scholarly journals Outcomes: the Battle for Hearts and Minds

2011 ◽  
Vol 93 (7) ◽  
pp. 238-240
Author(s):  
Ben Bridgewater
Keyword(s):  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Care Quality ◽  
Operative Risk ◽  
Care Quality Commission ◽  
Comparative Results ◽  
The Uk ◽  
Hearts And Minds

The cardiac surgical community in the UK has been at the forefront of collecting, analysing and publishing clinical outcomes. The outcome we have focused on is post-operative, risk-adjusted, in-hospital mortality, and comparative results for hospitals and the majority of surgeons have been published through the Care Quality Commission website since 2005.

Clinical outcomes, quality improvement and professional recertification: lessons from UK cardiac surgery

2010 ◽  
Vol 92 (5) ◽  
pp. 168-169
Author(s):  
Ben Bridgewater ◽  
Owen Nicholas ◽  
Leslie Hamilton ◽  
Graham Cooper
Keyword(s):  
Cardiac Surgery ◽  
Quality Improvement ◽  
Clinical Outcomes ◽  
Healthcare Professionals ◽  
Care Quality ◽  
Published Data ◽  
Form Part ◽  
Care Quality Commission ◽  
The Uk ◽  
Cardiac Surgeons

At the time of writing this paper, mortality outcomes for cardiac surgeons in the UK are being updated on the Care Quality Commission (CQC) website. The initial clamour for results to become available followed events in paediatric cardiac surgery at Bristol and recommendations from the subsequent inquiry (see http://www.bristol-inquiry.org.uk/). A decade later these published data remain unique in British medicine. More recently legislation was introduced to regulate healthcare professionals and outcomes data will form part of the evidence required. What are the lessons from cardiac surgery?

Do we need medical leadership or medical engagement?

2015 ◽  
Vol 28 (3) ◽  
pp. 173-184 ◽  
Author(s):  
Peter Spurgeon ◽  
Paul Long ◽  
John Clark ◽  
Frank Daly
Keyword(s):  
Care Quality ◽  
Current Evidence ◽  
Organisational Performance ◽  
Content Type ◽  
Care Quality Commission ◽  
The Uk ◽  
Medical Leadership ◽  
First Time ◽  
Practical Implications ◽  
A Current

Purpose – The purpose of this paper is to address issues of medical leadership within health systems and to clarify the associated conceptual issues, for example, leadership versus management and medical versus clinical leadership. However, its principle contribution is to raise the issue of the purpose or outcome of medical leadership, and, in this respect, it argues that it is to promote medical engagement. Design/methodology/approach – The approach is to provide evidence, both from the literature and empirically, to suggest that enhanced medical engagement leads to improved organisational performance and, in doing so, to review the associated concepts. Findings – Building on current evidence from the UK and Australia, the authors strengthen previous findings that effective medical leadership underpins the effective organisational performance. Research limitations/implications – There is a current imbalance between the size of the databases on medical engagement between the UK (very large) and Australia (small but developing). Practical implications – The authors aim to equip medical leaders with the appropriate skill set to promote and enhance greater medical engagement. The focus of leaders in organisations should be in creating a culture that fosters and supports medical engagement. Social implications – This paper provides empowerment of medical professionals to have greater influence in the running of the organisation in which they deliver care. Originality/value – The paper contains, for the first time, linked performance data from the Care Quality Commission in the UK and from Australia with the new set of medical engagement findings.

scholarly journals SP4.2.8 Does Care quality commission need to change its inspection strategy after COVID-19?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shruti Bodapati ◽  
Raghvinder Gambhir
Keyword(s):  
Care Quality ◽  
Specific Domain ◽  
Care Treatment ◽  
Time Period ◽  
Inspection Strategy ◽  
Care Quality Commission ◽  
The Uk ◽  
Effective Domain

Abstract Aim To see if the Care quality commission’s (CQC) overall inspection ratings and specific domain ratings had any association with COVID-19 related deaths. Methods We looked at CQC ratings of the Shelford group of trusts and 10 trusts with maximum number of deaths in the time period from the first wave till 23rd January 2021. We then looked at each of the 5 domains: safe, effective, caring, responsive, and well led, to see if they were in any way indicative of the number of deaths in that trust. Results Among the 19 trusts studied (one trust featured in both groups) only 1 had an overall outstanding rating; 10 were rated good, 8 required improvement. None were rated inadequate in any of the domains, 16 /19 were rated good in effective domain which means “there care, treatment and support achieves good outcomes”. In safe domain 13/ the 19 were rated as requires improvement which means that “a patient may not be protected from avoidable harm”. Conclusion COVID-19 is no respecter of the CQC ratings, even if the trust was rated as well led and had good ratings in all other domains it could still have the highest mortality figures from COVID in the UK. CQC probably needs to add a 6th domain to its future inspections to assess the readiness the trusts for future Pandemics.

scholarly journals What Does a Systems Approach to Quality Improvement Look Like in Practice?

