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Strategy to improve the quality of care in England. 提高英格兰护理质量的战略。
Future hospital journal Pub Date : 2016-10-01 DOI: 10.7861/futurehosp.3-3-182
Sheila Leatherman, Tim Gardner, Aoife Molloy, Sara Martin, Jennifer Dixon
{"title":"Strategy to improve the quality of care in England.","authors":"Sheila Leatherman, Tim Gardner, Aoife Molloy, Sara Martin, Jennifer Dixon","doi":"10.7861/futurehosp.3-3-182","DOIUrl":"10.7861/futurehosp.3-3-182","url":null,"abstract":"<p><p>The Five Year Forward View describes 'closing the care and quality gap' as one of three strategic challenges facing the English NHS by 2020. The need for a coherent national strategy for achieving high-quality, affordable care has rarely been more pressing, but how effectively do existing national decisions and interventions support clinicians delivering care on the front line? And, in a complex and dynamic environment with multiple players, how should the health service move forward to develop a balanced strategy for quality that accommodates longer term goals as well as more immediate political priorities? Research by a team at the Health Foundation has assessed how the array of organisations, initiatives and approaches to quality stack up as an emergent strategy. Four concepts were used to provide a yardstick for quality-related policies and activities to help identify potential imbalances, gaps and duplication. The findings of this work, together with suggested steps to rectify the issues identified, are described here.</p>","PeriodicalId":92635,"journal":{"name":"Future hospital journal","volume":"3 3","pages":"182-187"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465817/pdf/futurehosp-3-3-182.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37246505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Taking an organisational approach to quality improvement. 采用组织方法提高质量。
Future hospital journal Pub Date : 2016-10-01 DOI: 10.7861/futurehosp.3-3-165
Robert E Klaber, Ralph A Critchley
{"title":"Taking an organisational approach to quality improvement.","authors":"Robert E Klaber, Ralph A Critchley","doi":"10.7861/futurehosp.3-3-165","DOIUrl":"10.7861/futurehosp.3-3-165","url":null,"abstract":"<p><p>The challenge for all healthcare organisations is to develop and implement an approach that will enable improvements to the quality of healthcare to happen. This case study describes some of the thinking, design and learning from Imperial College Healthcare NHS Trust, on the early steps of our journey to create a culture of continuous improvement across the organisation.</p>","PeriodicalId":92635,"journal":{"name":"Future hospital journal","volume":"3 3","pages":"165-168"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465803/pdf/futurehosp-3-3-165.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37246501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The foundations of quality improvement science. 质量改进科学的基础。
Future hospital journal Pub Date : 2016-10-01 DOI: 10.7861/futurehosp.3-3-199
Julie E Reed, Nicola Davey, Thomas Woodcock
{"title":"The foundations of quality improvement science.","authors":"Julie E Reed,&nbsp;Nicola Davey,&nbsp;Thomas Woodcock","doi":"10.7861/futurehosp.3-3-199","DOIUrl":"https://doi.org/10.7861/futurehosp.3-3-199","url":null,"abstract":"ABSTRACT As an alternative to ‘big bang’ initiatives, plan-do-study-act (PDSA) cycles are an increasingly popular approach to conducting tests of change to support quality improvement in healthcare. Using PDSA cycles can help clinicians deliver improvements in patient care through a structured experimental approach to learning and tests of change. The PDSA approach facilitates individual, team and organisational learning, making it an essential tool for the future hospital. This paper provides an example of the benefits of using PDSA in practice to test and develop a change idea to ensure it is fit for purpose. As with any new skill or competency, learning to use PDSA cycles takes time and practice and is necessary to ensure that the method is being used to its full effect. This paper explores some of the challenges encountered by clinicians in learning to use PDSA cycles well, and provides advice on how they can be overcome to help practitioners get more out of using the method.","PeriodicalId":92635,"journal":{"name":"Future hospital journal","volume":"3 3","pages":"199-202"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465814/pdf/futurehosp-3-3-199.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37422191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 23
Improving quality. 提高质量。
Future hospital journal Pub Date : 2016-10-01 DOI: 10.7861/futurehosp.3-3-157
Tom Downes
{"title":"Improving quality.","authors":"Tom Downes","doi":"10.7861/futurehosp.3-3-157","DOIUrl":"https://doi.org/10.7861/futurehosp.3-3-157","url":null,"abstract":"","PeriodicalId":92635,"journal":{"name":"Future hospital journal","volume":"3 3","pages":"157"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465807/pdf/futurehosp-3-3-157.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37246497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does quality improvement improve quality? 质量改进能提高质量吗?
