Hospital finances and productivity: in a critical condition? – The Health Foundation – April 2015

Posted on April 15, 2015. Filed under: Health Economics | Tags: |

Hospital finances and productivity: in a critical condition? – The Health Foundation – April 2015

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Constructive comfort: accelerating change in the NHS – The Health Foundation – February 2015

Posted on February 27, 2015. Filed under: Health Mgmt Policy Planning | Tags: , , |

Constructive comfort: accelerating change in the NHS – The Health Foundation – February 2015

How can the NHS become better at change? – news release – The Health Foundation – February 2015

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A quick guide to person-centred care – The Health Foundation – October 2014

Posted on October 31, 2014. Filed under: Patient Participation | Tags: |

A quick guide to person-centred care – The Health Foundation – October 2014

“Despite a growing recognition of the need for care to be more person-centred, there remains a gap between the commitment to a person-centred approach and the reality on the ground.
Person-centred care is hard to define. Instead, we have identified a framework that outlines its four main principles.
There is a strong argument for adopting more person-centred approaches, including improved clinical and health outcomes, better value for money and happier patients and health care staff.”

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Posted on October 14, 2014. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , , , |

Cause for concern: second annual statement – Quality Watch, The Health Foundation & Nuffield Trust – 10 October 2014

“Our second annual statement, Cause for concern, offers an independent assessment of the current quality of NHS health and social care services in England. We observe that while care quality has improved since a decade ago, the last year has seen progress in some areas slow down or begin to reverse.”

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Focus on: allied health professionals – Nuffied Trust and QualityWatch – 30 September 2014

Posted on October 1, 2014. Filed under: Allied Health, Clin Governance / Risk Mgmt / Quality | Tags: , |

Focus on: allied health professionals – Nuffied Trust and QualityWatch – 30 September 2014

“This QualityWatch report, published in partnership with the Health Foundation, explores how best the quality of care delivered by allied health professionals can be measured, and presents the key findings from the available data.”

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Focus on: A&E attendances – why are patients waiting longer? – QualityWatch – The Health Foundation & Nuffield Trust – July 2014

Posted on July 25, 2014. Filed under: Emergency Medicine | Tags: , |

Focus on: A&E attendances – why are patients waiting longer? – QualityWatch – The Health Foundation & Nuffield Trust – July 2014

Web page for the report

“Accident and emergency departments are facing unprecedented demand and making headlines by missing the high profile four-hour waiting time target. Our in-depth study looks at patterns of A&E activity, the nature of the increased demand and what has driven waiting times upwards.”

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Closing the Gap through Changing Relationships: evaluation An independent evaluation of the programme – The Health Foundation – June 2014

Posted on July 8, 2014. Filed under: Patient Participation | Tags: |

Closing the Gap through Changing Relationships: evaluation An independent evaluation of the programme – The Health Foundation – June 2014

“The Health Foundation’s Closing the Gap through Changing Relationships programme was launched in 2010. The programme funded seven projects, which aimed to change one or more of three types of relationships:

between the individual using a service and those who work in healthcare provision
between people using services and the wider healthcare system
between communities and the wider healthcare system.

This is the report of the programme evaluation carried out by the Office for Public Management (OPM). They were asked to look at

how and whether each of the projects led to relationships changing;
how change was experienced by the different actors;
the key barriers to, and promoters of, success.”

… continues on the site

 

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Spreading improvement ideas: Tips from empirical research – The Health Foundation – May 2014

Posted on May 16, 2014. Filed under: Health Systems Improvement | Tags: |

Spreading improvement ideas: Tips from empirical research – The Health Foundation – May 2014

“Within the NHS there are many pockets of good practice and examples of successful innovation and improvement. Sometimes these good ideas are not adopted by the wider system, or take a long time to spread.

This evidence scan provides examples from the published empirical literature of techniques for spreading innovation and improvement. The focus is on identifying practical things that teams and organisations can do to publicise and spread new ideas and ways of working.

The scan addresses two key questions:

What research evidence is there about the best ways to spread health care innovations and improvement?
What does the research evidence suggest contributes to the successful spread of a health care improvement or innovation?

The scan draws on the empirical research to present a number of tips for spreading good practice.”

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Skilled for improvement? Learning communities and the skills needed to improve care: an evaluative service development – The Health Foundation – March 2014

Posted on April 8, 2014. Filed under: Educ for Hlth Professions, Health Systems Improvement | Tags: |

Skilled for improvement? Learning communities and the skills needed to improve care: an evaluative service development – The Health Foundation – March 2014

“This report tells the story of the Learning Communities Initiative, in which an experienced research team used an action approach (combining action research and action learning) to study four improvement projects across two sites, while working with participants to facilitate the flow of knowledge and learning.

The report provides a graphic and illuminating description of the difficulties and barriers which arise in improvement work.

Key lessons

Key lessons identified by the authors include the following:

Applying the techniques of improvement science alone is unlikely to be sufficient to deliver sustained quality improvements in healthcare.
Any organisation wishing to improve quality – whatever its starting point – must invest in developing the three sets of skills: ‘technical’, ‘soft’ and ‘learning’ skills.
Developing these skills must be a central part of managers’ and practitioners’ roles – not just a marginal ‘add on’.
Strong and sustained institutional support is necessary to create an organisational environment that is conducive to improvement.
Improvement work should not underestimate the influence of key individuals who can either drive projects forward or hold them back.
Strong leadership is vital.
Improvement projects require in-built flexibility to adapt to changing realities.
Differences or lack of engagement and partnership working between various sectors and disciplines can determine the success of improvement interventions.
It is generally easier to move forward with an improvement project when it coincides with existing work streams.

The improvement skills pyramid

The authors identify three sets of skills – ‘technical’, ‘soft’ and ‘learning’ skills – that they found were essential for successful implementation of improvement. They use the analogy of a three-sided pyramid: to reach the point of sustained improvement (the apex of the pyramid), the organisational base (environment, culture, structures and resources) should be broad and solid enough to support the construction of the three ‘walls’ (each of the three sets of skills) to the same (maximum) height.”

… continues on the site – including a model of the improvement skills pryamid

 

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Reducing harm to patients – The Health Foundation – March 2014

Posted on April 3, 2014. Filed under: Patient Safety | Tags: |

Reducing harm to patients – The Health Foundation – March 2014

“This briefing follows a March 2014 speech by the Secretary of State for Health at Virginia Mason Medical Center in Seattle. In his speech, Jeremy Hunt MP set out a new ambition to reduce avoidable harm to patients in the NHS.

In recent years, Virginia Mason has had considerable success in delivering safe care and financial sustainability. This briefing outlines the factors that have contributed to their success, and how a similar approach has been used in the UK. It aims to help those working to improve patient safety in the NHS. The key points are:

As demonstrated by Virginia Mason in the US, and some inspiring examples in the UK, the ambition to reduce harm must be matched by the ingredients that help to deliver sustainable improvements in safety.
These ingredients include a stable and dedicated leadership team, an explicit and agreed vision for improvement, a systematic approach to engaging staff and developing their skills, and a commitment to the incremental improvement of quality.
We set out five questions that organisations should ask themselves to help make the ambition to reduce avoidable harm a reality.”

 

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Social care for older people – The Health Foundation and Nuffield Trust – 26 March 2014

Posted on March 27, 2014. Filed under: Aged Care / Geriatrics, Health Economics | Tags: , |

Social care for older people – The Health Foundation and Nuffield Trust – 26 March 2014

“Budget allocations from central Government to English local authorities were reduced by 14% in real terms between 2011/12 and 2014/15. This report asks how local authorities have responded to this decline in income and explores the possible impact on older adults’ health and wellbeing.”

