Category Archives: efficiency

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

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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.

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

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Why might nurses miss people’s ‘danger signs’ at night? – Dr Jo Hope

We know that nurses miss or delay taking patients’ vital signs (such as pulse, temperature and blood pressure) at night. Until now, no one knew why.

The NHS expects hospitals to use ‘Early Warning Scores’ to measure how ill someone is. These are based on the observation of ‘vital signs’ – measurements of things like pulse, temperature, blood pressure and breathing speed. The higher the score, the more often someone’s vital signs should be checked. This is so staff can spot the early danger signs of someone becoming very unwell, in time to help them.

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Your local hospital will probably have an ‘early warning protocol’ that says how often people should be checked according to their early warning score. At higher levels observations will need to be done in the middle of the night. Despite this, we know that nurses are much less likely to do the observations that are expected to be done at night.

Continue reading Why might nurses miss people’s ‘danger signs’ at night? – Dr Jo Hope

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.

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

Using Health Systems Analytics to help the NHS improve the quality and equity of services -Dr Marion Penn, Dr Rudabeh Meskarian and Dr Thomas Monks

In Hampshire, Solent NHS Trust and Commissioners are making use of advanced Health Systems Analytics to visualise their demand, and support their decisions about the how many sexual health clinics should be funded to meet future patient need.

Continue reading Using Health Systems Analytics to help the NHS improve the quality and equity of services -Dr Marion Penn, Dr Rudabeh Meskarian and Dr Thomas Monks

Prioritising the fundamentals of care with patients, professionals, carers and the public – Anya de Iongh

As PPI Champion for the Fundamentals of Care theme within NIHR CLAHRC Wessex, I’ve a great experience and opportunity to be an equal member of a team developing the research priorities for this area of work. Crucially, these weren’t priorities that we developed together in a closed room, but rather they were co-produced at several stages.

Continue reading Prioritising the fundamentals of care with patients, professionals, carers and the public – Anya de Iongh

Are some social networks better for self-management than others? Dr Ivaylo Vassilev, Senior Research Fellow

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The everyday management of a long-term condition is almost never done by individuals in isolation from others. The networks of relationships around people may include family members, friends, neighbours, colleagues, health professionals and even pets all of who play an important role in the management of long-term conditions. This is through, for example, their knowledge, support, help with accessing services, resources and valued activities.

Continue reading Are some social networks better for self-management than others? Dr Ivaylo Vassilev, Senior Research Fellow

Dementia care at meal times in acute hospitals – Naomi Gallant

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Almost a year on from my last post here and I’ve done a lot of work on my developing my research proposal – reading, learning, literature reviewing – but sadly not a lot has changed for people with dementia in acute hospitals. My desire to improve the quality of care, especially at meal times has certainly grown.

Continue reading Dementia care at meal times in acute hospitals – Naomi Gallant

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.

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Getting a grip on high risk older inpatients with low grip strength -Dr Kinda Ibrahim and Dr Helen Roberts, Associate Professor in Geriatric Medicine

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

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.

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