Nearly two thirds (65%) of people admitted to hospital in the UK are aged over 65 years old. Many of them are frail and at high risk of poor healthcare outcomes – like staying longer in hospital, reduced physical abilities, becoming dependant, going to a care home, and even death.
National recommendations suggest that these high-risk older individuals should be routinely identified when they are admitted to hospital to allow healthcare teams to provide appropriate individual care that meets patient’s needs (1). It is unclear whether and how those people are identified in hospital. Therefore our study looked at the current practice in one hospital with regard to identification of patients at high-risk of poor healthcare outcomes. To do that, we reviewed a random sample of patient’s clinical notes and interviewed staff members who worked at five acute medicine for older people wards (2).
Continue reading What are we missing here? (Are at risk older people spotted early enough in hospital?) – Dr Kinda Ibrahim, Research Fellow at Academic Geriatric Medicine
It was palpable with research geekery excitement while travelling to Nottingham for the 2017 Health Services Research UK Conference. I needed this, I thought, an opportunity for positivity, to talk enthusiastically about how we as researchers can help sustain the future of the NHS and wider health services. The conference didn’t disappoint.
We are all too aware of the popular rhetoric that consumes newsfeeds and social media channels, with headlines like ‘The NHS is in Crisis’ and ‘too many people are pitching up to A&E’. All doom and gloom. The conference was a perfect antidote to this. While there are no panaceas to these ongoing issues, my fellow health services researchers offered positivity and direction against the troubling backdrop of public service austerity and Brexit uncertainty.
Continue reading The importance of the academic citizen in Health Services Research – Dr Gemma McKenna
The event in Southampton attracted organisations* from across the Wessex region and beyond and a wide range of people including the public, paramedics, nursing staff, clinicians, managers and researchers.
Many stakeholders were represented bringing together 44 delegates, all there to examine and reflect on whether the ReSPECT approach to decision making for emergency care should be adopted.
Continue reading Should Wessex implement ReSPECT process? – The NIHR CLAHRC Wessex hosted event May 11, 2017
If you surf to a news website right now or flick on the TV news this evening, you might for a moment think that you watching a bad science fiction movie of a dystopian future starring your local A&E department. Sadly, it is real. The news has gone mad about A&E and the waiting time crisis that it faces. This morning the BBC reported that only 82% of patients are meeting the four-hour waiting time target. It doesn’t make pleasant reading.
Continue reading OPINION: Tonight’s movie is a set in a dystopian future and stars your local A&E department. Dr Tom Monks
Having conversations about the best course of action in the event a person’s condition deteriorates is difficult for everyone involved, whether it is the patient themselves, their family or carer and the clinician.
After an initial study on Advance Care Planning (A. Richardson, S. Lund1), research into the current application of treatment escalation plans across the country, and early engagement with some of the acute trusts in the Wessex region, it was apparent there was a desire to improve this process.
Continue reading NATIONAL CONSULTATION ON EMERGENCY CARE AND TREATMENT PLAN: IMPLICATIONS FOR THE TREATMENT ESCALATION PLAN (TEP) PROJECT? Professor Alison Richardson
Previously I have written about using a detailed computer model to ask ‘what-if’ an emergency department could be run differently. Hidden away in complex models like these are important rules of thumb that tell us how to efficiently manage patient flow.
Continue reading Maths without equations: Dr Tom Monks insights into patient flow from queuing theory
Our muscles play an important role in our health and grip strength is a good way of measuring how well our muscles are doing. Our grip strength builds through young adulthood to reach its peak in our 30s after which it gradually tails away. It is a reliable and valid way of evaluating someone’s hand strength, which in turns provides an objective measure of the skeletal muscle strength and function in their whole body.
Continue reading Getting a grip on high risk older inpatients with low grip strength -Dr Kinda Ibrahim and Dr Helen Roberts, Associate Professor in Geriatric Medicine
Job satisfaction and burnout in the nursing workforce are global concerns. Not only do job satisfaction and burnout impact on the quality and safety of care, but job satisfaction is also a factor in nurses’ decisions to stay or leave their jobs. Shift patterns may be an important aspect influencing wellbeing and satisfaction among nurses. Many hospitals worldwide are moving to 12 hour shifts in an effort to improve efficiency and cope with nursing shortages. But what is the effect of these work patterns on the wellbeing of nurses working on hospital wards? In this digest we report on the results of a study performed in 12 European countries exploring whether 12 hour shifts are associated with burnout, job satisfaction and intention to leave the job.
Continue reading Evidence Brief – 12 hour shifts: Nurse burnout, job satisfaction & intention to leave – by Chiara Dall’ora
Dr Tom Monks puzzles the opportunities and pitfalls of modelling large parts of the health care system and how this might help patients waiting to leave hospital.
I work as a modeller for CLAHRC Wessex. In part that means I spend a lot of time speaking to health care professionals and commissioners about their priorities and teasing out if modelling could help. More and more often I am asked “can we model the whole health care system?”.
Continue reading I want to go home: Can modelling the whole health care system reduce the number of patients waiting to leave hospital?
Spring. The headlines about A&E overcrowding are beginning to disappear just as a fresh wave of news reports burst forth with the NHS priorities for the next government. We now have the luxury of a brief respite to reflect on how we can improve the lot of our hospital A&E’s before the seasonal cycle repeats itself. I have spent my winter looking at A&E data examining the question – could the answer to A&E attendance lie in providing GP appointments for urgent – but non-emergency – care at the weekend?
Continue reading What are the fresh ideas to reduce A&E overcrowding? Dr Tom Monks CLAHRC Wessex Methodological Hub