Celia Ingham Clark National Director: Reducing Premature Mortality. Slides from Celia's presentation from the 7 Day Services events West Midlands 11th June and East Midlands 12th June 2014
This document summarizes a presentation on quality, standards, and guidelines in intensive care units. It discusses the importance of quality improvement in ICUs given their high costs and complex patient needs. It outlines various quality indicators and tools used for quality improvement, including guidelines, checklists, audits, and peer review. National guidelines and standards from organizations like ICS and FICM are referenced. The presentation emphasizes that ongoing quality improvement is needed to ensure ICUs are providing the best possible care for every patient.
Presentation made by Celia Ingham Clark National Director for Reducing Premature Mortality, at Improving access to seven day services. Southampton 25 March 2015
Clinical standards - Celia Ingham Clark
NHS England
Presentation from the 'NHS services open seven days a week: every day counts' event on Saturday 16 November at The Metropole Hotel, Birmingham.
This event was hosted by NHS Improving Quality and NHS England to share the views and ideas of public, patients, carers, NHS England and health and social care staff on how to improve access to services for patients across the seven day week.
More information at http://www.nhsiq.nhs.uk/improvement-programmes/acute-care/seven-day-services.aspx or #7DayServices
This document summarizes Lee Berry's training and experience as an Acute Care Practitioner (ACP). It outlines their educational background and clinical rotations in intensive care, anesthesia, and outreach. It also describes the practical procedures Lee performed such as intubation, vascular access, and prescribing. Feedback was generally positive but some misunderstanding of the ACP role was encountered. Long term goals include increased responsibility and competency in the intensive care unit.
This document discusses organ donation in the UK. It outlines the UK framework for organ donation and recent achievements in increasing donation rates, especially through donations after circulatory death. Future challenges discussed include taking organ transplantation to 2020 by increasing donation rates to match other countries. A key part of meeting this goal is optimizing the family approach to discussing organ donation with families of potential donors to minimize refusal rates. The document provides guidance on best practices for the family approach, including planning discussions, ensuring understanding of the patient's condition, and carefully discussing donation.
Think Kidneys: Raising the profile of AKI in EnglandRenal Association
The document discusses the Think Kidneys program in England, which aims to raise awareness of acute kidney injury (AKI) and improve care. The program has established data flows to allow audit and quality improvement, provided education to clinicians and patients about AKI, and supported leaders in prioritizing AKI care. An evaluation found the program delivered national frameworks to guide action, raised the profile of AKI, and supported other improvement initiatives. The objectives of establishing better data, education, and championing have been met.
Nephrology leadership program 3 Infection control and prevention in dialysis...Ala Ali
Provide educational materials and resources to help patients and
caregivers understand infection prevention practices. Encourage questions so
they know the signs of infection and how to prevent the spread of germs. A
well-informed patient is an essential part of any infection control program.
This document summarizes a presentation on quality, standards, and guidelines in intensive care units. It discusses the importance of quality improvement in ICUs given their high costs and complex patient needs. It outlines various quality indicators and tools used for quality improvement, including guidelines, checklists, audits, and peer review. National guidelines and standards from organizations like ICS and FICM are referenced. The presentation emphasizes that ongoing quality improvement is needed to ensure ICUs are providing the best possible care for every patient.
Presentation made by Celia Ingham Clark National Director for Reducing Premature Mortality, at Improving access to seven day services. Southampton 25 March 2015
Clinical standards - Celia Ingham Clark
NHS England
Presentation from the 'NHS services open seven days a week: every day counts' event on Saturday 16 November at The Metropole Hotel, Birmingham.
This event was hosted by NHS Improving Quality and NHS England to share the views and ideas of public, patients, carers, NHS England and health and social care staff on how to improve access to services for patients across the seven day week.
More information at http://www.nhsiq.nhs.uk/improvement-programmes/acute-care/seven-day-services.aspx or #7DayServices
This document summarizes Lee Berry's training and experience as an Acute Care Practitioner (ACP). It outlines their educational background and clinical rotations in intensive care, anesthesia, and outreach. It also describes the practical procedures Lee performed such as intubation, vascular access, and prescribing. Feedback was generally positive but some misunderstanding of the ACP role was encountered. Long term goals include increased responsibility and competency in the intensive care unit.
This document discusses organ donation in the UK. It outlines the UK framework for organ donation and recent achievements in increasing donation rates, especially through donations after circulatory death. Future challenges discussed include taking organ transplantation to 2020 by increasing donation rates to match other countries. A key part of meeting this goal is optimizing the family approach to discussing organ donation with families of potential donors to minimize refusal rates. The document provides guidance on best practices for the family approach, including planning discussions, ensuring understanding of the patient's condition, and carefully discussing donation.
Think Kidneys: Raising the profile of AKI in EnglandRenal Association
The document discusses the Think Kidneys program in England, which aims to raise awareness of acute kidney injury (AKI) and improve care. The program has established data flows to allow audit and quality improvement, provided education to clinicians and patients about AKI, and supported leaders in prioritizing AKI care. An evaluation found the program delivered national frameworks to guide action, raised the profile of AKI, and supported other improvement initiatives. The objectives of establishing better data, education, and championing have been met.
Nephrology leadership program 3 Infection control and prevention in dialysis...Ala Ali
Provide educational materials and resources to help patients and
caregivers understand infection prevention practices. Encourage questions so
they know the signs of infection and how to prevent the spread of germs. A
well-informed patient is an essential part of any infection control program.
Nephrology leadership program 2 setting a renal transplant program june 2019Ala Ali
This document outlines the key considerations for setting up a renal transplant program in a developing country. It discusses the challenges such as lack of infrastructure, political will, and cost concerns. It recommends starting with living donation and engaging an experienced transplant center for skill transfer. It also addresses the requirements for deceased donation, including legal frameworks, ethics committees, ICU support, and training transplant clinicians. The basic requirements listed are political and economic support, legal frameworks, independent ethics, national databases, validated allocation systems, and trained transplant teams.
