
...  
Keyword(s):  
Workforce Development ◽  
Health Care Providers ◽  
Health Science ◽  
Research Translation ◽  
Care Providers ◽  
Structured Interviews ◽  
The Public ◽  
Healthcare Improvement ◽  
Research And Education ◽  
The Uk

Abstract Background: Over the past decade Research Translation Centres (RTC’s) have been established in many countries. These Centres (sometimes referred to as Academic Health Science Centres) are designed to bring universities and health care providers together in order to accelerate the generation and translation of new evidence that is responsive to health service and community priorities. This has the potential to effectively ‘flip’ the traditional research and education paradigms because it requires active participation and continuous engagement with stakeholders (especially service users, the community and frontline clinicians). Although investment and expectations of RTCs are high, the literature confirms a need to better understand the processes RTCs use to mobilise knowledge, build workforce capacity and co-produce research with patients and the public to ensure population impact and drive healthcare improvement is needed. Methods: Semi structured interviews were conducted with selected leaders and members from select RTCs in England and Australia. Convenience sampling was utilised to identify RTC’s, based on their geography, accessibility and availability. Purposive sampling and a snowballing approach was employed to recruit individual participants for interviews that were conducted face to face or via videoconferencing. Interviews were recorded, transcribed verbatim and analysed using a reflexive and inductive approach. This involved two researchers comparing codes and interrogating themes that were analysed inductively against the study aims and through meetings with the research team. Results: A total of 41 participants, 22 from England and 19 from Australia were interviewed. Five major themes emerged including (1) dissonant metrics, (2) different models of leadership (3) public-patient involvement and research co-production (4) workforce development (5) barriers to collaboration.Conclusions: Participants identified the need for performance measures that capture community impact. Better aligned success metrics, enhanced leadership, strategies to partner with patients and the public, enhanced workforce development and strategies to enhance collaboration were all identified as crucial for RTCs to succeed.

scholarly journals Flipping the Paradigm: A Qualitative Exploration of Research Translation Centres in the UK and Australia

2020 ◽  
Author(s):  
Tracy Robinson ◽  
Helen Skouteris ◽  
Prue Burns ◽  
Angela Melder ◽  
Cate Bailey ◽  
...  
Keyword(s):  
Workforce Development ◽  
Health Science ◽  
Leadership Strategies ◽  
Research Translation ◽  
Structured Interviews ◽  
The Public ◽  
Inductive Approach ◽  
Healthcare Improvement ◽  
Research And Education ◽  
The Uk

Abstract Background: Over the past decade Research Translation Centres have been established in many countries. These Centres (sometimes referred to as Academic Health Science Centres) were established to accelerate the generation and translation of new evidence that is responsive to health service and community priorities. This effectively ‘flips’ the traditional research and education paradigms because it requires active participation and continuous engagement with stakeholders (especially service users, the community and frontline clinicians). Although investment and expectations of RCTs are high, the literature confirms a need to better understand the processes RTCs use to mobilise knowledge, build workforce capacity and co-produce research with patients and the public to ensure population impact and drive healthcare improvement is needed. Methods: Semi structured interviews were conducted with selected leaders and members from RTCs in the UK and Australia. Convenience sampling was utilised based on geography, accessibility and availability. In addition, a snowballing approach was employed with further participants identified by RTC leaders and advisors from Public and Patient initiatives in the UK. Interviews were conducted face to face or via videoconferencing and were recorded, transcribed verbatim and analysed using a reflexive and inductive approach described by Braun and Clarke (2???). This involved re-reading and coding transcripts to generate initial themes. This inductive approach was used to identify patterns and common threads that were subsequently reviewed by two researchers to ensure consistentcy of themes. Results: A total of 41 participants, 22 from the UK and 19 from Australia were interviewed. Five major themes emerged including (1) dissonant metrics, (2) Different models of leadership (3) Public-Patient Involvement and research co-production (4) Workforce development (5) Barriers to collaboration. Conclusions: Participants identified the need for performance measures that capture community impact. Better aligned success metrics, enhanced leadership, strategies to partner with patients and the public, enhanced workforce development and strategies to enhance collaboration were all identified as crucial for RTCs to succeed.

scholarly journals The relationship between alcohol-related hospital admission and specialist alcohol treatment provision across local authorities in England since passage of the Health and Social Care Act 2012