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Effective networks for improvement: learning report – The Health Foundation – March 2014

Posted on March 4, 2014. Filed under: Health Systems Improvement | Tags: , |

Effective networks for improvement: learning report – The Health Foundation – March 2014

“This learning report presents the lessons from an evidence review and case study work undertaken by McKinsey Hospital Institute. The review drew on the literature and empirical evidence about effective networks to describe the component parts of a successful improvement network.

While the review found no ‘one size fits all’ formula for successful network design, it did identify five core features of effective networks. These are:

common purpose
cooperative structure
critical mass
collective intelligence
community building.

These features are interdependent, and interact to give a network energy and momentum. They ensure a clear direction, credibility and increased scale and reach, while enhancing knowledge, encouraging innovation and creating meaningful relationships. All five features are mutually reinforcing, and their combined effect enables quality improvement, learning and change to happen.”

… continues on the site

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Helping measure person-centred care – The Health Foundation – March 2014

Posted on March 4, 2014. Filed under: Health Mgmt Policy Planning, Patient Participation | Tags: , , |

Helping measure person-centred care – The Health Foundation – March 2014

“Person-centred, individualised, personalised, patient-centred, family-centred, patient-centric and many other terms have been used to signal a change in how health services engage with people. This rapid review summarises research about measuring the extent to which care is person-centred.

Three key questions guided the review:

How is person-centred care being measured in healthcare?
What types of measures are used?
Why and by whom is measurement taking place?

The review signposts to research about commonly used approaches and tools to help measure person-centred care. It aims to showcase the many tools available.

A spreadsheet listing 160 of the most commonly researched measurement tools accompanies the review. This allows users to search according to the type of tool, who it targets and the main contexts it has been tested in. Hyperlinks to the abstracts of examples of research using each tool are also provided.

The review shows that, while a large number of tools are available to measure person-centred care, there is no agreement about which tools are most worthwhile.”

 

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Closing the NHS funding gap: Can it be done through greater efficiency? – The Health Foundation – February 2014

Posted on February 28, 2014. Filed under: Health Economics | Tags: , |

Closing the NHS funding gap: Can it be done through greater efficiency? – The Health Foundation – February 2014

“Recently, the Health Foundation brought together senior health sector leaders to consider whether the NHS can close the £30bn funding gap through greater efficiency.

The discussion was stimulated by Monitor’s publication last year of Closing the NHS funding gap: how to get better value healthcare for patients which highlighted the financial challenges facing the NHS in England. The report identified four key areas where there were opportunities to make significant productivity gains across the NHS by 2021 and beyond:

improving productivity within existing services
delivering the right care in the right setting
developing new ways of delivering care
allocating spending more rationally.

While the original intention had been to focus the roundtable discussion around the 2021 challenge, it quickly became clear that there was a more immediate hurdle to clear first – the financial pressures facing the system in 2014/15 and 2015/16.

This report highlights the following key points from the presentations and discussions on the day:”

… continues on the site

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Distance from home for emergency care [UK] – Quality Watch – February 2014

Posted on February 19, 2014. Filed under: Emergency Medicine | Tags: , |

Distance from home for emergency care [UK] – Quality Watch – February 2014

“How far away from home do people receive their emergency care, and how has this changed over the past decade? It is important that we have a clear picture of the distances involved in accessing emergency care in order to understand the impact of changes in hospital and A&E locations.”

Report –  developed in partnership by the Nuffield Trust and the Health Foundation

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Using clinical communities to improve quality – The Health Foundation – December 2013

Posted on December 20, 2013. Filed under: Clin Governance / Risk Mgmt / Quality, Health Systems Improvement | Tags: |

Using clinical communities to improve quality – The Health Foundation – December 2013

“Gaps are often found between how healthcare should be delivered, as defined by high-quality evidence, and the care that patients actually receive. Closing these gaps is an important priority for health systems everywhere. But finding the right structures to facilitate improvement is not easy.

This report introduces an approach – the clinical community – used by the Health Foundation’s Closing the Gap through Clinical Communities programme to support and secure improvements in health systems across multiple sites. The programme supported 11 clinical communities to come together around shared goals, to learn from each other but with the latitude to develop and apply local solutions. The programme has led to a range of improvements in the quality of care which continue to be sustained today.

Drawing on the evaluation of the programme, the report outlines ten key lessons for getting the approach to work in practice and avoiding potential pitfalls:”

… continues on the site

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Developing an early warning system for hospital staffing levels – The Health Foundation – December 2013

Posted on December 19, 2013. Filed under: Patient Safety, Workforce | Tags: |

Developing an early warning system for hospital staffing levels – The Health Foundation – December 2013

“The transparent reporting of ward-by-ward staffing levels has been highlighted as a key action in the government’s response to the Francis Inquiry. Here we look at a tool being developed by Imperial College Healthcare NHS Trust which will alert multidisciplinary teams to staffing level risks on patient safety.”

… continues on the site

Minimum nurse staffing levels are only part of the picture – The Health Foundation – December 2013

“Perhaps one of the mostly hotly debated issues before and since the publication of the Francis Inquiry report has been the question of whether there should be nationally set minimum nurse staffing levels.

While the case for the connection between inadequate staffing levels and avoidable harm has been largely made (for instance by the Health Committee, Dr Foster and the Keogh Review), I find interesting that there has been opposition to setting a minimum level from a number of different perspectives.

The policy community have largely argued that, by specifying a minimum, there is a risk that it becomes a ‘ceiling’ rather than a ‘floor’, with the possible unintended consequences of nurse numbers being cut in some places on the assumption that this would be safe.

From a more evidence-based perspective, people have argued that the complexity of care in today’s hospitals means that a single figure would be misleading and, again, could result in inappropriate staffing in the most complex areas of care.

The improvement community have rightly argued that, given many of the current inefficiencies in how we provide care, setting a minimum would risk complacency in seeking opportunities to release time to care through workflow redesign.

That so many different perspectives have challenged the concept of a national minimum staffing level serves to illustrate the complexity of the issue.”

… continues on the site

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Patient safety timeline – The Health Foundation – December 2013

Posted on December 19, 2013. Filed under: Patient Safety | Tags: |

Patient safety timeline – The Health Foundation – December 2013

“Patient safety today has evolved through a combination of inspirational individuals, local initiatives, legal requirements as well as some high profile failures of care. This interactive timeline is a visual guide through some of the key patient safety events, both in the UK and internationally, over the past 150 years.

As the timeline shows, a huge amount of progress has been made in so many areas of patient safety. However history is marked by sobering reminders of the impact on people’s lives when serious failures of care take place.”

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Improving patient flow across organisations and pathways: evidence scan – The Health Foundation – November 2013

Posted on November 28, 2013. Filed under: Health Mgmt Policy Planning | Tags: , |

Improving patient flow across organisations and pathways: evidence scan – The Health Foundation – November 2013

“Poor patient flow increases the likelihood of harm to patients and raises healthcare costs by failing to make the best use of skilled staff time. This evidence scan compiles examples, from published empirical research, of strategies used to help improve patient flow across organisations or pathways of care.

The scan addressed the question:

What empirical literature exists about methods to analyse or alter patient flow across organisations or pathways of care?

The empirical evidence reviewed by the scan suggests that healthcare teams wanting to analyse and alter patient flow should note the following key learning points:”

… continues on the site

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Focus on preventable admissions: Trends in emergency admissions for ambulatory care sensitive conditions, 2001 to 2013 – The Health Foundation – October 2013

Posted on October 14, 2013. Filed under: Chronic Disease Mgmt, Emergency Medicine | Tags: |

Focus on preventable admissions: Trends in emergency admissions for ambulatory care sensitive conditions, 2001 to 2013 – The Health Foundation – October 2013

“This QualityWatch report, published in partnership with the Nuffield Trust, explores patterns of emergency admissions across England for people with ambulatory care sensitive conditions.