The greatest pleasure in life is doing what people say you cannot do. Anonymo...NHS Improving Quality
The document discusses issues with diagnosing and managing patients with respiratory conditions like COPD, asthma, and heart failure in primary care settings, noting evidence of high rates of misdiagnosis, underdiagnosis of comorbidities, and fragmented services. It proposes a new enhanced care/case management service called the "Breathlessness Service" to provide more coordinated care to improve outcomes for these patients experiencing breathlessness. Case studies are presented showing how the new service achieved better diagnoses and management of patients' conditions.
Nephrology leadership program 4 patient safety in dialysis and nephrology au...Ala Ali
This document discusses patient safety in nephrology. It defines safety and harm, and provides the iceberg model of accidents and errors. It notes that adverse events during hospital admission occur in approximately 9% of patients and lead to death in 7% of cases. Many adverse events are preventable. Examples of errors in nephrology include adverse drug reactions, drug interactions, and failures to adhere to protocols. Implementing patient safety requires acknowledging problems, diagnosing issues, accepting responsibility for improvement, encouraging participation, standardizing care through guidelines, and ensuring adherence to guidelines.
Consultant Connect is a service that connects NHS Tayside consultants with professionals to provide advice and avoid unnecessary admissions. It allows secure recording and review of calls. Since launching in October 2018, it has facilitated over 12,000 calls between emergency medicine consultants, GPs, and the Scottish Ambulance Service, with 30% of ambulance calls avoiding ED attendance. Feedback from GPs has been positive, praising the quick access to specialists and improved patient care. There is potential to expand the service to additional specialties.
Presentation 223 rebecca brittain als tele health_ a patient centered approa...The ALS Association
This document discusses the development of an ALS tele-health program that allows patients to receive multidisciplinary care through virtual clinic visits. A nurse was trained to conduct remote assessments using video conferencing equipment. Standardized assessment tools were identified or developed for each discipline. The nurse would visit patients' homes to record exams and gather data, which was then reviewed virtually by the care team. An evaluation found high patient and provider satisfaction with the tele-health approach, which expanded access to care for patients unable to attend in-person clinics. The program aims to continue improving the process and identifying sustainable funding.
This lecture discusses different outpatient care settings for delivering healthcare, including retail clinics, urgent care centers, and emergency departments. It notes issues with overcrowding in emergency departments, with many visits being non-emergency cases that could be handled elsewhere. This is due in part to problems accessing primary care and a lack of after-hours options. Solutions proposed include improving access to primary care medical homes, telephone triage systems, and expanding availability of after-hours clinics.
This resume is for Alisa Hoffarth, an RN with over 15 years of experience in acute medical-surgical settings. She is currently working as an RN at the University of Minnesota Physicians assessing oncology and bone marrow transplant patients, monitoring lab values, performing vascular access and infusions. Previously she worked as an LPN at the VA Medical Center where she specialized in vascular access and as an LPN in the pre and post-surgical unit at Abbott Northwestern Hospital preparing patients for surgery and monitoring recovery. She has a variety of clinical skills and is pursuing her BSN degree with an expected graduation in December 2016.
The Pediatric Nephrology Fellowship Training Program at Albert Einstein College of Medicine and Children's Hospital at Montefiore aims to train physicians for careers in academic pediatric nephrology. The three year program consists of one year of clinical training, followed by two years focused on research. Trainees receive clinical experience in both inpatient and outpatient settings, learn procedures, and participate in research projects. Their progress is regularly evaluated based on clinical competencies and research milestones. The goal is for trainees to become skilled clinicians, researchers, and teachers in pediatric nephrology.
The document discusses a VA initiative using telehealth and phone care to reduce readmission rates for congestive heart failure (CHF) patients. Previously, care coordinators were located off-site, hindering collaboration. The new approach uses home telehealth technology to monitor patients after discharge, telephone care for communication, and evidence-based protocols. This led to lower readmission rates within 4 months - 20 patients using telehealth versus 28 with standard care. Statistical analysis found a significant difference between the telehealth and standard care groups in preventing readmissions. The conclusion is that telehealth and phone care can reduce costs by treating CHF patients at home while improving their experience.
Dr Richard Fluck - Chair of Think Kidneys spoke at HPE Live yesterday. The slides from his talk:Think(ing) Kidneys
Reducing the impact of AKI in secondary care can be found here.
1) Mrs. C, an 86-year-old woman with diabetes and other medical issues, presented with declining mobility and confusion to her primary care physician and out-of-hours doctor before being found fallen at home.
2) At an ambulatory care unit, her creatinine was found to be over 3 times her usual level, indicating stage 3 acute kidney injury (AKI). She was admitted to hospital where her renal function and mobility improved with treatment.
3) The presentation discusses AKI in vulnerable elderly populations in primary care and interface settings, calling for improved diagnostics, identification of at-risk groups, and guidance on suspecting and managing AKI outside of hospitals.
Value of secondary prevention in cardiac rehabilitationShagufaAmber
1. Secondary prevention plays an important role in the continuum of cardiovascular care by improving patient adherence to medical and lifestyle therapies, improving control of risk factors, and coordinating care between providers.
2. There are gaps in utilization of cardiac rehabilitation and secondary prevention programs due to low referral and enrollment rates.
3. Key factors that can help bridge gaps include establishing effective delivery models, developing collaborative relationships between hospitals and practices, and communicating about gaps in care to set common quality improvement goals.
Improving Quality And Reducing Cost In Healthcare The Role Of Information And...healthcareisi
The document discusses using information technology to improve healthcare quality and reduce costs. It argues that applying information and technology can reduce costs, improve access, and improve quality. It then provides examples of healthcare budget cuts in several countries due to fiscal pressures. The document also discusses using data and evidence-based practices, clinical decision support, and engaging patients to help drive cost reductions and improve outcomes.
