scholarly journals Identifying avoidable switchboard delays in England’s NHS hospitals: phase one of the national SWITCH project

2019 ◽  
Vol 18 (4) ◽  
pp. 210-215
Author(s):  
Rahul Ghelani ◽  
◽  
Edd Maclean ◽  
Myra Adra ◽  
Sarah Anderson ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Quality Improvement ◽  
Infection Control ◽  
Patient Care ◽  
Improve Patient Care ◽  
Acute Hospital ◽  
Mean Delay ◽  
The Mean ◽  
Hospital Communication ◽  
Improve Patient

Background: Inter-hospital communication frequently requires mediation via a switchboard. Identifying and eliminating switchboard inefficiencies may improve patient care. Methods: All 175 acute hospital switchboards in England were contacted six times. Call contents and duration were recorded. No clinician calls or bleeps were connected. Results: The mean delay before contacting a switchboard operative was 55±46 seconds. 115 hospitals (66%) used automated switchboards; 34 of these (30%) had infection control messages. Robot operators introduced an additional 40 second delay versus humans (mean 70.3±28 versus 29.8±23 seconds, p<0.0001). Multivariate analysis identified robot operators (HR 5.1, p<0.0001) and infection control messages (HR 2.9, p=0.003) as predictors of delays over 60 seconds. Conclusions: There are significant avoidable delays in contacting switchboard operatives across England. Quality improvement is underway.

scholarly journals P108: Characterizing use of next-day ultrasound from the emergency department

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S103
Author(s):  
C. Roberts ◽  
T. Oyedokun ◽  
B. Cload ◽  
L. Witt
Keyword(s):  
Emergency Department ◽  
Patient Care ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Improve Patient Care ◽  
Additional Stress ◽  
Start Date ◽  
The Mean ◽  
Tertiary Care Hospitals ◽  
Improve Patient

Introduction: Formal ultrasound imaging, with use of ultrasound technicians and radiologists, provides a valuable diagnostic component to patient care in the Emergency Department (ED). Outside of regular weekday hours, ordering formal ultrasounds can produce logistical difficulties. EDs have developed protocols for next-day ultrasounds, where the patient returns the following day for imaging and reassessment by an ED physician. This creates additional stress on ED resources – personnel, bed space, finances – that are already strained. There is a dearth of literature regarding the use of next-day ultrasounds or guidelines to direct efficient use. This study sought to accumulate data on the use of ED next-day ultrasounds and patient oriented clinical outcomes. Methods: This study was a retrospective chart review of 150 patients, 75 from each of two different tertiary care hospitals in Saskatoon, Saskatchewan. After a predetermined start date, convenience samples were collected of all patients who had undergone a next-day ultrasound ordered from the ED until the quota was satisfied. Patients were identified by an electronic medical record search for specific triage note phrases indicating use of next-day ultrasounds. Different demographic, clinical, and administrative parameters were collected and analyzed. Results: Of the 150 patients, the mean age was 35.9 years and 75.3% were female. Median length of stay for the first visit was 4.1 hours, and 2.2 hours for the return visit. Most common ultrasound scans performed were abdomen and pelvis/gyne (34.7%), complete abdomen (30.0%), duplex extremity venous (10.0%). Most common indications on the ultrasound requisition were nonspecific abdominal pain (18.7%), vaginal bleeding with or without pregnancy (17.3%), and hepatobiliary pathology (15.3%). Ultrasounds results reported a relevant finding 56% of the time, and 34% were completely normal. After the next-day ultrasound 5.3% of patients had a CT scan, 10.7% had specialist consultation, 8.2% were admitted, and 7.3% underwent surgery. Conclusion: Information was gathered to close gaps in knowledge about the use of next-day ultrasounds from the ED. A large proportion of patients are discharged home without further interventions. Additional research and the development of next-day ultrasound guidelines or outpatient pathways may improve patient care and ED resource utilization.

scholarly journals Exploring nurses’ experiences of value congruence and the perceived relationship with wellbeing and patient care and safety: a qualitative study

2021 ◽  
pp. 174498712097617
Author(s):  
Alice Dunning ◽  
Gemma Louch ◽  
Angela Grange ◽  
Karen Spilsbury ◽  
Judith Johnson
Keyword(s):  
Patient Care ◽  
Work Environment ◽  
Thematic Analysis ◽  
Value Congruence ◽  
Improve Patient Care ◽  
Acute Hospital ◽  
Telephone Interviews ◽  
Organisational Values ◽  
The Uk ◽  
Improve Patient

Background Values are of high importance to the nursing profession. Value congruence is the extent to which an individual’s values align with the values of their organisation. Value congruence has important implications for job satisfaction. Aim This study explored nurse values, value congruence and potential implications for individual nurses and organisations in terms of wellbeing and patient care and safety. Method Fifteen nurses who worked in acute hospital settings within the UK participated in semi-structured telephone interviews. Thematic analysis was utilised to analyse the data. Results Four themes were identified: organisational values incongruent with the work environment; personal and professional value alignment; nurse and supervisor values in conflict; nurses’ values at odds with the work environment. Perceived value incongruence was related to poorer wellbeing, increased burnout and poorer perceived patient care and safety. The barriers identified for nurses being able to work in line with their values are described. Conclusions Value congruence is important for nurse wellbeing and patient care and safety. Improving the alignment between the values that organisations state they hold, and the values implied by the work environment may help improve patient care and safety and support nurses in practice.