For many years, clinicians, managers and policy-makers have tried various strategies to reduce hospital admissions, but rates have continued to increase. A particular focus has been on patients with conditions where timely access to high quality primary and preventive care can avoid the need for hospital admission in most cases.

These conditions are known as ambulatory care sensitive (ACS). Aggregate rates of emergency admissions for ACS conditions are commonly used to measure how well the health system is preventing unplanned hospital use. We were interested to understand how these rates varied across areas, and how they have changed over time – particularly in relation to the recent financial constraints introduced in the NHS.”

… continues on the site

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Sustaining and spreading self-management support: Lessons from Co-creating Health phase 2 – The Health Foundation – September 2013

Posted on September 17, 2013. Filed under: Chronic Disease Mgmt | Tags: |

Sustaining and spreading self-management support: Lessons from Co-creating Health phase 2 – The Health Foundation – September 2013

“This report contains the independent evaluation of the second phase of our Co-creating Health improvement programme. The evaluation, conducted by Firefly, provides valuable insight into how to sustain changes in clinical practice to more effectively support people with long-term conditions.

Through the Co-creating Health programme, the Health Foundation has invested £5 million over five years to test how to embed and sustain self-management support in primary and secondary care across a range of long-term conditions. The Co-creating Health model incorporates self-management training for people with long-term conditions, training in self-management support skills for clinicians, and a service improvement programme to put systems and processes in place to support patients and clinicians in their self-management activities.

Firefly’s evaluation of the programme concludes that to have the best chance of success there needs to be a strategic, whole-system approach to implementation of self-management support. The evaluation also highlights:

the benefits of training teams rather than individuals
the importance of support from senior leadership within the clinical community
the added value of integrating with concurrent initiatives
the value of providing support for both patients and clinicians after their initial self-management training as they seek to embed new habits.

The Co-creating Health model for supporting self-management can have a profound and positive effect on patients, clinicians and health services but, as the evaluation shows, making the necessary changes can be hugely challenging. However, Co-creating Health offers a theoretically robust, well evaluated model with tried and tested training, techniques and tools to successfully support people to self-manage.”

… continues on the site

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Quality improvement made simple – The Health Foundation – August 2013

Posted on September 17, 2013. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: |

Quality improvement made simple – The Health Foundation – August 2013

“Improving quality is about making healthcare safe, effective, patient-centred, timely, efficient and equitable. In the history of the NHS, there has never been a greater focus on improving the quality of health services.

This guide focuses on one important element of the quality agenda: quality improvement. It looks in particular at what are known as organisational or industrial approaches to quality improvement. These aim to bring about a measurable improvement by applying specific methods within a healthcare setting.

This is not a ‘how to’ guide. Instead, it offers a clear explanation of some common approaches used to improve quality, including where they have come from, their underlying principles and their efficacy and applicability within the healthcare arena.

It is written for a general healthcare audience and will be most useful for those new to the field of quality improvement, or those wanting to be reminded of the key points.

Updated in 2013, this is the second edition of Quality improvement made simple.”

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Lining Up: How do improvement programmes work? – Health Foundation – August 2013

Posted on August 29, 2013. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: |

Lining Up: How do improvement programmes work? – Health Foundation – August 2013

“This learning report looks at lessons from the Health Foundation’s Lining Up research project – an investigation into interventions to reduce central line infections. It explores the reasons why potentially promising improvement programmes might fall short when implemented in a new setting.

The Lining Up researchers set out to explain what lay behind the achievements of the successful Keystone programme conducted in the US state of Michigan, and then explore what happened when an initiative it inspired, Matching Michigan, was launched in England.

Researchers found that not only were there differences in the design and implementation of the programmes, but also that an array of contextual influences, including local factors and the legacy of previous initiatives, had a major impact.

The report shows that successful replication and spread of improvement initiatives depends on a deep understanding of how and why programmes work and the contexts into which they are introduced. It also highlights the importance of understanding what has contributed to the success of an improvement intervention in any given setting, and paying attention to more than simply the technical components of effective improvement programmes.”

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Enabling people to live well: fresh thinking about collaborative approaches to care for people with long-term conditions – The Health Foundation – May 2013

Posted on May 21, 2013. Filed under: Chronic Disease Mgmt | Tags: , , |

Enabling people to live well: fresh thinking about collaborative approaches to care for people with long-term conditions – The Health Foundation – May 2013

“This is the report of a research project undertaken by Professors Vikki Entwistle and Alan Cribb.

The project:

critically analysed the ways that collaborative approaches are currently described
started to examine what goes on in practice when clinicians and patients work together in ways they appreciate as meaningfully collaborative.

The project used a combination of philosophical analysis and discussions with clinicians and patients experienced in collaborative approaches to managing long-term conditions.

In the report, the authors reflect on clinicians’ and patients’ experiences and draw on ideas from development economics and social justice. They argue that thinking in terms of people’s capabilities, and how they live in relationship with others, may be able to help us understand and overcome some of the barriers to more collaborative working between health professionals and patients with long-term conditions.

The report also makes clear that, while the ways people describe collaborative approaches to healthcare can be helpful in indicating how care could be delivered differently, they can also be counter-productive. Current descriptions are developed within the dominant and traditional way of thinking about the patient-health professional relationship and this could be limiting the uptake and effectiveness of more collaborative ways of working.

Making care truly person-centred requires radically different ways of thinking. The ideas explored in this report suggest fresh ways of thinking about how patients and clinicians can work together in a meaningful partnership. Thinking in terms of capabilities and relational autonomy will not resolve tensions between patient and clinician priorities, but these concepts can help support much-needed discussion.”

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The measurement and monitoring of safety – The Health Foundation – April 2013

Posted on April 29, 2013. Filed under: Patient Safety | Tags: |

The measurement and monitoring of safety – The Health Foundation – April 2013

by Charles Vincent; Susan Burnett; Jane Carthey

“Over the past 10 years there has been a deluge of statistics on medical error and harm to patients, many tragic cases of healthcare failure and a growing number of major government and professional reports on the need to make healthcare safer. There is now widespread acceptance and awareness of the problem of medical harm, and considerable efforts have been made to improve the safety of healthcare. But if we ask whether patients are any safer than they were 10 years ago, the answer is curiously elusive.

The Health Foundation commissioned Professor Charles Vincent and his colleagues from Imperial College London to bring together evidence from a range of sources (published research, public data, case studies and interviews), both from within healthcare settings and from other safety critical industries. The authors have synthesised this evidence and have proposed a single framework that brings together a number of conceptual and technical facets of safety.

Five dimensions: a proposed framework

This framework highlights the following five dimensions, which the authors believe should be included in any safety and monitoring approach in order to give a comprehensive and rounded picture of an organisation’s safety:

Past harm: this encompasses both psychological and physical measures.
Reliability: this is defined as ‘failure free operation over time’ and applies to measures of behaviour, processes and systems.
Sensitivity to operations: the information and capacity to monitor safety on an hourly or daily basis.
Anticipation and preparedness: the ability to anticipate, and be prepared for, problems.
Integration and learning: the ability to respond to, and improve from, safety information.

This framework provides a starting point for discussions about what ‘safety’ means and how it can be actively managed. A diagram of the framework is available.”

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The puzzle of changing relationships – The Health Foundation – March 2013

Posted on April 26, 2013. Filed under: Health Mgmt Policy Planning, Health Technology Assessment | Tags: , |

The puzzle of changing relationships – The Health Foundation – March 2013

“Encouraging improvement through changing the relationships between healthcare service users and providers is a key area of work for the Health Foundation.