Ian Blunt: PARR-30: a predictive model for readmission within 30 daysNuffield Trust
The document describes the PARR-30 model, which predicts hospital readmissions within 30 days of discharge. It was developed using hospital data from 2006-2009 and validated on additional data. The model includes factors like age, deprivation level, recent emergency admissions, and comorbidities. Testing showed it was easy to use and predicted a 59.2% readmission rate for high-risk patients. It could help hospitals plan interventions and reduce readmissions in a cost-effective way.
The document provides an update on the Specialist Nurse Programme (SNP) and Advanced MS Champion (AMSC) programme. It summarizes the outcomes from the first three SNP pilot sites, which showed reductions in caseloads, waiting times, and costs from avoided admissions. It also provides early learnings from AMSC sites, including potential cost savings. The programmes are demonstrating value through improved care coordination and access for people with MS.
Nephrology leadership program 2 setting a renal transplant program june 2019Ala Ali
This document outlines the key considerations for setting up a renal transplant program in a developing country. It discusses the challenges such as lack of infrastructure, political will, and cost concerns. It recommends starting with living donation and engaging an experienced transplant center for skill transfer. It also addresses the requirements for deceased donation, including legal frameworks, ethics committees, ICU support, and training transplant clinicians. The basic requirements listed are political and economic support, legal frameworks, independent ethics, national databases, validated allocation systems, and trained transplant teams.
The greatest pleasure in life is doing what people say you cannot do. Anonymo...NHS Improving Quality
The document discusses issues with diagnosing and managing patients with respiratory conditions like COPD, asthma, and heart failure in primary care settings, noting evidence of high rates of misdiagnosis, underdiagnosis of comorbidities, and fragmented services. It proposes a new enhanced care/case management service called the "Breathlessness Service" to provide more coordinated care to improve outcomes for these patients experiencing breathlessness. Case studies are presented showing how the new service achieved better diagnoses and management of patients' conditions.
Nephrology leadership program 4 patient safety in dialysis and nephrology au...Ala Ali
This document discusses patient safety in nephrology. It defines safety and harm, and provides the iceberg model of accidents and errors. It notes that adverse events during hospital admission occur in approximately 9% of patients and lead to death in 7% of cases. Many adverse events are preventable. Examples of errors in nephrology include adverse drug reactions, drug interactions, and failures to adhere to protocols. Implementing patient safety requires acknowledging problems, diagnosing issues, accepting responsibility for improvement, encouraging participation, standardizing care through guidelines, and ensuring adherence to guidelines.
Consultant Connect is a service that connects NHS Tayside consultants with professionals to provide advice and avoid unnecessary admissions. It allows secure recording and review of calls. Since launching in October 2018, it has facilitated over 12,000 calls between emergency medicine consultants, GPs, and the Scottish Ambulance Service, with 30% of ambulance calls avoiding ED attendance. Feedback from GPs has been positive, praising the quick access to specialists and improved patient care. There is potential to expand the service to additional specialties.
Presentation 223 rebecca brittain als tele health_ a patient centered approa...The ALS Association
This document discusses the development of an ALS tele-health program that allows patients to receive multidisciplinary care through virtual clinic visits. A nurse was trained to conduct remote assessments using video conferencing equipment. Standardized assessment tools were identified or developed for each discipline. The nurse would visit patients' homes to record exams and gather data, which was then reviewed virtually by the care team. An evaluation found high patient and provider satisfaction with the tele-health approach, which expanded access to care for patients unable to attend in-person clinics. The program aims to continue improving the process and identifying sustainable funding.
This lecture discusses different outpatient care settings for delivering healthcare, including retail clinics, urgent care centers, and emergency departments. It notes issues with overcrowding in emergency departments, with many visits being non-emergency cases that could be handled elsewhere. This is due in part to problems accessing primary care and a lack of after-hours options. Solutions proposed include improving access to primary care medical homes, telephone triage systems, and expanding availability of after-hours clinics.
This resume is for Alisa Hoffarth, an RN with over 15 years of experience in acute medical-surgical settings. She is currently working as an RN at the University of Minnesota Physicians assessing oncology and bone marrow transplant patients, monitoring lab values, performing vascular access and infusions. Previously she worked as an LPN at the VA Medical Center where she specialized in vascular access and as an LPN in the pre and post-surgical unit at Abbott Northwestern Hospital preparing patients for surgery and monitoring recovery. She has a variety of clinical skills and is pursuing her BSN degree with an expected graduation in December 2016.
The Pediatric Nephrology Fellowship Training Program at Albert Einstein College of Medicine and Children's Hospital at Montefiore aims to train physicians for careers in academic pediatric nephrology. The three year program consists of one year of clinical training, followed by two years focused on research. Trainees receive clinical experience in both inpatient and outpatient settings, learn procedures, and participate in research projects. Their progress is regularly evaluated based on clinical competencies and research milestones. The goal is for trainees to become skilled clinicians, researchers, and teachers in pediatric nephrology.
The document discusses a VA initiative using telehealth and phone care to reduce readmission rates for congestive heart failure (CHF) patients. Previously, care coordinators were located off-site, hindering collaboration. The new approach uses home telehealth technology to monitor patients after discharge, telephone care for communication, and evidence-based protocols. This led to lower readmission rates within 4 months - 20 patients using telehealth versus 28 with standard care. Statistical analysis found a significant difference between the telehealth and standard care groups in preventing readmissions. The conclusion is that telehealth and phone care can reduce costs by treating CHF patients at home while improving their experience.
Dr Richard Fluck - Chair of Think Kidneys spoke at HPE Live yesterday. The slides from his talk:Think(ing) Kidneys
Reducing the impact of AKI in secondary care can be found here.
