Hip fracture in the COVID-19 era: what can we say about care and patient outcomes?
Hip fractures remain an important public health issue, being the most common reason for emergency anaesthesia and surgery in older people. Following the start of the COVID-19 pandemic in March 2020, hospitals in many countries observed considerable reductions in admissions for acute medical conditions such as stroke and acute myocardial infarction1 2 but not for falls in older adults.3 Nevertheless, the pandemic greatly affected care for patients with hip fractures in the first wave, both directly for those patients who also were infected with COVID-19 before admission and indirectly, as staff were redeployed to deal with ...
Source: Quality and Safety in Health Care - April 19, 2023 Category: Health Management Authors: Bottle, A., Liddle, A. Tags: COVID-19 Editorials Source Type: research
Nurse staffing and patient safety in acute hospitals: Cassandra calls again?
The risk of adverse patient outcomes, including death, is lower in hospitals that provide more registered nurses to care for patients on inpatient wards. The association has been demonstrated in a body of evidence comprising several hundred studies, involving hundreds of hospitals and millions of patients from around the world. The association has been shown at hospital level in large cross-sectional studies and in a growing number of longitudinal studies examining the effect of variation in staffing experienced by individuals.1–3 In the context of such an extensive body of evidence, one might ask what could possibly...
Source: Quality and Safety in Health Care - April 19, 2023 Category: Health Management Authors: Griffiths, P., Dall'Ora, C. Tags: Editorials Source Type: research
Communication about sexual orientation and gender between clinicians, LGBT+ people facing serious illness and their significant others: a qualitative interview study of experiences, preferences and recommendations
Conclusions
Person-centred care can be enhanced by incorporating discussions about sexual orientation and gender identity into routine clinical practice. Inclusive language and sensitive exploration of relationships and identities are core activities. Institutions need to support clinicians through provision of adequate training, resources, inclusive monitoring systems, policies and structures. Ten inclusive communication recommendations are made based on the data. (Source: Quality and Safety in Health Care)
Source: Quality and Safety in Health Care - January 19, 2023 Category: Health Management Authors: Braybrook, D., Bristowe, K., Timmins, L., Roach, A., Day, E., Clift, P., Rose, R., Marshall, S., Johnson, K., Sleeman, K. E., Harding, R. Tags: Open access, Editor's choice Original research Source Type: research
Retrospective evaluation of an intervention based on training sessions to increase the use of control charts in hospitals
Conclusions
The results suggest that a scalable educational training initiative to improve use of SPCs within organisations can be effective. Future research could aim to overcome the limitations of observational research with an experimental design or seek to better understand mechanisms, decision-making and patient outcomes. (Source: Quality and Safety in Health Care)
Source: Quality and Safety in Health Care - January 19, 2023 Category: Health Management Authors: Kudrna, L., Bird, P., Hemming, K., Quinn, L., Schmidtke, K., Lilford, R. Tags: Open access Original research Source Type: research
Evaluation of the NHS England evidence-based interventions programme: a difference-in-difference analysis
Conclusions
Our analysis shows that the EBI programme did not accelerate disinvestment for procedures under its remit during our period of analysis. However, we find that financial and organisational factors may have had some influence on the degree of responsiveness to the EBI programme. (Source: Quality and Safety in Health Care)
Source: Quality and Safety in Health Care - January 19, 2023 Category: Health Management Authors: Anderson, M., Molloy, A., Maynou, L., Kyriopoulos, I., McGuire, A., Mossialos, E. Tags: Open access Original research Source Type: research
National improvements in resident physician-reported patient safety after limiting first-year resident physicians extended duration work shifts: a pooled analysis of prospective cohort studies
Conclusions
These findings have broad relevance for those who work in and receive care from academic hospitals in the USA. The decision to lift this work hour policy in 2017 may expose patients to preventable harm. (Source: Quality and Safety in Health Care)
Source: Quality and Safety in Health Care - January 19, 2023 Category: Health Management Authors: Weaver, M. D., Landrigan, C. P., Sullivan, J. P., O'Brien, C. S., Qadri, S., Viyaran, N., Czeisler, C. A., Barger, L. K. Tags: Open access Original research Source Type: research
You can lead clinicians to water, but you cant make them drink: the role of tailoring in clinical performance feedback to improve care quality
Introduction Health systems worldwide are focused on improving patient and population healthcare outcomes. Data are increasingly leveraged to support these aims, including clinical performance feedback (CPF) initiatives that provide clinicians with data on how often their patients are receiving evidence-based care compared with a specific improvement goal, which may reflect a standardised target or how they perform in comparison to their peers.1 2 Unfortunately, engagement with and impact of providing data is variable. We need to tailor data to the nature of its clinician recipients in the same way we tailor the nature of ...
Source: Quality and Safety in Health Care - January 19, 2023 Category: Health Management Authors: Desveaux, L., Rosenberg-Yunger, Z. R. S., Ivers, N. Tags: Viewpoints Source Type: research
Monitoring patients sexual orientation and gender identity: Can we ask? Should we ask? How do we ask?