This report aims to contribute to the understanding of how changing relationships impacts on the quality of care. It does this by reviewing the conceptual and theoretical literature on relationships between service users and providers and then exploring the extent to which a chosen set of interventions correlate with the conceptual evidence, and their likely impacts on the quality of care.”

… continues

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Implementing shared decision making – The Health Foundation – April 2013

Posted on April 23, 2013. Filed under: Patient Participation | Tags: , |

Implementing shared decision making – The Health Foundation – April 2013

“The Health Foundation’s MAGIC (Making good decisions in collaboration) improvement programme aims to support clinical teams in primary and secondary care to embed shared decision making with patients in their everyday practice. The programme is developing and testing practical solutions that support patients to make informed and considered decisions about their own care and treatment.

This learning report is based on seven improvement stories developed by the Office for Public Management (OPM) as part of their evaluation of the first phase of the programme. The stories draw on a series of interviews with clinicians and patients carried out by the evaluation team and present the experiences of both primary care and hospital-based teams.

The stories explore the participants’ experiences of the MAGIC programme, and of implementing shared decision making in practice. Each story explains:”

… continues on the site

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Safety culture: What is it and how do we monitor and measure it? – The Health Foundation – March 2013

Posted on March 22, 2013. Filed under: Patient Safety | Tags: , |

Safety culture: What is it and how do we monitor and measure it? – The Health Foundation – March 2013

“On 20 February 2013, the Health Foundation hosted a roundtable event to discuss what is understood as ‘safety culture’, why it is important and how it can be measured and monitored. This roundtable was held as part of the Health Foundation’s work to lead a step-change in thinking about patient safety.

Patient safety experts from academia, public policy, quality improvement and frontline care came together to share their knowledge and learning in order to build understanding in this area, and to recommend some practical next steps.

This event report summarises the discussion and identifies themes that should be explored further.

Key messages include:”

… continues on the site

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Leading networks in healthcare: Learning about what works – the theory and the practice – The Health Foundation – January 2013

Posted on February 5, 2013. Filed under: Health Mgmt Policy Planning | Tags: , |

Leading networks in healthcare: Learning about what works – the theory and the practice – The Health Foundation – January 2013
“In autumn 2011, we launched an improvement programme to support networks in healthcare. We linked the selected networks with a faculty of experts, and with each other, to provide an exchange of ideas, advice, support and training in network leadership and development.

The aim was to see what could be achieved by combining the experiences of those who are building and running networks with the theory and knowledge from a range of sectors about what makes a network succeed.

This report captures the experiences of the programme participants as they began working together, highlights key learning and early insights, and examines how all this relates to what the research evidence tells us about running networks.

The report includes the voices of many of the network leaders who took part in this programme. It also provides an informal overview of the literature on networks and a glossary of commonly used network terms.”

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Involving patients in improving safety – The Health Foundation – January 2013

Posted on January 24, 2013. Filed under: Patient Participation, Patient Safety | Tags: |

Involving patients in improving safety – The Health Foundation – January 2013

“Much is being done to improve safety in healthcare. Patients themselves can help to safeguard their own wellbeing and promote change. This evidence scan describes ways that patients have been involved in improving safety.

The scan addresses the questions:
•How have patients and carers been involved in improving safety in healthcare?
•Is there any evidence that patient involvement leads to improved safety?

The main approaches to involving patients in safety improvement that the scan identifies include:
•collecting feedback retrospectively
•asking patients to help plan broad service change
•encouraging patients to help identify risks when they are receiving care.”

… continues on the site

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Using safety cases in industry and healthcare – The Health Foundation – December 2012

Posted on January 3, 2013. Filed under: Patient Safety | Tags: |

Using safety cases in industry and healthcare – The Health Foundation – December 2012

ISBN:  978-1-906461-43-0

“This report presents the results of a study that reviewed the use of safety cases in six safety-critical industries, as well as the emerging use of safety cases in healthcare. Details of these reviews are available in the supplements to the report.

The aims of the study were to describe safety case use in other industries, to make pragmatic recommendations for the adoption of safety cases in healthcare and to outline possible healthcare application scenarios.”

… continues on the site

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Shared decision making resource centre – The Health Foundation

Posted on October 19, 2012. Filed under: Patient Participation | Tags: |

Shared decision making resource centre – The Health Foundation

“Shared decision making is a process in which clinicians and patients work together to select tests, treatments, management, or support packages, based on clinical evidence and patients’ informed preferences. It involves the provision of evidence-based information about options, outcomes and uncertainties, together with decision support counselling and systems for recording and implementing patients’ treatment preferences.”

 

 

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Quality improvement training for healthcare professionals – The Health Foundation – August 2012

Posted on September 21, 2012. Filed under: Clin Governance / Risk Mgmt / Quality, Educ for Hlth Professions | Tags: |

Quality improvement training for healthcare professionals – The Health Foundation – August 2012

“There is an increasing focus on improving healthcare in order to ensure higher quality. Training programmes have been developed to teach health professionals and students formal quality improvement methods.

This evidence scan explores the following questions:

What types of training about formal quality improvement techniques are available for health professionals?

What evidence is there about the most effective methods for training clinicians in quality improvement?

The scan looks at the content of training and the impact it is shown to have, as well as the effectiveness of different methods.

This is an essential area for further exploration and the scan shows that a great deal remains uncertain about training in quality improvement. This includes: the most appropriate content; how training can best be delivered to improve processes and patient outcomes; how to measure and ensure quality within training.”

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Looking for value in hard times: How a new approach to priority setting can help improve patient care while making savings – The Health Foundation – August 2012

Posted on September 11, 2012. Filed under: Health Economics, Health Mgmt Policy Planning | Tags: , |

Looking for value in hard times: How a new approach to priority setting can help improve patient care while making savings – The Health Foundation – August 2012

“This report describes a new approach to priority setting called Star (socio-technical allocation of resources). The approach is designed to help commissioners and others pinpoint where they may be able to get additional value from their resources by using them more effectively.

It works by producing simple visual models, developed interactively with stakeholders, so that everyone involved can understand the nature of the choices to be made, and the disadvantages of not changing current practices.

The approach combines value for money analysis with stakeholder engagement. This allows those planning services to determine how resources can be most effectively invested, while the engagement of stakeholders means the decisions are understood and supported by those most affected.

This report shows how, by using the Star approach, NHS Sheffield were able to agee changes to their eating disorder services with clinicians, service users and other stakeholders. The changes they have made are expected to improve both patient care and value for money, with the project showing potential for substantial savings.”

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A simple tool to facilitate shared decisions – The Health Foundation’s MAGIC programme

Posted on July 20, 2012. Filed under: Patient Participation | Tags: |

A simple tool to facilitate shared decisions – The Health Foundation’s MAGIC programme

“The Health Foundation’s MAGIC programme has been examining how best to enable and embed shared decision making in the NHS. Here, Dr Marie-Anne Durand, and Professor Glyn Elwyn, from the MAGIC Option Grids Collaborative, explain the value of Option Grids as decision aids and talk us through how to use one.”

MAGIC – making good decisions in collaboration

Examples of Option Grids

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Snapshot: Patient safety: Transforming organisational approaches to deliver safer patient care – The Health Foundation – May 2012

Posted on June 5, 2012. Filed under: Patient Safety | Tags: |

Snapshot: Patient safety: Transforming organisational approaches to deliver safer patient care – The Health Foundation – May 2012

“This Snapshot looks at the fundamental priorities for clinicians, managers, boards and policy makers to improve patient safety.