1) Mrs. C, an 86-year-old woman with diabetes and other medical issues, presented with declining mobility and confusion to her primary care physician and out-of-hours doctor before being found fallen at home.
2) At an ambulatory care unit, her creatinine was found to be over 3 times her usual level, indicating stage 3 acute kidney injury (AKI). She was admitted to hospital where her renal function and mobility improved with treatment.
3) The presentation discusses AKI in vulnerable elderly populations in primary care and interface settings, calling for improved diagnostics, identification of at-risk groups, and guidance on suspecting and managing AKI outside of hospitals.
Value of secondary prevention in cardiac rehabilitationShagufaAmber
1. Secondary prevention plays an important role in the continuum of cardiovascular care by improving patient adherence to medical and lifestyle therapies, improving control of risk factors, and coordinating care between providers.
2. There are gaps in utilization of cardiac rehabilitation and secondary prevention programs due to low referral and enrollment rates.
3. Key factors that can help bridge gaps include establishing effective delivery models, developing collaborative relationships between hospitals and practices, and communicating about gaps in care to set common quality improvement goals.
Improving Quality And Reducing Cost In Healthcare The Role Of Information And...healthcareisi
The document discusses using information technology to improve healthcare quality and reduce costs. It argues that applying information and technology can reduce costs, improve access, and improve quality. It then provides examples of healthcare budget cuts in several countries due to fiscal pressures. The document also discusses using data and evidence-based practices, clinical decision support, and engaging patients to help drive cost reductions and improve outcomes.
Ian Blunt: PARR-30: a predictive model for readmission within 30 daysNuffield Trust
The document describes the PARR-30 model, which predicts hospital readmissions within 30 days of discharge. It was developed using hospital data from 2006-2009 and validated on additional data. The model includes factors like age, deprivation level, recent emergency admissions, and comorbidities. Testing showed it was easy to use and predicted a 59.2% readmission rate for high-risk patients. It could help hospitals plan interventions and reduce readmissions in a cost-effective way.
The document provides an update on the Specialist Nurse Programme (SNP) and Advanced MS Champion (AMSC) programme. It summarizes the outcomes from the first three SNP pilot sites, which showed reductions in caseloads, waiting times, and costs from avoided admissions. It also provides early learnings from AMSC sites, including potential cost savings. The programmes are demonstrating value through improved care coordination and access for people with MS.
Making Seven Day Services a reality, pop up uni, 2 pm, 3 september 2015NHS England
Following discussions on reducing weekend mortality rates, four clinical standards were identified as having the most impact: timely consultant review, access to diagnostics, access to interventions, and ongoing review. Each NHS trust was asked to complete a self-assessment tool to establish a baseline for meeting these standards by September 2015. The results will be used to track national progress in implementing seven-day services. Key lessons from early adopter sites included the importance of workforce, shared vision, increased partnerships, measurement, leadership, and patient experience.
Human: Thank you for the summary. Summarize the following section of the document:
Step Up Step Down - Key Outcomes
- Monthly report and dashboard to measure:
- Number
Seven day consultant present care
Professor Norman Williams
Chair, Academy Steering Group
President, Royal College of Surgeons of England
Presentation from the 'NHS services open seven days a week: every day counts' event on Saturday 16 November at The Metropole Hotel, Birmingham.
This event was hosted by NHS Improving Quality and NHS England to share the views and ideas of public, patients, carers, NHS England and health and social care staff on how to improve access to services for patients across the seven day week.
More information at http://www.nhsiq.nhs.uk/improvement-programmes/acute-care/seven-day-services.aspx or #7DayServices
TYA and Adult Late Effects Service at UCLHUCLPartners
Presentation by Victoria Grandage of University College London Hospitals NHS Foundation Trust at the London Cancer Children, Teenager and Young Adults Study Day, held on 25 July 2013.
Jacquie White, Deputy Director of NHS England Long Term Conditions, Older People & End of Life Care and Dr Eileen Pepler, Academic, Researcher and Consultant in the Canadian Healthcare will discuss how NHS England work in chronic disease is being translated into a Canadian context.
Cheshire and Wirral Best Practice event - 8 NovemberInnovation Agency
The document outlines plans for developing integrated care communities across South Cheshire and Vale Royal. Key points include:
- The formation of 5 care community teams to provide coordinated, patient-centered care across the region.
- Initial priority projects include developing the care community teams, improving GP out-of-hours care, and musculoskeletal physiotherapy.
- Achievements so far include aligning staff to the 5 communities, implementing rapid response services, and beginning multidisciplinary team meetings.
- Future goals involve strengthening primary care partnerships, expanding social care support, and using data to better manage patient risk levels.
The document discusses bringing together various organizations across north and east London to transform cancer care through implementing a timed oesophago-gastric cancer pathway. It describes the old, uncoordinated system and the new proposed pathway, which aims to streamline services, reduce variation in outcomes, and meet national cancer standards. Initial audit data from nine trusts shows that while some can diagnose patients within 28 days, the median time exceeds this, identifying need for pathway improvements.
Testing Telehealth Solutions for Post Acute CareVSee
Telehealth Failures & Secrets to Success Conference 2017 by VSee
Speaker: Tomi Ryba & Margaret Wilmer
Senior Director of Integrated Care of El Camino Hospital
More info at: vsee.com/conference
7 day services practical tips for achieving consultant review of patients wit...NHS England
Sue Cottle, Programme Lead, 7 Day Services, Sustainable Improvement, NHS England South
Celia Ingham Clark, MBE, Medical Director for Clinical Effectiveness, NHS England
Claire Gorzanski, Head of Clinical Effectiveness, Salisbury NHS Foundation Trust
Sam Burrows, Director of Strategy, NHS Wokingham CCG
This webinar aims to provide you with:
An overview of the updated guidance for the priority clinical standards and timing of the forthcoming self-assessment survey
Practical examples of how commissioners and acute providers are working together to support delivery of timely Consultant assessment (clinical standard 2) – their successes, challenges and opportunities
An opportunity to ask questions of your colleagues and identify key areas of support required
Two of the New York metro area’s largest provider organizations will share their experiences leveraging HIE as one of many tools to decrease fragmentation of care and improve patients’ experiences across acute and post-acute care settings for patients undergoing elective surgeries. Representatives from NYULMC and VNSNY will summarize their efforts to redesign more personalized specific care pathways and the central role played by the implementation of real-time data exchange to provide a seamless transfer of clinical data between providers caring for the patient at the time of discharge and throughout the post-acute period.
