scholarly journals Evaluating quality improvement at scale: design considerations for routine reporting to executive board of a healthcare organisation in the UK National Health Service

2020 ◽  
Author(s):  
Kia-Chong Chua ◽  
Claire Henderson ◽  
Barbara Grey ◽  
Michael Holland ◽  
Nick Sevdalis
Keyword(s):  
Quality Improvement ◽  
National Health Service ◽  
Health Service ◽  
Healthcare Organisation ◽  
Retrospective Evaluation ◽  
Executive Board ◽  
Project Outcomes ◽  
Uk National Health Service ◽  
The Uk

Abstract Background Quality improvement (QI) in healthcare is a cultural transformation process that requires long-term commitment from the executive board, a critical theme in emerging accounts of QI success in the UK National Health Service (NHS). To help sustain long-term commitment from the executive board, an organisation-wide picture of QI applications and their impact needs to be made routinely visible.Method We developed a retrospective evaluation drawing inputs from the resident QI team of a healthcare organisation and academic colleagues in the field of implementation and improvement science, as well as peer-reviewed and grey literature on what constitutes success for QI in healthcare. Formative feedback on content relevance, acceptability, and feasibility issues were used to guide evaluation design. The evaluation was conducted as an online survey so that the data accrual process resembles routine reporting to help surface implementation challenges. A purposive sample of QI projects was identified to maximise contrast between projects that were or were not successful as determined by the resident QI team. To hone strategic focus in what should be reported, we also compared factors that might affect project outcomes. For understanding implementation issues, we reviewed data quality to surface challenges in the design and sustainability of routine reporting for the executive board.Results Out of 52 QI projects, 10 led to a change in routine practice (henceforth referred to as adoption). Details of project outcomes were limited. Project team outcomes, indicative of capacity building, were not systematically documented. Service user involvement, quality of measurement plan, fidelity and documentation of plan-do-study-act (PDSA) cycles had a major impact on adoption. The proximal impact of these process factors on adoption was consistently more apparent than the distal impact of input and contextual factors.Conclusions Designing a routine reporting framework is an iterative process involving continual dialogue with frontline staff and improvement specialists to navigate data accrual demands. A retrospective evaluation, as in this study, can yield empirical insights for dialogue about the routine visibility of QI applications and their organisation-wide impact, thereby honing the implementation science of QI in a healthcare organisation.

scholarly journals Evaluating Quality Improvement at Scale: Design Considerations for Routine Reporting to Executive Board of a Healthcare Organisation in the UK National Health Service

2020 ◽  
Author(s):  
Kia-Chong Chua ◽  
Claire Henderson ◽  
Barbara Grey ◽  
Michael Holland ◽  
Nick Sevdalis
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Healthcare Organisation ◽  
Retrospective Evaluation ◽  
Executive Board ◽  
Project Outcomes ◽  
Uk National Health Service ◽  
The Uk

Abstract BackgroundQuality improvement (QI) in healthcare is a cultural transformation process that requires long-term commitment from the executive board, a critical theme in emerging accounts of QI success in the UK National Health Service (NHS). To help sustain long-term commitment from the executive board, an organisation-wide picture of QI applications and their impact needs to be made routinely visible.MethodWe developed a retrospective evaluation drawing inputs from the resident QI team of a healthcare organisation and academic colleagues in the field of implementation and improvement science, as well as peer-reviewed and grey literature on what constitutes success for QI in healthcare. Formative feedback on content relevance, acceptability, and feasibility issues were used to guide evaluation design. The evaluation was conducted as an online survey so that the data accrual process resembles routine reporting to help surface implementation challenges. A purposive sample of QI projects was identified to maximise contrast between projects that were or were not successful as determined by the resident QI team. To hone strategic focus in what should be reported, we also compared factors that might affect project outcomes. For understanding implementation issues, we reviewed data quality to surface challenges in the design and sustainability of routine reporting for the executive board.ResultsOut of 52 QI projects, 10 led to a change in routine practice (henceforth referred to as adoption). Details of project outcomes were limited. Project team outcomes, indicative of capacity building, were not systematically documented. Service user involvement, quality of measurement plan, fidelity and documentation of plan-do-study-act (PDSA) cycles had a major impact on adoption. The proximal impact of these process factors on adoption was consistently more apparent than the distal impact of input and contextual factors.ConclusionsDesigning a routine reporting framework is an iterative process involving continual dialogue with frontline staff and improvement specialists to navigate data accrual demands. A retrospective evaluation, as in this study, can yield empirical insights for dialogue about the routine visibility of QI applications and their organisation-wide impact, thereby honing the implementation science of QI in a healthcare organisation.

National trends and cost of litigation in UK National Health Service (NHS): a specialty-specific analysis from the past decade

2021 ◽  
Vol 66 (4) ◽  
pp. 168-174
Author(s):  
Jenni Lane ◽  
Rahul Bhome ◽  
Bhaskar Somani
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Financial Burden ◽  
Total Annual Cost ◽  
Legal Reforms ◽  
Specific Analysis ◽  
Uk National Health Service ◽  
The Uk ◽  
National Trends

Background and aims Medical litigation claim and costs in UK are rising. This study aims to analyse the 10-year trend in litigation costs for individual clinical specialties in the UK from 2009/10 to 2018/19. Methods Data were procured from National Health Service (NHS) Resolution. Number of claims, total litigation costs and cost per claim were ascertained for each financial year. The data collected also includes the number of claims and average amount per claim per speciality during the years 2009–2019 (2009/2010 to 2018/2019 financial years). Results The total annual cost of NHS litigation is currently £3.6 billion(2018/2019). Damages make up the greatest proportion of costs(£1.5 billion). Surgical specialties have the greatest number of claims annually(2847) but Obstetrics has the greatest total litigation(£1.9 billion) and cost per claim(£2.6 million). Number of claims, total costs and cost per claim are significantly greater in 2018/2019 than in 2009/2010. Conclusions Addressing the issue of litigations is complex. Medically there are speciality specific issues that require attention, whilst some general measures are common to all: effective communication, setting realistic targets and maintaining a motivated, adequately staffed workforce. These, alongside legal reforms, may reduce the financial burden of increasing litigation on the NHS.

scholarly journals Pharmacogenomics in the UK National Health Service: opportunities and challenges

2020 ◽  
Vol 21 (17) ◽  
pp. 1237-1246
Author(s):  
Richard M Turner ◽  
William G Newman ◽  
Elvira Bramon ◽  
Christine J McNamee ◽  
Wai Lup Wong ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Genomic Medicine ◽  
Improve Patient Care ◽  
Healthcare Sector ◽  
Patient Representatives ◽  
To Come ◽  
Uk National Health Service ◽  
The Uk

Despite increasing interest in pharmacogenomics, and the potential benefits to improve patient care, implementation into clinical practice has not been widespread. Recently, there has been a drive to implement genomic medicine into the UK National Health Service (NHS), largely spurred on by the success of the 100,000 Genomes Project. The UK Pharmacogenetics and Stratified Medicine Network, NHS England and Genomics England invited experts from academia, the healthcare sector, industry and patient representatives to come together to discuss the opportunities and challenges of implementing pharmacogenomics into the NHS. This report highlights the discussions of the workshop to provide an overview of the issues that need to be considered to enable pharmacogenomic medicine to become mainstream within the NHS.

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