At the Health Foundation, we are committed to maintaining our focus on improving patient safety; in fact we are placing more emphasis on it than ever before. We believe that safety needs to remain at the forefront of the mind of all leaders, healthcare workers and policy leads – particularly in the current economic climate. Everyone needs to focus on finding new ways to recognise and prevent unsafe care and make improvements at all levels of the healthcare system.

To help make this happen, we are:

working to identify the problems, raise awareness and build the evidence base
bringing people together
listening to staff, patients and leaders
supporting the development of new solutions and interventions
encouraging the deployment of systems approaches to improving safety
working to understand safety culture and how to influence it
encouraging leadership for safety.

We have learned a lot and have been able to make significant improvements. However, we also know that there are areas where more work is needed.

We have identified some vital future challenges and priorities that need to be addressed across health services to improve safety:”

… continues on the site

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The Health Foundation [UK] launches thought papers from patient safety experts – 30 May 2012

Posted on June 1, 2012. Filed under: Patient Safety | Tags: |

The Health Foundation [UK] launches thought papers from patient safety experts – 30 May 2012

“The Health Foundation is urging healthcare organisations and leaders to ensure patient safety remains their top priority at a time when many are faced with unprecedented financial pressures and increasing demand on their services.

As part of its drive to increase awareness, the Health Foundation is launching a series of thought papers, giving healthcare experts within their respective fields the opportunity to share their ideas and experiences in patient safety.

The studies will be unveiled during the 2012 Patient Safety Congress, which takes place at the Birmingham NEC between 29 and 30 May.”

… continues on the site

Health Foundation thought papers

The role of the patient in clinical safety / Rebecca Lawton & Gerry Armitage

Proactive approaches to safety management / Erik Hollnagel

Personal accountability in healthcare: searching for the right balance / Robert Wachter

How can leaders influence a safety culture? / Michael Leonard & Allan Frankel

Reinventing healthcare delivery / Steven Spear

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Co-creating Health: Evaluation of first phase – The Health Foundation [UK] – April 2012

Posted on May 8, 2012. Filed under: Chronic Disease Mgmt, Clin Governance / Risk Mgmt / Quality | Tags: , , |

Co-creating Health: Evaluation of first phase – The Health Foundation [UK] – April 2012

An independent evaluation of the Health Foundation’s Co-creating Health improvement programme

ISBN 978-1-906461-39-3

“This report gives the findings from an independent evaluation of phase 1 of our Co-creating Health self-management support improvement programme.

The first phase of Co-Creating Health began in 2007. It was a three year initiative in eight sites across the UK that aimed to demonstrate the impact, on clinicians and patients alike, of integrating self-management support into routine care for people with long-term conditions.

The evaluation of the programme provides valuable insights into what worked and the further challenges health systems need to address to support people to develop confidence in managing their long-term conditions themselves.
Key findings

Some of the key findings from the evaluation were:”

… continues on the site

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Involving primary care clinicians in quality improvement – The Health Foundation [UK] – April 2012

Posted on May 8, 2012. Filed under: Clin Governance / Risk Mgmt / Quality, General Practice, Primary Hlth Care | Tags: |

Involving primary care clinicians in quality improvement – The Health Foundation [UK] – April 2012

An independent evaluation of the Health Foundation’s Engaging with Quality in Primary Care programme

ISBN 978-1-906461-37-9

“This is the report of an independent evaluation of our Engaging with Quality in Primary Care (EwQPC) improvement programme.

In 2007 we launched the EwQPC improvement programme. The programme funded nine projects that would increase the capacity for clinical quality improvement in primary care and engage primary care clinicians in clinical quality improvement. Building upon a previous initiative in secondary care (the Engaging with Quality Initiative), it aimed to engage primary care clinicians in clinical quality measurement and enable them to contribute to the knowledge base on improvement.

The independent evaluation, undertaken by a team from RAND Europe, identified a wide set of benefits. The projects secured and maintained the involvement of clinicians and were associated with changes in clinicians’ attitudes, behaviours and understanding. Patient involvement was an important and successful element of the programme. The projects also learned a lot about the challenges and opportunities of implementing improvement efforts. Measureable benefits for patients were found, but overall they were modest and patchy.

This thoughtful report highlights the lessons to be drawn from the programme and also offers a candid critique of quality improvement approaches and evaluation methods.”

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Overcoming challenges to improving quality – The Health Foundation [UK] – April 2012

Posted on May 8, 2012. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: |

Overcoming challenges to improving quality – The Health Foundation [UK] – April 2012

Lessons from the Health Foundation’s improvement programme evaluations and relevant literature

ISBN 9781906461386

“For nearly ten years, the Health Foundation has been working with the NHS to deliver improvement through service and staff development programmes.

In a unique contribution to advancing the field of improvement, the Health Foundation has ensured that each of our improvement programmes is evaluated. We evaluate our programmes to provide sound evidence of their impact, and to better understand how it has been achieved.

In 2011, a team of researchers undertook a synthesis of learning from 14 of the Health Foundation’s improvement programme evaluations and set the learning in the context of the wider literature. They looked at the factors that affected the likelihood of improvement methods being applied and new interventions adopted.

The researchers organised their analysis within three broad themes:

design and planning
organisational and institutional contexts, professions and leadership
sustainability, spread and unintended consequences.

Within these themes, they identified 10 key challenges to improvement that consistently emerged in the programmes evaluated:”

… continues on the site

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Can changing clinician–patient interactions improve healthcare quality? – The Health Foundation – December 2011

Posted on December 9, 2011. Filed under: Medicine, Patient Participation | Tags: , |

Can changing clinician–patient interactions improve healthcare quality? – The Health Foundation – December 2011

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Could quality be cheaper? How quality improvements helped to reduce costs for three local services – The Health Foundation [UK] – December 2011

Posted on December 9, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Economics | Tags: |

Could quality be cheaper?  How quality improvements helped to reduce costs for three local services – The Health Foundation [UK] – December 2011

“Intuitively we believe that improving quality in our health services should lead to reduced waste and therefore save money. However, in practice this is often hard to prove and as a result there is little published evidence to demonstrate that improving quality does save money.

The Health Foundation aims to build this evidence base by encouraging all those involved in improvement initiatives to accurately measure costs and identify where savings are made.

This case study looks in detail at three improvement projects that received support from our Shine 2010 programme. They aimed to introduce innovations, redesign services, improve patient care and identify savings for their local health services.

We look at the evidence already gathered about whether improving quality saves money, and ask what these three examples can add to our knowledge. By exploring their journeys and the challenges they faced, we hope to build a clearer understanding of whether quality improvement can be a central component of cost reduction.”

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Self management support resource centre [new UK website] – The Health Foundation – 14 November 2011

Posted on November 17, 2011. Filed under: Chronic Disease Mgmt | Tags: |

Self management support resource centre [new UK website] – The Health Foundation – 14 November 2011

New online resource launched to support self management 

“An online self management support resource centre has been launched by the Health Foundation for commissioners, providers and patients to help them develop self management support within local health economies.

The new digital resource shares important learning about self management from the Health Foundation’s £7.5 million Co-creating Health programme which was established to understand how best to put self management support at the heart of care for people with long term conditions.

Jo Bibby, Director of Improvement Programmes at the Health Foundation said, ‘There is compelling evidence that, for people with long term conditions, self management support reduces anxiety and depression; facilitates a better quality of life and enables people to feel more in control of their health’.

The resource centre provides information and practical resources that can be adopted and adapted locally to enable services and health professionals to develop their own self management support programmes. These are based on the Co-creating Health evidence-based model for self management support that identifies people with long term conditions, health professionals and organisational systems and processes as key components.”