• Kathleen Mullaly - Senior Director for Clinical Operations, Department of Network Integration, NYU Langone Medical Center
• Amy Weiss - Director for Strategic Account Development, Integrated Delivery Systems, Visiting Nurse Service of New York (VNSNY)
New York eHealth Collaborative Digital Health Conference
November 18, 2014
The document summarizes a palliative and end of life care service called Coordinated, Safe and Integrated (CoSI) care. CoSI aims to [1] reduce hospital admissions and support patient choice for place of care and death, [2] provide enhanced coordination of care across partner organizations for patients with 6-8 weeks to live, and [3] lower costs compared to usual care. Since launching in 2014, CoSI has supported over 500 patients, with 76% receiving care within 48 hours and 100% of patients who died achieving their preferred place of death at home. Evaluation found acute care costs were £1,700 on average for CoSI patients versus £3,812 for others in their last 3 months
Seven Day Hospital Services Workshop: South West NHS England
This workshop event, hosted by NHS England and NHS Improvement, brought together acute trust’s working towards the delivery of the four priority clinical standards by March 2018. Trust clinical leads and operational managers shared local challenges and solutions to delivery.
Dr David Maltz: The challenge of length of stayNuffield Trust
In this slideshow, Dr David Maltz, of The Oak Group, explores the challenge of length of stay and opportunities for improvement.
Dr Maltz spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September 2014.
- 35% of non-elective hospital admissions in the UK are concentrated in just 1% of the population, who are highly transient and in need of proactive support.
- A proactive health coaching intervention aims to circumvent periods of high healthcare utilization by providing non-clinical support to empower patients and improve self-management, especially at the earliest signs of disease progression.
- Initial results found the intervention led to fewer hospital admissions and emergency department visits, shorter hospital stays, better health outcomes, and higher quality of life for patients.
Health Navigator lunch and learn – 15 January 2016Rebecca Wootton
- 35% of non-elective hospital admissions in the UK are concentrated in just 1% of the population, who are highly transient and in need of proactive support.
- A proactive health coaching intervention aims to circumvent periods of high healthcare utilization by providing non-clinical support to empower patients and improve self-management from the earliest signs of disease progression.
- Initial results found the intervention led to fewer emergency admissions and hospital bed days, reduced healthcare costs, and improved patient health outcomes and quality of life.
Similar to Developing and implementing clinical standards for seven day services (20)
The document discusses factors that contribute to successful change agents or "boat rockers". It identifies four key things: 1) having a strong sense of self-efficacy or belief in one's ability to create change; 2) being able to join forces with others to take action; 3) being able to achieve small wins which build momentum; and 4) viewing obstacles as challenges to overcome rather than barriers. Building self-efficacy involves tactics like starting with small, achievable changes and reframing failures as learning opportunities. Social support and learning from exemplars are also discussed.
Stopping over-medication of People with Learning Disabilities
(STOMPLD) 2016.
Reducing Inappropriate Psychotropic Drugs in People with a Learning Disability in General Practice and Hospitals in 2016.
The document discusses how change is happening more rapidly, with projects now lasting 30-60 days rather than years. It also discusses how power is shifting away from hierarchies and centralized control to networks and relationships. Leaders are needed who can operate from the "edge" and empower others through open relationships rather than closed transactions. Rebels are needed who can disrupt and challenge the status quo in a responsible way to drive innovation and new ways of thinking.
Presentation slides Frailty: building understanding, empathy and the skills t...NHS Improving Quality
Frailty: building understanding, empathy and the skills to support self-care
Guest speaker:Dr Dawn Moody, Director - Fusion48
An opportunity to learn about some innovative approaches to making the health and care workforce 'Fit for Frailty'* (*British Geriatrics Society 2015).
Learning outcomes:
To explore the Frailty Fulcrum as a tool for holistic assessment and management of frailty
To hear how Virtual Reality is being used to build empathy for older people living with frailty
To learn about the impact of a county-wide, multi-agency, multi-professional training an toolkit for care professionals working with older people
Resources:www.fusion48.net
Self-management in the community and on the Internet - Presentation 22nd Marc...NHS Improving Quality
LTC Lunch & Learn webinar:- 22nd March 2016
Presenter:- Pete Moore, Educator, Author & Pain Toolkit Trainer
As pain is the most daily health problem reported to a GP-
Developing a national pain strategy- reviews from around the world
Electronic Palliative Care Coordination Systems (EPaCCS): Improving Patient C...NHS Improving Quality
Speaker slides from the national conference, 'Electronic Palliative Care Coordination Systems (EPaCCS): Improving Patient Care at End of Life', 17 March 2016
Fire service as an asset: providing telecare support in the community Webinar...NHS Improving Quality
Guest speaker: Steve Vincent - West Midlands Fire Service & Simon Brake from Coventry Council
Hosted by: Bev Matthews, Long Term Conditions Programme Lead, NHS England
Learning Outcomes:-
To better understand the role that the Fire and Rescue service can provide as a community asset to support health needs Enhancing the quality of life for people by supporting them to stay in their own home, even in a crisis
An overview of the work carried out by NHS England and NHS Improving Quality's Long Term Conditions Sustainable Improvement Team. It puts the case for why person-centred care has to be at the heart of healthcare.