2020 ◽  
pp. 1-3 ◽  
Author(s):  
Emmert Roberts ◽  
Matthew Hotopf ◽  
Colin Drummond
Keyword(s):  
Hospital Admission ◽  
Social Care ◽  
Local Authority ◽  
Hospital Admissions ◽  
Alcohol Treatment ◽  
Data Sets ◽  
Treatment Provision ◽  
Health And Social Care ◽  
High Prevalence ◽  
The Uk

Summary To our knowledge no previous studies have been conducted at the local authority level assessing relationships between alcohol-related hospital admission, specialist alcohol treatment provision and socioeconomic deprivation since the UK government passed the Health and Social Care Act in 2012. Our results, using publicly available national data-sets, suggest that the local authority areas in England most in need of adequately funded specialist alcohol treatment, because of high prevalence of alcohol dependence and deprivation, are not receiving targeted increased funding, and that the national rise in alcohol-related hospital admissions may be fuelled by local authority funding cuts to specialist alcohol treatment.

scholarly journals Specialist alcohol inpatient treatment admissions and non-specialist hospital admissions for alcohol withdrawal in England: an inverse relationship

2020 ◽  
Vol 56 (1) ◽  
pp. 28-33
Author(s):  
Thomas Phillips ◽  
Chao Huang ◽  
Emmert Roberts ◽  
Colin Drummond
Keyword(s):  
Alcohol Withdrawal ◽  
Hospital Admissions ◽  
Significant Negative Correlation ◽  
Data Sets ◽  
Complex Needs ◽  
Specialist Services ◽  
Health And Social Care ◽  
Specialist Treatment ◽  
The Uk ◽  
The Relationship

ABSTRACT Aims We assessed the relationship between specialist and non-specialist admissions for alcohol withdrawal since the introduction of the UK government Health and Social Care Act in 2012. Methods Using publicly available national data sets from 2009 to 2019, we compared the number of alcohol withdrawal admissions and estimated costs in specialist and non-specialist treatment settings. Results A significant negative correlation providing strong evidence of an association was observed between the fall in specialist and rise in non-specialist admissions. Significant cost reductions within specialist services were displaced to non-specialist settings. Conclusions The shift in demand from specialist to non-specialist alcohol admissions due to policy changes in England should be reversed by specialist workforce investment to improve outcomes. In the meantime, non-specialist services and staff must be resourced and equipped to meet the complex needs of these service users.

Achieving Clinical Quality and Patient Safety: Education and Research as Critical Success Factors

2013 ◽  
Vol 3 (5) ◽  
Author(s):  
Darrell G. Kirch ◽  
◽  
David A. Davis ◽  
Linda A. Headrick ◽  
Nancy Davis ◽  
...  
Keyword(s):  
Patient Safety ◽  
Critical Success Factors ◽  
Success Factors ◽  
Safety Education ◽  
Clinical Quality ◽  
Critical Success ◽  
Quality And Patient Safety ◽  
Patient Safety Education

scholarly journals When “Good Enough” Isn’t Good Enough: Interdisciplinary Perspectives on Caring for Adults Using Substances at the End of Life

2021 ◽  
Author(s):  
Lorna Templeton ◽  
Sarah Galvani ◽  
Marian Peacock
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Structured Interview ◽  
Life Care ◽  
Snowball Sampling ◽  
Policy And Practice ◽  
Template Analysis ◽  
Health And Social Care ◽  
The Uk ◽  
Key Terms

AbstractThis paper draws on data from one strand of a six-strand, exploratory study on end of life care for adults using substances (AUS). It presents data from the key informant (KI) strand of the study that aimed to identify models of practice in the UK. Participant recruitment was purposive and used snowball sampling to recruit KIs from a range of health and social care, policy and practice backgrounds. Data were collected in 2016–2017 from 20 KIs using a semi-structured interview approach. The data were analysed using template analysis as discussed by King (2012). This paper focusses on two of seven resulting themes, namely “Definitions and perceptions of key terms” in end of life care and substance use sectors, and “Service commissioning and delivery.” The KIs demonstrated dedicated individual practice, but were critical of the systemic failure to provide adequate direction and resources to support people using substances at the end of their lives.

