Learning from failure: lessons from the Checklist project in Wessex – by Dr Kate Lyle and Professor Catherine Pope

Dr Kate Lyle is a Research Fellow based in Health Sciences at the University of Southampton

Professor Catherine Pope is Deputy Director NIHR CLAHRC Wessex

Dr Kate Lyle is a Research Fellow in Health Sciences at the University of Southampton and Professor Catherine Pope (right) is Deputy Director of NIHR CLAHRC Wessex

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As academics, practitioners, and users of healthcare services we are all used to hearing about examples of successful interventions that have improved health services and care.  Indeed one of the core aims of the NIHR CLARHC programme is to improve patient outcomes locally and across the wider NHS. Here in Wessex we have been working hard over the past 5 years to do just that, spreading best practice and evidence based research throughout the NHS.

But what about the things that don’t work? Attempts at service improvement or innovation that went nowhere? Often these are the things we don’t hear about.  Yet, arguably there is as much to learn from our failures, as there is from successful innovations.

Right idea? Wrong time

Overloaded A&Es – Have we got this all wrong? Dr Brad Keogh

Dr Brad Keogh

Accident and Emergency wait times seem to be constantly in the news. Less commonly but equally importantly are headlines that waiting lists for elective operations and procedures are on the rise. Although these topics hit our headlines regularly there is actually very little evidence and understanding behind the reasons for these changes in NHS services, and how the NHS can take positive action to cope with these issues.

From what we understand a lot of the currently held beliefs around the causes for pressure on NHS services come from very basic, non peer-reviewed, and potentially flawed analyses. It does not need too much explaining that making decisions based on these might be a bad idea.

What are we missing here? (Are at risk older people spotted early enough in hospital?) – Dr Kinda Ibrahim, Research Fellow at Academic Geriatric Medicine

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).

The importance of the academic citizen in Health Services Research – Dr Gemma McKenna

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.

Should Wessex implement ReSPECT process? – The NIHR CLAHRC Wessex hosted event May 11, 2017

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.

OPINION: Tonight’s movie is a set in a dystopian future and stars your local A&E department. Dr Tom Monks

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.

Breathe in the knowledge -by Lindsay Welch

Lindsay Welch is the Integrated COPD Team Lead; Solent NHS Trust and UHS NHS Foundation Trust

COPD or Chronic Obstructive Pulmonary Disease is a preventable disease and is one of the world’s biggest killers – it causes a narrowing of the breathing tubes and air sacs in our chest and lungs, reducing the amount of oxygen we can get into our bodies. There are several causes, air pollution and exposure to dust, but the main culprit is smoking. It is estimated that over three million people with COPD in the UK but only a quarter of those are diagnosed

Maths without equations: Dr Tom Monks insights into patient flow from queuing theory

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.

Evidence Brief – 12 hour shifts: Nurse burnout, job satisfaction & intention to leave – by Chiara Dall’ora

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.

Why we need to deal with the realities of Dementia in our hospitals – Dr Jackie Bridges Associate Professor, Older People’s and Dementia Care

Dr Jackie Bridges – Associate Professor, Older People’s and Dementia Care, Faculty of Heath Sciences at the University of Southampton

When people with dementia get admitted to hospital, their need for fundamental care can be high. Everyone coming in to hospital wants to be treated with respect and dignity by health care workers who have the time, resources and training needed to keep them safe and well cared for.  But having dementia can put people at higher risk of not having these needs met.