Commissioning Integrated models of care
Kent LTC Year of Care Commissioning Early Implementer Site
Alison Davis, Integration Programme Health and Social Care, Working on behalf of Kent County Council and South Kent Coast and Thanet CCG's
Integrated data to support service redesign decision making 19 01 2016 finalNHS Improving Quality
Integrated data to support service redesign decision making
Leeds LTC Year of Care Commissioning Early Implementer Site
Tricia Cable, Year of Care Lead
Alison Phiri, Business Intelligence Manager
Mohini Chauhan, Year of Care Commissioning Manager
Slides from a lunch and learn webinar hosted by NHS England's Long Term Conditions Team, on the topic of health coaching by lay professionals.
The speakers and Anya de Longh and Jim Phillips.
This document announces a networking event hosted by the Sustainable Improvement Team for long term conditions in the Midlands and East of England on November 3rd, 2015 in Leicester. The event aimed to connect professionals working with long term conditions to discuss improvement initiatives. It used the hashtags #LTCImp and #A4PCC to promote discussion of long term condition improvement and accountable care organizations on social media.
COLOUR CODING IN THE PERIOPERATIVE NURSING PRACTICE.SamboGlo
COLOUR CODING IN THE PERIOPERATIVE ENVIRONMENT HAS COME TO STAY ,SOME SENCE OF HUMOUR WILL BE APPRECIATED AT THE RIGHT TIME BY THE PATIENT AND OTHER SURGICAL TEAM MEMBERS.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
English Drug and Alcohol Commissioners June 2024.pptxMatSouthwell1
Presentation made by Mat Southwell to the Harm Reduction Working Group of the English Drug and Alcohol Commissioners. Discuss stimulants, OAMT, NSP coverage and community-led approach to DCRs. Focussing on active drug user perspectives and interests
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTblessyjannu21
Prepared by Prof. BLESSY THOMAS, VICE PRINCIPAL, FNCON, SPN.
Emphysema is a disease condition of respiratory system.
Emphysema is an abnormal permanent enlargement of the air spaces distal to terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.
Emphysema of lung is defined as hyper inflation of the lung ais spaces due to obstruction of non respiratory bronchioles as due to loss of elasticity of alveoli.
It is a type of chronic obstructive
pulmonary disease.
It is a progressive disease of lungs.
As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
CHAPTER 1 SEMESTER V COMMUNICATION TECHNIQUES FOR CHILDREN.pdfSachin Sharma
Here are some key objectives of communication with children:
Build Trust and Security:
Establish a safe and supportive environment where children feel comfortable expressing themselves.
Encourage Expression:
Enable children to articulate their thoughts, feelings, and experiences.
Promote Emotional Understanding:
Help children identify and understand their own emotions and the emotions of others.
Enhance Listening Skills:
Develop children’s ability to listen attentively and respond appropriately.
Foster Positive Relationships:
Strengthen the bond between children and caregivers, peers, and other adults.
Support Learning and Development:
Aid cognitive and language development through engaging and meaningful conversations.
Teach Social Skills:
Encourage polite, respectful, and empathetic interactions with others.
Resolve Conflicts:
Provide tools and guidance for children to handle disagreements constructively.
Encourage Independence:
Support children in making decisions and solving problems on their own.
Provide Reassurance and Comfort:
Offer comfort and understanding during times of distress or uncertainty.
Reinforce Positive Behavior:
Acknowledge and encourage positive actions and behaviors.
Guide and Educate:
Offer clear instructions and explanations to help children understand expectations and learn new concepts.
By focusing on these objectives, communication with children can be both effective and nurturing, supporting their overall growth and well-being.
Exploring the Benefits of Binaural Hearing: Why Two Hearing Aids Are Better T...Ear Solutions (ESPL)
Binaural hearing using two hearing aids instead of one offers numerous advantages, including improved sound localization, enhanced sound quality, better speech understanding in noise, reduced listening effort, and greater overall satisfaction. By leveraging the brain’s natural ability to process sound from both ears, binaural hearing aids provide a more balanced, clear, and comfortable hearing experience. If you or a loved one is considering hearing aids, consult with a hearing care professional at Ear Solutions hearing aid clinic in Mumbai to explore the benefits of binaural hearing and determine the best solution for your hearing needs. Embracing binaural hearing can lead to a richer, more engaging auditory experience and significantly improve your quality of life.
Exploring the Benefits of Binaural Hearing: Why Two Hearing Aids Are Better T...
Developing and implementing clinical standards for seven day services
1. Developing and implementing
clinical standards for seven day
services
Celia Ingham Clark
National Director:
Reducing Premature
Mortality
11/12 June 2014
2. National seven day services Forum
• The national Seven Day Services Forum led by Bruce Keogh is
leading the approach to deliver seven day health care services
• It initially focussed on the acute inpatient pathway, although there
is recognition of the need for whole-system change.
• As such, there is alignment with other national work including the
Urgent and Emergency Care review, primary care transformation
and the integrated care programme.
• A clinical reference group reviewed the evidence base and
developed clinical standards for acute inpatients, based on
recommendations from professional bodies.