2022 ◽  
Vol 19 (2) ◽  
pp. 747
Author(s):  
Sharon J. Williams ◽  
Stephanie Best
Keyword(s):  
Quality Improvement ◽  
Systems Approach ◽  
Secondary Data ◽  
Healthcare Systems ◽  
Care Quality ◽  
Secondary Case ◽  
Care Quality Commission ◽  
Leadership Structure ◽  
The Uk

Universally improving healthcare systems is difficult to achieve in practice with organisations implementing a range of quality improvement (QI) approaches, in varying and changing contexts, and efforts ranging from project-based improvements to whole system change. This study aimed to identify how organisations overcome the challenges to improving the quality of the services they deliver. Drawing on the eight challenges from the ‘Quality and Safety in Europe by Research (QUASER) hospital guide, we assessed eight cases reported by the UK-based regulator Care Quality Commission as improving their performance. A thematic analysis of these secondary data established that all eight challenges had been addressed or considered in varying degrees. Education and physical and technological challenges seemed less prominent than developments made to address other challenges such as developing leadership, structure, and culture to support improving quality. This paper relies on the analysis of secondary case data and one framework to assess improvement efforts. Further research is required to consider other models and frameworks and to collate longitudinal data to capture the dynamics and increasing the maturity of improving healthcare systems in practice.

Strengthening independent opinion in dentistry

2011 ◽  
Vol 93 (6) ◽  
pp. 210-210
Author(s):  
Charlotte Worker
Keyword(s):  
Dental Care ◽  
Care Quality ◽  
Delivery Of Healthcare ◽  
Quality Outcomes ◽  
Structure Quality ◽  
Major Significance ◽  
Care Quality Commission ◽  
Dental Practices ◽  
The Uk

Not for many years has the structure, quality and delivery of healthcare in the UK been subject to the degree of scrutiny we have seen in recent months. Plans have been set out that would see the NHS focus on quality outcomes, with a number of implications for the commissioning and delivery of, and access to, NHS dental care. Also of major significance are proposals by the General Dental Council (GDC) to introduce a system of revalidation for dentists, and the requirement for all dental practices to be registered with the Care Quality Commission by April 2011.

The ENGAGED framework: a qualitative study of the current use of social media by NHS trusts (Preprint)

2020 ◽  
Author(s):  
Sonika Sethi ◽  
Sharukh Zuberi ◽  
Nishma Gokani ◽  
Rosie Bhogal ◽  
Shaneil Tanna ◽  
...  
Keyword(s):  
Social Media ◽  
Media Use ◽  
Care Quality ◽  
Theory Approach ◽  
Structured Interviews ◽  
Social Media Use ◽  
Quality Ratings ◽  
Care Quality Commission ◽  
Use Of Social Media ◽  
The Uk

BACKGROUND The number of social media users in the UK is rapidly rising. However, there is a lack on primary research as to how the National Health Service (NHS) is using social media to engage patients and the public. OBJECTIVE To understand the current methodology, implementation and strategy of social media use within NHS Trusts. METHODS A qualitative grounded theory approach was taken through semi-structured interviews with NHS Trusts. Selection was based on the Trusts quality ratings by the Care Quality Commission (CQC) in 2017, selecting the highest 15 and lowest 15 ranked trusts. Telephone interviews were conducted with a member of the communication teams and were audio recorded then transcribed. Three independent researchers thematically analysed the transcripts, to draw themes that emerged from the transcripts. RESULTS Following a pilot study, we conducted interviews with the communications team of 27 NHS trusts across the UK. Six main themes arose from the interviews: 1) The social media and communications teams; 2)The Trust; 3) The Trusts’ use of social media; 4)The Trusts’ management of their social media ; 5)The future of social media; 6)The use of social media within the NHS). These six higher themes consisted of a total of 26 subthemes. CONCLUSIONS The themes allow us to understand how social media is currently used within the NHS, as well as its potential future scope. Recognising the main areas of importance to Trusts and current difficulties they are facing, allow us to explore ways of increasing social media use by NHS Trusts. We have proposed a set of guidelines, known as the ENGAGED framework, which trusts can use to enhance social media use and enagagement. CLINICALTRIAL Nil

Factors associated with satisfaction of inpatient psychiatric care: a cross country comparison

2019 ◽  
Vol 50 (2) ◽  
pp. 284-292 ◽  
Author(s):  
Victoria Bird ◽  
Elisabetta Miglietta ◽  
Domenico Giacco ◽  
Michael Bauer ◽  
Lauren Greenberg ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Clinical Outcomes ◽  
Inpatient Care ◽  
Psychiatric Inpatient ◽  
Patient Characteristics ◽  
Care Quality ◽  
Severe Illness ◽  
Inpatient Psychiatric Care ◽  
Education Levels ◽  
The Uk