… continues on the site

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New medical professionalism. A scoping report for the Health Foundation – October 2011

Posted on October 18, 2011. Filed under: Health Professions, Medicine | Tags: |

New medical professionalism. A scoping report for the Health Foundation – October 2011

“This report reviews the ways in which doctors’ relationships with evidence, society, patients, teams, regulators and employers have changed, are changing or may need to change. It discusses the implications of these changing relationships for medical professionalism.

The role of doctors has always evolved in response to changes in society, demand, the structure of healthcare services and the changing state of medicine itself. This trend continues with various factors driving important changes in the roles played by doctors and others working in healthcare. The motivation exists among doctors and others to rise to both the challenges and opportunities these changes create.

Recent history has left many working in healthcare feeling battered, exhausted and cynical about further change. This situation creates significant risks for patients and public.

The Health Foundation wants to play an active and constructive role in addressing these risks. The first step is to conduct a genuine dialogue involving truly diverse participants. This report address these three questions:

•What questions are worth discussing?
•Who needs to be involved in the discussion?
•How can we make sure the discussion is constructive?

While the focus of the report is on medical professionalism, the question of whether ‘medical professionalism’ is even the right topic for dialogue is also discussed.”

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Involving junior doctors in quality improvement (research scan) – Health Foundation [UK] September 2011

Posted on September 30, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Medicine | Tags: |

Involving junior doctors in quality improvement (research scan) – Health Foundation [UK] September 2011

“This research scan describes how junior doctors have been engaged in quality improvement and factors that help and hinder their involvement.

In the UK and the Republic of Ireland, the term ‘junior doctors’ refers to newly qualified doctors who have taken up posts after leaving medical school. These doctors provide care for patients in hospital or general practice under the broad supervision of more senior doctors. This role is somewhat equivalent to the first three years of a ‘resident’ post in North America. The years immediately after leaving medical school may be a prime time for supporting practitioners to develop an interest and expertise in improving the quality of healthcare.

This research scan summarises some published literature about the involvement of junior doctors in quality improvement in the UK and internationally. Ten databases were searched for material available as at July 2011 and 78 articles have been included.”

 

 

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Getting out of hospital? The evidence for shifting acute inpatient and day case services from hospitals into the community – The Health Foundation – June 2011

Posted on August 8, 2011. Filed under: Health Mgmt Policy Planning | Tags: |

Getting out of hospital? The evidence for shifting acute inpatient and day case services from hospitals into the community – The Health Foundation – June 2011

“This report examines and updates the review of evidence of underpinning the policy drive to transfer acute inpatient and day-case services from hospitals into the community and the effectiveness of this to improve quality of care and save money.”

 

 

 

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Making care safer: Improving medication safety for people in care homes: thoughts and experiences from carers and relatives – The Health Foundation – June 2011

Posted on July 7, 2011. Filed under: Patient Safety, Pharmacy | Tags: |

Making care safer: Improving medication safety for people in care homes: thoughts and experiences from carers and relatives – The Health Foundation – June 2011

“This report collects together the testimony given by family and carers of people living in a care home, specifically around issues of medication safety. Three day-long focus groups were held in 2010, in Manchester, Birmingham and London. In total 26 people attended the events. Members of the group also shared testimony they had collected from fellow carers.

During the focus groups, attendees were invited to tell their stories and think about ways to improve medication safety in care homes. They were asked to consider what improvements would be possible in practice given the current culture and constraints, and what could be done strategically in the longer term.

The issues and potential solutions raised by the groups are presented in this report under four main headings:

•communication and information sharing
•prescribing and administration of medication
•staff development and support
•advocacy and rights.”

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Does clinical coordination improve quality and save money? A review of the evidence – The Health Foundation – June 2011

Posted on June 29, 2011. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: |

Does clinical coordination improve quality and save money? A review of the evidence – The Health Foundation – June 2011
Author: Dr John Øvretveit

“This report examines the evidence for the extent to which poor coordination contributes to poor quality outcomes for patients and the approaches to clinical coordination which are shown to improve care and whether these can reduce costs.

Background
As healthcare and payments become more fragmented, and resources become fewer, there is a greater emphasis on improving the value of healthcare services through reducing costs while maintaining or improving quality.

Providers may focus more on their part of the care pathway and less on passing on information and adjusting their work around the total care of the patient. Without coordination, adverse events and poor quality can increase, adding costs and then leading to bureaucracy to enforce procedures which do not solve the problems of under-coordination.

Evidence that clinical coordination improves quality and saves costs
The review concludes that greater coordination of care has the potential to reduce costs and should be a major consideration for how to improve quality and save money in the current funding situation. However, while better process coordination could release significant savings, these approaches also have high risks and costs.”

… continues on the site

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Are clinicians engaged in quality improvement? – The Health Foundation – May 2011

Posted on May 23, 2011. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: |

Are clinicians engaged in quality improvement? – The Health Foundation – May 2011

“A review of the literature on healthcare professionals’ views on quality improvement initiatives

The active involvement of clinical staff is an essential component of quality improvement, yet systematic improvement initiatives in the NHS have not generally secured the full engagement of clinicians.

In 2006, we commissioned a review seeking to clarify what is already known about the views of UK healthcare professionals in this area. This updated review builds on this and highlights how clinical engagement in improvement remains a complex, challenging issue.”   … continues on the site

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Closing the Gap: Changing Relationships [UK The Health Foundation] – March 2011

Posted on March 18, 2011. Filed under: Patient Participation | Tags: , |

Closing the Gap: Changing Relationships [UK The Health Foundation] – March 2011

“With the complexity of services increasing, it is more important than ever that people are equipped to actively manage their care and that services do not lose the ability to ‘see the person in the patient’.

In Closing the Gap through Changing Relationships, over 2011 and 2012, eight partnerships will be working on projects that aim to build new relationships between people and health services.

This booklet contains overviews and information on the eight projects”  … continues on the site

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Learning report: Safer Patients Initiative. Lessons from a complex, large-scale intervention to improve patient safety in the UK – February 2011

Posted on February 22, 2011. Filed under: Patient Safety | Tags: |

Learning report: Safer Patients Initiative. Lessons from a complex, large-scale intervention to improve patient safety in the UK – February 2011    The Health Foundation.

“One million people use the NHS every day – making sure they receive safe and reliable care is a massive challenge for health services. While the majority of people are treated without incident, it is estimated that one in 10 people admitted to hospital in the UK will experience some sort of harm during their stay. In nearly every case the problem is caused by unreliable healthcare systems and processes.

When the Health Foundation began the Safer Patients Initiative in 2004, there was a growing awareness of the level of harm in the NHS but no national support to the health service to reduce it. The Safer Patients Initiative was the first major improvement programme addressing patient safety in the UK.  The initiative was ground-breaking with the first wave of four hospitals working from 2004–2006 and the second wave of twenty hospitals working from 2006–2008. The purpose of the Safer Patients Initiative was to test ways of improving patient safety on an organisation-wide basis within NHS hospitals. 

This report draws not only on the independent evaluation but also on case studies from those involved in the programme and from a five-year research programme which ran alongside the Safer Patients Initiative – Journey to Safety – carried out by Imperial College London.

This learning report provides an overview of the Safer Patients Initiative (phases 1 and 2) and its evaluation, and highlights the impact of the programme, key lessons and further issues for exploration.”

…continues on the site

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Identification and Referral to Improve Safety of women experiencing domestic violence (IRIS) project – The Health Foundation (UK) – 11 February 2011

Posted on February 16, 2011. Filed under: General Practice | Tags: , |

Identification and Referral to Improve Safety of women experiencing domestic violence (IRIS) project – The Health Foundation (UK) – 11 February 2011

Case study: Identification and Referral to Improve Safety (IRIS)

“Domestic violence is a severe breach of human rights, with profound health consquences, particularly for women, who experience a greater proportion of domestic violence than men.