• The NHS England Board has agreed to the inclusion of these
clinical standards in the standard contract over the next three
years
2
3. Seven day services: Why?
• Illness happens seven days a week
• Currently outcomes differ at weekends
• Trainee feedback suggests variable consultant involvement in
acute care out of hours
• Hypothesis that patients admitted at weekends are sicker due to
limited access to primary care
• Importance of “failure to rescue” in defining the difference
between hospitals with high and low mortality rates
• Acute illness can occur at any time and patient expectations are
rising as other sectors (e.g. banking and retail) have moved to
offer seven day services
3
4. Key themes
• There is often inadequate involvement of senior medical
personnel in the assessment and subsequent management of
many acutely ill patients, particularly at the weekend
• Limited access to diagnostic services and allied health
professionals at weekends to establish multi-disciplinary
management plans and facilitate transfer out of hospital
• Poor weekend emergency service provision is associated with an
increased variation in outcomes such as:
• Mortality rates
• Patient experience
• Length of stay
4
5. Cause of the weekend effect - multifactorial
• Variable staffing levels in hospitals at the weekend
• Fewer senior decision makers of consultant level skill and
experience on site at the weekend
• A lack of consistent support services, such as diagnostic and
scientific services at weekends
• A lack of community, primary and social care services which
could prevent some unnecessary admissions and support
timely discharge
5
6. In London data shows higher mortality rates for
weekend emergency admissions than weekdays
Total
emergency
admissions
In hospital mortality
following emergency
admission
In hospital mortality
following emergency
admission (%)
Weekday 521,868 16,377 3.14
+0.32
Weekend 159,676 5,531 3.46
The 0.32% difference between weekday and weekend
mortality equates to 520 potentially avoidable deaths
London’s heart attack centres already operate a consultant
delivered service seven days per week and no observed
difference is found in mortality rates in the week and at the
weekend, suggesting where systems are in place to respond
seven days a week, there is a direct effect on mortality rates
6
7. Similarly elective surgical mortality is higher
for weekend admissions
Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics
BMJ 2013;346:f2424 (Published 28 May 2013)
7
8. Seven Day Services – What?
• What we mean by Seven Day Services
• Emergency care Must Do
• Urgent care Should Do
• Elective care Could Do
• ? All of the above
8
9. Seven day services: What?
9
True emergencies –
where minutes delay
can affect risk of death
• Cardiac arrest
• Ruptured aortic aneurysm
• Acute MI
• Extra-dural haematoma
Services provided
promptly
• Emergency laparotomy
• Fractured NOF (DH 2011 BPT to improve care)
• “hot” cholecystectomy
Routine services
• Endoscopy
• MRI scans
Services not
commonly provided
at weekends now
• Routine elective surgery
• Routine GP consultations
• Contact with specialist nurses
• Routine outpatient appointments
Similar spectrum applies to diagnostics and their reports: FBC, U&E, ECG,
CXR, CT, USS and cardiac echo, spirometry, histopathology
Spectrumofcare
10. Seven day services:
Not ‘should we’ but ‘how far should we go’?
10
• Care and services need to shift towards seven day services to
abolish differentials in:
• Patient safety
• Patient experience
• Clinical effectiveness
• Discussions underway: should this also address patient
convenience?
11. 11
Review of literature
and College reports
Develop case for
change
Develop
standards
Commission
standards
Audit acute hospitals
against standards
Follow up with acute
hospitals
Engagementwithkeystakeholders
Development of the London acute care quality
standards
12. London quality standards – overview
• Addressing the variations in service arrangements and patient outcomes
between weekdays and weekends was identified by the NHS in London
as a key priority in 2012/13 and has remained as such.
• Scope of the standards:
12
Adult emergency
services (AES)
Paediatric emergency
services (PES)
Maternity
services
Emergency departments
Acute medicine
Emergency general surgery
Critical care
Fractured neck of femur
Emergency departments
Emergency inpatient
medicine
Emergency general
surgery
Specific parts of the
pathway requiring
specialist acute care:
- Labour
- Birth
- Immediate postnatal
care
13. London quality standards: Key themes
• Admissions seen by consultant <12 hours
• Twice daily ward rounds for all acute patients
• MDT plan within 24 hours including EDD
• Timely access to diagnostics and reports
• Timely access to interventions including theatre
• Good information for patients and their carers
• Timely transfer to next place of care
13
14. London quality standards:
consultant-delivered care
• All patients seen and assessed by a consultant within 12 hours
of admission
• Emergency admissions to be managed in MAU, SAU or Critical
Care Unit
• Rotas constructed to maximise continuity of patient care
• Access to all key diagnostic services in a timely manner 24
hours a day, seven days a week to support clinical decision making
• Access to Interventional Radiology 24 hours a day, seven days
a week within 1 hour for critical patients
• Access to comprehensive endoscopy 24 hours a day, seven
days a week
14
15. London quality standards:
consultant-delivered care
• All health professionals use unitary document for medical record
• EDD set within 24 hours of admission
• All patients on MAU/SAU seen and reviewed by a consultant
during twice daily ward rounds
• All referrals to intensive care should have consultant involvement
• Structured handovers should take place twice a day and at every
handover between consultant teams
Patient experience
• Consultant-led communications and information to patients,
including patient information leaflets
• Patient experience data recorded, analysed and acted on
15
16. National approach
The National Seven Day Services Forum established by
Professor Sir Bruce Keogh in 2013 found that:
• Variation in outcomes exists for patients admitted at the
weekend, seen in mortality rates, patient experience, length of
hospital stay and re-admission rates
• Our junior doctors often feel clinically exposed and
unsupported at weekends
• Lack of many seven day services has an adverse effect on
measurable outcomes in each of the five domains of the NHS
Outcomes Framework:
• mortality amenable to healthcare
• quality of care for people with long term conditions
• outcomes from acute episodes of care
• patient experience
• patient safety16
17. Developing national clinical standards
A Clinical Reference Group (CRG) was convened with
representation from patients, primary care, secondary care, social
care and colleagues from Colleges and professional bodies to
develop clinical standards on behalf of the Forum.
The CRG was asked to:
• Establish the clinical evidence base for providing NHS
Services, 7 days a week
• Defining standards of care that will help commissioners and
providers to deliver a consistently high quality acute care
service at all times of the week.
17
18. 18
Consultant review within 12/14 hrs
Availability of core MDT
Rapid access to diagnostics
Only 16% of hospitals
review all emergency
medical admissions
within 14 hours of
arrival
Nearly 80% have
5 or more MDT
members during
the week. This is
just 30% at the
weekend
X-ray and CT availability is
consistently high but other services
vary considerably making informed
decision making difficult
Seven Day Services Forum: survey findings
19. Seven Day Services Forum: clinical standards
The CRG developed 10 clinical standards based on the evidence
and recommendations from Royal Colleges and expert bodies.