Quality and Patient Safety in a Pathology Residency Training Program

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S95-S96
Author(s):  
R Demkowicz ◽  
S Sapatnekar ◽  
D Chute
Keyword(s):  
Patient Safety ◽  
Residency Training ◽  
Chief Resident ◽  
Residency Training Program ◽  
Basic Structure ◽  
Learning Activities ◽  
Before And After ◽  
Quality And Patient Safety ◽  
The Impact ◽  
Quiz Scores

Abstract Introduction/Objective Since the start of the new millennium, optimization of Quality and Patient Safety (QPS) has taken a renewed focus in the healthcare industry. Consequently, the Accreditation Council for Graduate Medical Education has mandated that QPS be a part of residency training. We have previously presented our curriculum designed to meet the specific needs of Pathology training programs, and covering four content areas: Handoffs, Error Management, Laboratory Administration, and Process Improvement. We are now presenting implementation. Methods To implement this curriculum, we 1) created online modules for self-directed learning on basic topics (using courses developed by IHI and CAP, and assigned articles), and paired these with faculty-facilitated interactive learning activities on more complex topics, including proficiency testing, root cause analysis and test utilization, 2) assigned every resident to a QPS project that was aligned with departmental priorities, led by a faculty advisor, and ran over 8- 10 months, and 3) appointed a QPS Chief Resident to coordinate and support the residents’ QPS activities. We measured the impact of the curriculum by comparing RISE laboratory accreditation percentiles and QPS curriculum quiz scores before and after curriculum implementation. Results After its implementation, RISE percentiles increased by at least 25 for every PGY, and QPS quiz scores increased by at least 10% for 3 of 4 PGY. Every QPS project was presented at Grand Rounds, and 4 were presented externally, including 2 at national conferences. Conclusion Our curriculum was successful in improving residents’ knowledge and competence in QPS. Challenges included designing appropriate learning activities, tracking completion of activities, coordinating faculty schedules and maintaining resident buy-in to the curriculum. We believe that the basic structure of our curriculum offers a solid foundation to which revisions can be made as QPS priorities evolve, and which can be readily adapted to other programs and locations.

scholarly journals Psychosocial impact on frontline health and social care professionals in the UK during the COVID-19 pandemic: a qualitative interview study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047353
Author(s):  
Henry Aughterson ◽  
Alison R McKinlay ◽  
Daisy Fancourt ◽  
Alexandra Burton
Keyword(s):  
Personal Growth ◽  
Social Care ◽  
Well Being ◽  
Work Conditions ◽  
Individual Interviews ◽  
Work Related ◽  
Qualitative Interview Study ◽  
Health And Social Care ◽  
Communication Challenges ◽  
The Uk

ObjectivesTo explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic.DesignThis was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding.ParticipantsThis study involved 25 participants from a range of frontline professions in health and social care.SettingInterviews were conducted over the phone or video call, depending on participant preference.ResultsFrom the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life.ConclusionsThis study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.

scholarly journals Collateral impact of COVID-19: why should children continue to suffer?

2021 ◽  
Author(s):  
Prasad Nagakumar ◽  
Ceri-Louise Chadwick ◽  
Andrew Bush ◽  
Atul Gupta
Keyword(s):  
Young People ◽  
Large Scale ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Children And Young People ◽  
Collateral Effects ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Set Up ◽  
The Uk

AbstractThe COVID-19 pandemic caused by SARS-COV-2 virus fortunately resulted in few children suffering from severe disease. However, the collateral effects on the COVID-19 pandemic appear to have had significant detrimental effects on children affected and young people. There are also some positive impacts in the form of reduced prevalence of viral bronchiolitis. The new strain of SARS-COV-2 identified recently in the UK appears to have increased transmissibility to children. However, there are no large vaccine trials set up in children to evaluate safety and efficacy. In this short communication, we review the collateral effects of COVID-19 pandemic in children and young people. We highlight the need for urgent strategies to mitigate the risks to children due to the COVID-19 pandemic. What is Known:• Children and young people account for <2% of all COVID-19 hospital admissions• The collateral impact of COVID-19 pandemic on children and young people is devastating• Significant reduction in influenza and respiratory syncytial virus (RSV) infection in the southern hemisphere What is New:• The public health measures to reduce COVID-19 infection may have also resulted in near elimination of influenza and RSV infections across the globe• A COVID-19 vaccine has been licensed for adults. However, large scale vaccine studies are yet to be initiated although there is emerging evidence of the new SARS-COV-2 strain spreading more rapidly though young people.• Children and young people continue to bear the collateral effects of COVID-19 pandemic

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