It is a major public health issue, and a risk factor for chronic ill health and premature death in women. Nevertheless, in primary care it is under-recognised and under-treated.

A training and support programme called Identification and Referral to Improve Safety (IRIS) is working to change this. The results from the first stage of the programme show a marked increase in referral to specialist domestic violence services, and significant improvement in the identification of women experiencing domestic violence.

The programme is now in its implementation phase, with a target of 12 primary care trusts (PCTs) for initial roll-out of the service.”

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Do quality improvements in primary care reduce secondary care costs? – The Health Foundation (UK) – 15 February 2011

Posted on February 16, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Economics, Neurology, Primary Hlth Care | Tags: |

Do quality improvements in primary care reduce secondary care costs? – The Health Foundation (UK) – 15 February 2011

Primary research into the impact of the Quality and Outcomes Framework on hospital costs and mortality

“A leading edge study published by the Health Foundation today shows an association between achievement of the Quality and Outcomes Framework (QOF) indicators and a reduction in hospital costs and lives saved, particularly for stroke care.

The primary research, which analyses newly available data to establish the impact of QOF on hospital costs and mortality, finds that a single point increase in the QOF stroke score, across England, could lead to 2,385 fewer deaths in a year.

Do quality improvements in primary care reduce secondary care costs?‘ also estimates that improvements in primary care for stroke may have reduced secondary care costs by £165 million, over a four year period from 2004 to 2008, measured by a 10 per cent increase in the mean practice QOF stroke score.”

Full report
Summary

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What’s leadership got to do with it? Exploring links between quality improvement and leadership in the NHS – The Health Foundation, Evaluation report – January 2011

Posted on February 4, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Mgmt Policy Planning | Tags: , |

What’s leadership got to do with it? Exploring links between quality improvement and leadership in the NHS – The Health Foundation, Evaluation report – January 2011

“In December 2007, the Health Foundation commissioned ORCNi Ltd to undertake an in-depth evaluation of the Health Foundation’s leadership programmes, including an exploration of the links between leadership and quality improvement (QI).

The three core enquiry questions for the study were:

What are the links between QI and leadership behaviour?
Do different types of QI require different leadership behaviours?
What are the lessons for leadership development generally and for the Health Foundation specifically?

This report presents a detailed account of the two-year study and the conclusions that emerged. It contains insights into how leadership development can support QI in the NHS. In addition, our findings contribute to what is known about the links between leadership and improvement in the NHS, and provide new ways of understanding the nature of this improvement work.”

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Community engagement – A report for the Health Foundation Date – August 2011

Posted on September 7, 2010. Filed under: Community Services, Obstetrics, Public Hlth & Hlth Promotion | Tags: |

Community engagement – A report for the Health Foundation  – August 2011

Download publication [347kb PDF]

“What is meant by ‘community engagement’? This report looks at how we define communities and addresses barriers that some communities face when accessing health services.

There is a key focus on maternity, which seems to have specific obstacles around engagement.

Recommendations
The report contains a number of recommendations including:

Understand and define ‘community engagement’. Being clear about the group you are working with and the aspects of engagement you wish to use is essential for success.
Make sure you have an authentic community: those who belong to it should identify with each other and recognise themselves as a community or group with shared activities and aspirations.
Find and work with leaders, or those with leadership potential, in that community.

Maternity care

The report notes that pregnant women often become part of a community of pregnant women and new mothers. This community is separate from their usual community which might be based on family, friends, locality, faith or ethnicity.

This means that when engaging pregnant women and new mothers with healthcare services, you must consider the other communites that they might be part of.”

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Engaging communities for health improvement: A scoping study for the Health Foundation – August 2010

Posted on September 7, 2010. Filed under: Community Services, Health Systems Improvement, Public Hlth & Hlth Promotion | Tags: |

Engaging communities for health improvement: A scoping study for the Health Foundation – August 2010

Download publication [316kb PDF]

“A community engagement project involves talking to people in different communities about what they want and need from their healthcare services.

This kind of project can help healthcare professionals to:

determine local needs and aspirations
promote health and reduce health inequalities
improve service design and quality of care
strengthen local accountability.

This report looks at community engagement projects and provides some ideas about what can make them work well.

Recommendations
The report stresses that, in order for a community engagement project to be effective, it is important to consider the community it is aimed at by:

finding out exactly how people want to get involved
providing as much support as possible for people to get involved in the project easily
making sure community members know that their views will be taken into account when any decisions about healthcare are made once the project is complete.

For a community engagement project to work, the following factors are essential:

Engagement plan: Put together a plan which looks at how many community members will be approached and what will be done to make sure everyone is consulted and informed appropriately about what is happening with the project.
Participation methods: Research the best techniques for promoting participation in order to make sure people want to get involved.
Cultural awareness: If the target group for the project includes people from minority groups, be aware of cultural differences, and where necessary, seek guidance on meeting the needs of this group with local leaders”

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How do you get clinicians involved in quality improvement? – The Health Foundation – August 2010

Posted on August 12, 2010. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: |

How do you get clinicians involved in quality improvement? – The Health Foundation – August 2010

Download publication [1784kb PDF]

“The Engaging with Quality Initiative (EwQI) aimed to engage clinicians in leading quality improvement projects; identify effective quality improvement strategies and increase capacity for measurement and improvement in the UK. This report concludes that whilst positive outcomes in terms of measurable improvements proved to be modest, the EwQI has made progress in helping to implement quality improvement.”

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Evidence in brief: How safe are clinical systems? Primary research into the reliability of systems within seven NHS organisations and ideas for improvement – The Health Foundation – May 2010

Posted on June 2, 2010. Filed under: Clin Governance / Risk Mgmt / Quality, Patient Safety | Tags: |

Evidence in brief: How safe are clinical systems? Primary research into the reliability of systems within seven NHS organisations and ideas for improvement – The Health Foundation – May 2010

“The knowledge that poor systems can cause harm is not new, but the size of this problem has not been established
systematically. This report provides groundbreaking evidence of the extent to which important clinical systems and processes fail, and the potential these failings have to harm patients.

This study forms part of the Health Foundation’s work to help healthcare organisations improve the quality of services they offer. Our Safer Patients Initiative has highlighted the need to take a clinical systems approach to improving safety, since it is failings in these systems that often contribute to breakdowns in patient safety.

The work also supports our Safer Clinical Systems programme by providing a much-needed evidence base. It systematically identifies and documents the different defects in specific points of the care pathway, the extent to which they vary and their potential for patient harm.”

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Revision of professional roles and quality improvement: A review of the evidence – The Health Foundation – February 2010

Posted on April 20, 2010. Filed under: Allied Health, Health Professions, Nursing, Workforce | Tags: |

Revision of professional roles and quality improvement: A review of the evidence – The Health Foundation – February 2010  [UK]
By Miranda Laurant, Mirjam Harmsen, Marjan Faber, Hub Wollersheim, Bonnie Sibbald and Richard Grol
Pages 122  ISBN 978-1-606461-15-7

Download summary [496kb PDF]

Download publication [1093kb PDF]

“About this report

Our report, Revision of professional roles and quality improvement: a review of the evidence, considers the impact of professional role revision on quality of care and outcomes. It focuses on two types of changes to professional roles:

Substitution – exchanging one type of professional for another.
Supplementation – extending the range of service provision within one health delivery system.

This report focuses on the revision of roles between doctors and:

advanced practice nurses such as nurse practitioners, specialist nurses, clinical nurses and practice nurses
physician assistants pharmacists
allied healthcare professionals such as physical therapists (referred to as physiotherapists in this review), speech and language therapists, dietitians and paramedics.