These follow the patient pathway, apply seven days a week and aim
to ensure:
• Prompt access to consultant review and multi-disciplinary
assessment
• Availability of diagnostics to support decision-making
• Timely treatment and interventions
• Planned, safe and appropriate timing of transfers from hospitals
All standards are based on existing recommendations from Royal
Colleges and expert bodies and will cover the seven days of the
week
19
20. Alignment with Academy of Medical Royal
Colleges
The clinical standards are deliberately aligned with the Academy of
Medical Royal Colleges work on consultant-delivered care:
• Consultant involvement: All hospital inpatients should be reviewed by
an on-site consultant at least once every 24 hours, seven days a week,
unless it has been determined that this would not affect the patient's care
pathway
• Consultant supervision: Consultant-supervised interventions and
investigations, and their reports should be provided, seven days per
week, if the results will change the outcome or status of the patient’s
care pathway before the next ‘normal’ working day – this should include
interventions and investigations which will enable immediate discharge
or a shortened length of hospital stay
• Support services, seven days a week: Support services both in
hospital and in the community and primary care setting should be
available seven days per week to ensure that the next steps in the
patient’s care pathway, as determined by the daily consultant review, can
be taken20
21. Clinical standard 1:
Patient experience
• Patients, and where appropriate families and
carers, must be actively involved in shared
decision making and supported by clear
information from health and social care
professionals to make fully informed choices
about investigations, treatment and on-going care
that reflect what is important to them. This should
happen consistently, seven days a week.
21
22. 2: Time to first consultant review
• All emergency admissions must be seen and
have a thorough clinical assessment by a
suitable consultant as soon as possible but at
the latest within 14 hours of arrival at hospital
22
23. 3: Multi-disciplinary team review
• All emergency inpatients must have prompt
assessment by a multi-professional team to
identify complex or on-going needs, unless
deemed unnecessary by the responsible
consultant. The multi-disciplinary assessment
should be overseen by a competent decision-
maker, be undertaken within 14 hours and an
integrated management plan with estimated
discharge date to be in place along with
completed medicines reconciliation within 24
hours
23
24. 4: Shift handovers
• Handovers must be led by a competent senior
decision maker and take place at a designated
time and place, with multi-professional
participation from the relevant in-coming and out-
going shifts. Handover processes, including
communication and documentation, must be
reflected in hospital policy and standardised
across seven days of the week
24
25. 5: Diagnostics
Hospital inpatients must have scheduled seven-day
access to diagnostic services such as x-ray,
ultrasound, computerised tomography (CT),
magnetic resonance imaging (MRI),
echocardiography, endoscopy, bronchoscopy and
pathology. Consultant-directed diagnostic tests
and their reporting will be available seven days a
week:
• within 1 hour for critical patients
• within 12 hours for urgent patients
• within 24 hours for non-urgent patients
25
26. 6: Interventions
Hospital inpatients must have timely 24 hour
access, seven days a week, to consultant-
directed interventions that meet the relevant
specialty guidelines, either on-site or through
formally agreed networked arrangements with
clear protocols, such as:
• critical care
• interventional radiology
• interventional endoscopy
• emergency general surgery
26
27. 7: Mental health
Where a mental health need is identified following
an acute admission the patient must be assessed
by psychiatric liaison within the appropriate
timescales 24 hours a day, seven days a week:
• Within 1 hour for emergency care needs
• Within 14 hours for urgent care needs
27
28. 8: Ongoing review
• All patients on the AMU, SAU, ICU and other high
dependency areas must be seen and reviewed by
a consultant twice daily, including all acutely ill
patients directly transferred, or others who
deteriorate. To maximise continuity of care
consultants should be working multiple day blocks
• Once transferred from the acute area of the
hospital to a general ward patients should be
reviewed during a consultant-delivered ward
round at least once every 24 hours, seven days
a week, unless it has been determined that this
would not affect the patient’s care pathway
28
29. 9: Transfer to community, primary
and social care
• Support services, both in the hospital and in
primary, community and mental health settings
must be available seven days a week to ensure
that the next steps in the patient’s care pathway,
as determined by the daily consultant-led review,
can be taken
29
30. 10: Quality Improvement
• All those involved in the delivery of acute care
must participate in the review of patient outcomes
to drive care quality improvement. The duties,
working hours and supervision of trainees in all
healthcare professions must be consistent with
the delivery of high-quality, safe patient care,
seven days a week
30
31. Seven Day Services: Implementation
• Year 1 (2014/15) – local contracts should include an Action
Plan to deliver the clinical standards within the Service
Development and Improvement Plan Section
• Year 2 (2015/16) – those clinical standards which will have
the greatest impact should move into the national
requirements section of the NHS Standard Contract
• Year 3 (2016/17) – all clinical standards should be
incorporated into the national requirements section of the
NHS Standard Contract with appropriate contractual
sanctions for non-compliance.
31
32. Enablers for implementation
• NHS England Implementation Board and delivery sub-group
• Development of metrics to support the standards
• Clinical Senates support
• NHS IQ to introduce a large-scale transformational change
programme to support the spread of seven day services
• CRG continues to provide expert advice
• In London – ongoing audit of implementation of Quality
Standards, and lessons shared
• Inspection and assurance – CQC hospital inspections to
include assessment of seven day services implementation
32
33. The wider context
Recognising relationships with other work including:
• Primary Care Transformation
• Urgent and Emergency Care Review
• Integrated care programme
• Reconfiguration proposals and service change plans
• Productive elective care
33
34. Patient perspective
• “I was lucky. Shouldn’t every one of us
have the best chance possible no
matter what time of day or day of the
week it is?”
• Rodney Partington, Patient representative
34