Monitoring patients’ sexual orientation and gender identity: can we ask? should we ask? how do we ask? There is a growing body of research which evidences that lesbian, gay, bisexual and/or transgender (LGBT+) people experience significant health inequalities.1 We know that LGBT+ individuals may have encountered accumulative experiences of stigma and discrimination across their lives, which can have a negative impact on their health and can even have some bearing on their life expectancy.2 The fear of stigma and discrimination can also impact on LGBT+ people accessing timely healthcare. Furthermore, there are barrier...
Source: Quality and Safety in Health Care - January 19, 2023 Category: Health Management Authors: Almack, K. Tags: Editorials Source Type: research
'Show me the data! Using time series to display performance data for hospital boards
Core to the role of a hospital board is establishing organisational strategy and multi-year priorities, ensuring processes are in place for risk prevention and mitigation, and overseeing progress on strategic outcomes relevant to multiple quality domains. This role is distinct from that of the hospital management team (comprised of managers and clinical and operational leaders) that is responsible for daily operations and implementing the hospital’s strategic plan.1 While senior executives such as Chief Executive Officers may sit on both boards and management teams in some countries (such as the UK and Canada), the r...
Source: Quality and Safety in Health Care - January 19, 2023 Category: Health Management Authors: Soong, C., Bell, C. M., Blackstien-Hirsch, P. Tags: Editorials Source Type: research
Top-down and bottom-up approaches to low-value care
Low-value care refers to tests or treatments for which there is little evidence of benefit or more harm than benefit, which can result in poor patient outcomes such as unwarranted secondary tests or adverse events. In this context, inefficient use of scarce healthcare resources threatens the sustainability of healthcare systems and low-value care is an obvious target. About 25%–30% of all care has been estimated to be of low value in countries such as Australia, Canada, Spain, Brazil and the USA, and this estimate rises to 80% for certain procedures.1 There is increasing interest to identify areas of low-value care b...
Source: Quality and Safety in Health Care - January 19, 2023 Category: Health Management Authors: Patey, A. M., Soong, C. Tags: Editorials Source Type: research
Impact of medical education on patient safety: finding the signal through the noise
Medical education and patient care are inextricably linked. At this time, with the limitations of simulation training and our continued dependence on educated physicians for clinical decision-making, one domain cannot exist without the other. The involvement of medical trainees in patient care means it is vital that the impact of changes to medical training programmes on patient outcomes are assessed with well-designed studies. The study, "National improvements in resident physician-reported patient safety after limiting first-year resident physicians’ extended duration work shifts,"1 by Weaver and colleagues publish...
Source: Quality and Safety in Health Care - January 19, 2023 Category: Health Management Authors: Hwang, J., Kelz, R. Tags: Editorials Source Type: research
Medication-related interventions to improve medication safety and patient outcomes on transition from adult intensive care settings: a systematic review and meta-analysis
Conclusions
Multicomponent interventions based on education of staff and guidelines were effective at achieving almost four times more de-prescribing of inappropriate medication by the time of patient hospital discharge. Based on the findings, practice and policy recommendations are made and guidance is provided on the need for, and design of theory informed interventions in this area, including the requirement for process and economic evaluations. (Source: Quality and Safety in Health Care)
Source: Quality and Safety in Health Care - July 19, 2022 Category: Health Management Authors: Bourne, R. S., Jennings, J. K., Panagioti, M., Hodkinson, A., Sutton, A., Ashcroft, D. M. Tags: Open access Systematic review Source Type: research
Evaluating patient-reported outcome measures in Peru: a cross-sectional study of satisfaction and net promoter score using the 2016 EnSuSalud survey
Conclusion
While satisfaction and NPS were broadly similar at an individual level, this evidence suggests NPS may be useful for benchmarking facility performance as part of national efforts in Peru and throughout Latin America to identify deficits in health service quality. (Source: Quality and Safety in Health Care)
Source: Quality and Safety in Health Care - July 19, 2022 Category: Health Management Authors: Leslie, H. H., Lee, H.-Y., Blouin, B., Kruk, M. E., Garcia, P. J. Tags: Open access Original research Source Type: research
Socioeconomic deprivation and ethnicity inequalities in disruption to NHS hospital admissions during the COVID-19 pandemic: a national observational study
Conclusions
Even in a healthcare system founded on the principle of equal access for equal need, the impact of COVID-19 on NHS hospital care for non-COVID patients has not been spread evenly by ethnicity and deprivation in England. While we cannot conclusively determine the mechanisms behind these differences, they risk exacerbating prepandemic health inequalities. (Source: Quality and Safety in Health Care)
Source: Quality and Safety in Health Care - July 19, 2022 Category: Health Management Authors: Warner, M., Burn, S., Stoye, G., Aylin, P. P., Bottle, A., Propper, C. Tags: Open access, Editor's choice, COVID-19 Original research Source Type: research
Concordance with urgent referral guidelines in patients presenting with any of six 'alarm features of possible cancer: a retrospective cohort study using linked primary care records
Conclusions
Guideline recommendations for action are not followed for the majority of patients presenting with common possible cancer features. A significant number of these patients developed cancer within 1 year of their consultation, indicating scope for improvement in the diagnostic process. (Source: Quality and Safety in Health Care)
Source: Quality and Safety in Health Care - July 19, 2022 Category: Health Management Authors: Wiering, B., Lyratzopoulos, G., Hamilton, W., Campbell, J., Abel, G. Tags: Open access, Press releases Original research Source Type: research