AbstractBackgroundPatient satisfaction is a key indicator of inpatient care quality and is associated with clinical outcomes following admission. Different patient characteristics have been inconsistently linked with satisfaction. This study aims to overcome previous limitations by assessing which patient characteristics are associated with satisfaction within a large study of psychiatric inpatients conducted across five European countries.MethodsAll patients with a diagnosis of psychotic (F2), affective (F3) or anxiety/somataform (F4) disorder admitted to 57 psychiatric inpatient units in Belgium, Germany, Italy, Poland and the UK were included. Data were collected from medical records and face-to-face interviews, with patients approached within 2 days of admission. Satisfaction with inpatient care was measured on the Client Assessment of Treatment Scale.ResultsHigher satisfaction scores were associated with being older, employed, living with others, having a close friend, less severe illness and a first admission. In contrast, higher education levels, comorbid personality disorder and involuntary admission were associated with lower levels of satisfaction. Although the same patient characteristics predicted satisfaction within the five countries, there were significant differences in overall satisfaction scores across countries. Compared to other countries, patients in the UK were significantly less satisfied with their inpatient care.ConclusionsHaving a better understanding of patient satisfaction may enable services to improve the quality of care provided as well as clinical outcomes for all patients. Across countries, the same patient characteristics predict satisfaction, suggesting that similar analytical frameworks can and should be used when assessing satisfaction both nationally and internationally.

scholarly journals The legal duty of candour in healthcare: the lessons of history?

2019 ◽  
Vol 70 (1) ◽  
pp. 77-92
Author(s):  
Catherine Kelly ◽  
Oliver Quick
Keyword(s):  
Social Care ◽  
Medical Profession ◽  
Care Quality ◽  
Standards Of Care ◽  
Professional Relationships ◽  
Statutory Duty ◽  
Health And Social Care ◽  
Care Quality Commission ◽  
Legal Duty ◽  
The Uk

Providers of health and social care in England are under a statutory duty to be open and honest with patients who suffer harm when receiving care or treatment. This ‘duty of candour’ was introduced by regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and is one of 13 fundamental standards of care regulated by the Care Quality Commission (CQC). This was hailed as a landmark for openness in patient–professional relationships and as having the potential for enhancing a safety culture in healthcare. However, the decision to supplement existing ethical duties and policy initiatives encouraging openness with a statutory duty was contentious and encountered considerable medical resistance. This paper will trace the background to the legal duty, analyse its contents and consider its enforcement and potential obstacles to its effectiveness. Our analysis will foreground resistance based in practitioners’ and healthcare institutions’ fear of litigation and prosecution in the UK. However, opposition to candour emerged within the medical profession prior to the emergence of modern liability systems. This paper will argue that in order to create a culture of candour it is important to look beyond the more commonly identified professional concerns about litigation and understand these historical trends. In particular, we argue that a longer-term understanding of medical resistance to openness has important lessons for the likely effectiveness of the legal duty of candour.

Risk factors and clinical outcomes associated with blood culture contamination

2021 ◽  
pp. 1-7
Author(s):  
Justin M. Klucher ◽  
Kevin Davis ◽  
Mrinmayee Lakkad ◽  
Jacob T. Painter ◽  
Ryan K. Dare
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Blood Culture ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Tertiary Care ◽  
Blood Cultures ◽  
Hospital Charges ◽  
Patient Specific ◽  
Contaminated Blood

Abstract Objective: To determine patient-specific risk factors and clinical outcomes associated with contaminated blood cultures. Design: A single-center, retrospective case-control risk factor and clinical outcome analysis performed on inpatients with blood cultures collected in the emergency department, 2014–2018. Patients with contaminated blood cultures (cases) were compared to patients with negative blood cultures (controls). Setting: A 509-bed tertiary-care university hospital. Methods: Risk factors independently associated with blood-culture contamination were determined using multivariable logistic regression. The impacts of contamination on clinical outcomes were assessed using linear regression, logistic regression, and generalized linear model with γ log link. Results: Of 13,782 blood cultures, 1,504 (10.9%) true positives were excluded, leaving 1,012 (7.3%) cases and 11,266 (81.7%) controls. The following factors were independently associated with blood-culture contamination: increasing age (adjusted odds ratio [aOR], 1.01; 95% confidence interval [CI], 1.01–1.01), black race (aOR, 1.32; 95% CI, 1.15–1.51), increased body mass index (BMI; aOR, 1.01; 95% CI, 1.00–1.02), chronic obstructive pulmonary disease (aOR, 1.16; 95% CI, 1.02–1.33), paralysis (aOR 1.64; 95% CI, 1.26–2.14) and sepsis plus shock (aOR, 1.26; 95% CI, 1.07–1.49). After controlling for age, race, BMI, and sepsis, blood-culture contamination increased length of stay (LOS; β = 1.24 ± 0.24; P < .0001), length of antibiotic treatment (LOT; β = 1.01 ± 0.20; P < .001), hospital charges (β = 0.22 ± 0.03; P < .0001), acute kidney injury (AKI; aOR, 1.60; 95% CI, 1.40–1.83), echocardiogram orders (aOR, 1.51; 95% CI, 1.30–1.75) and in-hospital mortality (aOR, 1.69; 95% CI, 1.31–2.16). Conclusions: These unique risk factors identify high-risk individuals for blood-culture contamination. After controlling for confounders, contamination significantly increased LOS, LOT, hospital charges, AKI, echocardiograms, and in-hospital mortality.

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