scholarly journals Utilizing Quality Improvement Methods to Improve Patient Care Outcomes in a Pediatric Residency Program

2009 ◽  
Vol 1 (2) ◽  
pp. 299-303 ◽  
Author(s):  
Ralitsa B. Akins ◽  
Gilbert A. Handal
Keyword(s):  
Quality Improvement ◽  
Patient Care ◽  
Residency Program ◽  
Improve Patient Care ◽  
Resident Training ◽  
Lessons Learned ◽  
Residency Programs ◽  
Pediatric Residency ◽  
Care Outcomes ◽  
Improve Patient

Abstract Objective Although there is an expectation for outcomes-oriented training in residency programs, the reality is that few guidelines and examples exist as to how to provide this type of education and training. We aimed to improve patient care outcomes in our pediatric residency program by using quality improvement (QI) methods, tools, and approaches. Methods A series of QI projects were implemented over a 3-year period in a pediatric residency program to improve patient care outcomes and teach the residents how to use QI methods, tools, and approaches. Residents experienced practice-based learning and systems-based assessment through group projects and review of their own patient outcomes. Resident QI experiences were reviewed quarterly by the program director and were a mandatory part of resident training portfolios. Results Using QI methodology, we were able to improve management of children with obesity, to achieve high compliance with the national patient safety goals, improve the pediatric hotline service, and implement better patient flow in resident continuity clinic. Conclusion Based on our experiences, we conclude that to successfully implement QI projects in residency programs, QI techniques must be formally taught, the opportunities for resident participation must be multiple and diverse, and QI outcomes should be incorporated in resident training and assessment so that they experience the benefits of the QI intervention. The lessons learned from our experiences, as well as the projects we describe, can be easily deployed and implemented in other residency programs.

The Hospital Epidemiologist: Practical Ideas

1995 ◽  
Vol 16 (3) ◽  
pp. 166-169
Author(s):  
Richard P. Wenzel
Keyword(s):  
Infection Control ◽  
Patient Care ◽  
Improve Patient Care ◽  
Improve Patient

AbstractThe modem hospital epidemiologist has broad perspectives and influence across clinical departmental lines. The opportunities to improve patient care by expanding traditional areas of focus beyond infection control are great. Useful skills include epidemiology, communication, and respect for colleagues.

scholarly journals Patients' Attitudes and Prior Treatments in Neuropathic Pain: A Pilot Study

2002 ◽  
Vol 7 (4) ◽  
pp. 199-203 ◽  
Author(s):  
Ian Gilron ◽  
Joan Bailey ◽  
Donald F Weaver ◽  
Robyn L Houlden
Keyword(s):  
Neuropathic Pain ◽  
Pain Management ◽  
Patient Care ◽  
Pain Control ◽  
Tricyclic Antidepressants ◽  
Improve Patient Care ◽  
Ongoing Research ◽  
Pain Duration ◽  
The Mean ◽  
Improve Patient

BACKGROUND:Ongoing research continues to expand the knowledge of neuropathic pain. It is vital that established treatments and valuable discoveries ultimately improve patient care.OBJECTIVES:Attitudes and prior treatments of patients being screened for neuropathic pain trials were evaluated to provide further understanding of the barriers to the management of neuropathic pain.METHODS:A questionnaire was completed by patients with neuropathic pain who were either referred by local physicians or self referred in response to clinical trial advertisements from the authors' facility.RESULTS:In total, 151 patients completed the questionnaire. Diagnoses included diabetic neuropathy (55.6%), postherpetic neuralgia (29.8%), idiopathic peripheral neuropathy (9.3%) and others (5.3%). The mean pain duration was 4.7 years, and the mean daily pain (on a score of 0 to 10) was 7.6. During questioning, 72.8% complained of inadequate pain control and 25.2% had never tried any antineuropathic analgesics (tricyclic antidepressants, opioids or anticonvulsants). New antineuropathic analgesics (eg, gabapentin) were being used by only 16.6%. Opioids, tricyclic antidepressants and anticonvulsants had never been tried by 41.1%, 59.6% and 72.2%, respectively. Fears of addiction and adverse effects were expressed by 31.8% and 48.3%, respectively.CONCLUSIONS:New, and even conventional, therapies are often not pursued, despite inadequate pain control. Several issues are discussed, including patient barriers to seeking pain management, patient and physician barriers to analgesic drug therapy, and appropriate use of and access to multidisciplinary pain centres. Failure to implement therapeutic advances in pain management not only hinders improvement in patient care, but also may render futile decades of research. Widespread professional, patient and public education, as well as continued interdisciplinary research on treatment barriers, is essential.

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