Professional role revision has a number of aims: to reduce the medical workload; to increase capacity and extend the range of services available to patients; to improve the quality of care; and/or to reduce costs.
Our report finds that there is no detrimental effect of revising or extending the roles of non-medical professionals, and in some cases there is a positive effect on the quality of patient care. Gains in service efficiency may be achieved if doctors stop providing the services that are transferred to other health professionals and instead invest their time in activities that they alone can perform. “

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Does improving quality save money? – September 2009

Posted on November 13, 2009. Filed under: Clin Governance / Risk Mgmt / Quality, Health Economics | Tags: |

Øvretveit J (2009). Does improving quality save money? A review of evidence of which
improvements to quality reduce costs to health service providers
. London: the Health Foundation.

From the foreword:

“The most successful hospitals or primary care organisations are not the ones which just deliver the best evidence-based clinical services, or are most focused on safety, or who’s services are highly customer-oriented, or which consistently managed to balance their budgets. The most successful healthcare organisations are the ones which recognise the multi-faceted nature of their endeavour and manage to deliver across all of the dimensions of quality. For most of the last decade, organisations have become accustomed to times of plenty – their challenge has been to improve patient care and health outcomes and they have been given the resources to do so. But the impending public sector spending crisis changes this context utterly. Every manager and clinician in the country should now be asking themselves how they can continue to improve quality while also cutting costs.

There are many ways in which savings can be made. At one end of the spectrum are the easy changes, the metaphorical slash and burn activities that we have seen so often in the past but which can be so damaging. At the other end are the kinds of sweeping changes such as implementing Wanless’s fully engaged scenario (2002) or reconsidering how healthcare should be funded for which there is no political consensus right now. In the timescale required, these options are unattractive and infeasible. But between these extremes lie solutions with perhaps the greatest potential in the time frame within which the health service has to respond.” … continues

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Collaboratives – Report from the Health Foundation (London) July 2009 on the effectiveness of the Quality Improvement Collaborative approach

Posted on July 29, 2009. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , , |

Collaboratives / Marlies Hulscher, Loes Schouten, and Richard Grol Radboud University Nijmegen  Published by The Health Foundation
July 2009    ISBN 978-1-906461-11-9
Download publication [722kb PDF]

“This report aims to describe the effectiveness of the Quality Improvement Collaborative approach by systematically reviewing empirical studies.

Background
Across the globe, healthcare organisations are adopting collaborative approaches. They are used in different clinical areas and organisational contexts. Collaboratives represent substantial investments in time, effort and funding in the healthcare delivery system.

This report
This systematic review describes the determinants of success and failure by getting under the skin of the collaborative approach to find what really works to improve quality. This ‘black box’ analysis enables the authors to detail the determinants for collaborative success.

What is quickly apparent from the review is the paucity of evidence available on the collaborative approach to quality improvement, but what results are available suggest positive benefits from the use of collaboratives. We have reflected on this evidence in light of our own investment and what people we are working with tell us about the lived experience of working in collaboratives.”

…continues on the website

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The link between healthcare spending and health outcomes for the new English primary care trusts, London, The Health Foundation, 2009

Posted on July 6, 2009. Filed under: Clin Governance / Risk Mgmt / Quality, Health Economics, Primary Hlth Care | Tags: , |

The link between healthcare spending and health outcomes for the new English primary care trusts by Stephen Martin, Nigel Rice and Peter C. Smith, University of York.  London, The Health Foundation, 2009   ISBN 978-1-906461-09-6 64 p.

“This study was produced as part of the Quest for Quality and Improved Performance (QQUIP), an initiative of The Health Foundation.”

“Abstract

English programme budgeting data have yielded major new insights into the link between healthcare spending and health outcomes. This paper updates two recent studies that used programme budgeting data for 295 primary care trusts (PCTs) in England to examine the link between spending and outcomes for several programmes of care (Martin, Rice and Smith 2008a; 2008b). We use the same  economic model employed in the two previous studies.

The paper focuses on the dilemmas facing decision-makers who must allocate a fixed budget across programmes of care so as to maximise social welfare, given a health production function for each programme. We estimate two equations – a health outcome equation and an expenditure equation – for each programme (data permitting). The two previous studies employed expenditure data for 2004/05 and 2005/06 for 295 PCTs and found that in several care programmes – cancer, circulation problems, respiratory problems, gastro-intestinal problems, trauma burns and injury, and diabetes – expenditure had the anticipated negative effect on the mortality rate.

Each health outcome equation was used to estimate the marginal cost of a life year saved. In 2006/07 the number of PCTs in England was reduced – largely through a series of mergers – to 152. In addition, several changes were made to the methods employed to construct the programme budgeting data. This paper employs updated budgeting and mortality data for the new 152 PCTs to re-estimate health production and expenditure functions, and also presents updated estimates of the marginal cost of a life year saved in each programme. Although there are some differences the results we obtained are broadly similar to those presented in our two previous studies.”

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Costs and benefits of health technology information – May 2009 – report done by RAND on behalf of the Health Foundation

Posted on May 12, 2009. Filed under: Health Economics, Health Informatics | Tags: , |

Costs and benefits of health technology information : an updated systematic review [675kb PDF]
An updated systematic review Author Paul G Shekelle and Caroline L Goldzweig Date published May 2009
The Health Foundation [UK]

“This report summarises the available international evidence on the costs and benefits of clinical health information technology (HIT) systems. This study has been undertaken by RAND on behalf of the Health Foundation and updates their 2005 study.

Background
The use of health information technology has been promoted as having tremendous promise in improving the efficiency, cost-effectiveness, quality and safety of medical care delivery. The promise of IT systems may be substantial, but across Europe healthcare leaders report problems with implementation. As such, gains in quality improvement through integrated and effective IT are not being realised.

This report
This report aims to gather the lessons learnt on the effects of HIT to costs and benefits that might be of use to organisations looking to develop and implement HIT programmes. This is a difficult exercise considering the multiple factors affecting implementation of an HIT programme. Factors include organisational characteristics, the kinds of changes being put in place and how they are managed, and the type of HIT system.

The report finds that barriers to HIT implementation are still substantial but that some progress has been made on reporting the organisational factors crucial for the adoption of HIT. However, there is a challenge to adapt the studies and publications from HIT leaders (early implementers and people using HIT to best effect) to offer lessons beyond their local circumstances. The report also finds limited data on the cost-effectiveness of HIT.

About QQUIP
This report is published as part of the Health Foundation’s Quest for Quality and Improved Performance (QQUIP) project. The QQUIP programme synthesises the international evidence about interventions to improve healthcare to ask which ones work to improve quality. Other reports analyse whether we are getting value for money from investment in the NHS. The QQUIP online database draws together the current data on quality and performance.

Who should read this report?
This report is intended for healthcare decision makers, including policy makers and managers. They should use this independent source of evidence to inform decisions and take actions that will lead to better quality of patient care.”

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Healthcare delivery models for prevention of cardiovascular disease (CVD)

Posted on April 29, 2009. Filed under: Cardiol / Cardiothor Surg | Tags: |

Healthcare delivery models for prevention of cardiovascular disease (CVD)

International evidence for health service providers and commissioners about how services might best prevent CVD is presented in a report from the Health Foundation. The report focuses on healthcare delivery processes that address the prevention and primary care management of modifiable CVD risk factors. There is strong evidence to show the successful impact GP-led services can have on identifying high risk patients and providing behavioural and educational services that would mitigate risk.

Published by:
The Health Foundation, London WC2E 9RA
First published 2009
ISBN 978-1-906461-07-2

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