Future hospital journal Pub Date : 2016-10-01 DOI: 10.7861/futurehosp.3-3-191
Mary Dixon-Woods, Graham P Martin
{"title":"Does quality improvement improve quality?","authors":"Mary Dixon-Woods,&nbsp;Graham P Martin","doi":"10.7861/futurehosp.3-3-191","DOIUrl":"https://doi.org/10.7861/futurehosp.3-3-191","url":null,"abstract":"<p><p>Although quality improvement (QI) is frequently advocated as a way of addressing the problems with healthcare, evidence of its effectiveness has remained very mixed. The reasons for this are varied but the growing literature highlights particular challenges. Fidelity in the application of QI methods is often variable. QI work is often pursued through time-limited, small-scale projects, led by professionals who may lack the expertise, power or resources to instigate the changes required. There is insufficient attention to rigorous evaluation of improvement and to sharing the lessons of successes and failures. Too many QI interventions are seen as 'magic bullets' that will produce improvement in any situation, regardless of context. Too much improvement work is undertaken in isolation at a local level, failing to pool resources and develop collective solutions, and introducing new hazards in the process. This article considers these challenges and proposes four key ways in which QI might itself be improved.</p>","PeriodicalId":92635,"journal":{"name":"Future hospital journal","volume":"3 3","pages":"191-194"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.7861/futurehosp.3-3-191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37422188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 192
The Royal College of Physician's Quality Improvement Hub - how can it help physicians to improve patient care? 皇家医师学院的质量改进中心-它如何帮助医生改善患者护理？
Future hospital journal Pub Date : 2016-10-01 DOI: 10.7861/futurehosp.3-3-211
Mohsin I Choudry, Kevin Stewart, Tricia Woodhead
{"title":"The Royal College of Physician's Quality Improvement Hub - how can it help physicians to improve patient care?","authors":"Mohsin I Choudry, Kevin Stewart, Tricia Woodhead","doi":"10.7861/futurehosp.3-3-211","DOIUrl":"10.7861/futurehosp.3-3-211","url":null,"abstract":"<p><p>Doctors have a central role in managing patients across a multitude of clinical environments, which places them in the ideal position to identify systemic issues. Traditional medical training focuses on the knowledge and technical skills required; rarely are doctors trained in leadership, management or how to analyse and understand systems so as to design safer, better care. Quality improvement methodology is an approach that is known to enable improvement of the systems in which healthcare professionals work in order to provide safe, timely, evidence-based, equitable, efficient and patient-centred care. To address the current disparity, the Royal College of Physicians (RCP) has launched a Quality Improvement Hub, which will aim to support physicians to face the challenges of improving medical care, enabling them to navigate the tools with more confidence and share and implement the learning more swiftly.</p>","PeriodicalId":92635,"journal":{"name":"Future hospital journal","volume":"3 3","pages":"211-216"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465801/pdf/futurehosp-3-3-211.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37422194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Documenting the process of patient decision making: a review of the development of the law on consent. 记录病人的决策过程:对同意法发展的回顾。
Future hospital journal Pub Date : 2016-06-01 DOI: 10.7861/futurehosp.3-2-109
Mohsin I Choudry, Aishah Latif, Leslie Hamilton, Bertie Leigh
{"title":"Documenting the process of patient decision making: a review of the development of the law on consent.","authors":"Mohsin I Choudry,&nbsp;Aishah Latif,&nbsp;Leslie Hamilton,&nbsp;Bertie Leigh","doi":"10.7861/futurehosp.3-2-109","DOIUrl":"https://doi.org/10.7861/futurehosp.3-2-109","url":null,"abstract":"<p><p>The doctor's role involves helping patients to understand their condition, including the anticipated benefits and risks of proposed treatments or omissions to treat. In order to treat, doctors require consent from patients but the duty to advise is equally strong if conservative management is appropriate. The recent judgement in the case of <i>Montgomery</i> has set a precedent for patient autonomy. However, doctors are still required to judge what risks they should disclose in their reasonable assessment of that patient and their specific situation. The General Medical Council reflects a consensus that the empowered autonomous patient is more likely to be satisfied with their clinical outcome than the passive victim of medical paternalism. Doctors, regardless of specialty, must counsel their patients adequately, paying particular attention to identifying material risks that are likely to be significant to their case.</p>","PeriodicalId":92635,"journal":{"name":"Future hospital journal","volume":"3 2","pages":"109-113"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465837/pdf/futurehosp-3-2-109.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37250660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Peer mentorship in medicine: a scheme for foundation trainees. 医学同侪辅导:基金学员计划。
Future hospital journal Pub Date : 2016-06-01 DOI: 10.7861/futurehosp.3-2s-s37
Celine Lakra, Jayne Ellis, Clifford Lisk, Penelope Smith, Katherine Elliot
{"title":"Peer mentorship in medicine: a scheme for foundation trainees.","authors":"Celine Lakra,&nbsp;Jayne Ellis,&nbsp;Clifford Lisk,&nbsp;Penelope Smith,&nbsp;Katherine Elliot","doi":"10.7861/futurehosp.3-2s-s37","DOIUrl":"https://doi.org/10.7861/futurehosp.3-2s-s37","url":null,"abstract":"","PeriodicalId":92635,"journal":{"name":"Future hospital journal","volume":"3 Suppl 2","pages":"s37"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465889/pdf/futurehosp-3-2s-s37.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37250683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Core medical trainees working in a district general hospital find entrustable professional activities (EPAs) useful as a means of curriculum development. 在地区综合医院工作的核心医学学员发现，可信赖的专业活动(EPAs)作为课程发展的一种手段很有用。
Future hospital journal Pub Date : 2016-06-01 DOI: 10.7861/futurehosp.3-2s-s40
Clifford Lisk
{"title":"Core medical trainees working in a district general hospital find entrustable professional activities (EPAs) useful as a means of curriculum development.","authors":"Clifford Lisk","doi":"10.7861/futurehosp.3-2s-s40","DOIUrl":"https://doi.org/10.7861/futurehosp.3-2s-s40","url":null,"abstract":"","PeriodicalId":92635,"journal":{"name":"Future hospital journal","volume":"3 Suppl 2","pages":"s40"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465925/pdf/futurehosp-3-2s-s40.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37250686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors affecting recruitment to higher specialty training: a questionnaire study. 影响高职人才招聘的因素:问卷调查。
Future hospital journal Pub Date : 2016-06-01 DOI: 10.7861/futurehosp.3-2s-s42
Hannah Hesselgreaves, Brian Wood, Madeline Carter, Chris Gibbins, Jan Illing
{"title":"Factors affecting recruitment to higher specialty training: a questionnaire study.","authors":"Hannah Hesselgreaves,&nbsp;Brian Wood,&nbsp;Madeline Carter,&nbsp;Chris Gibbins,&nbsp;Jan Illing","doi":"10.7861/futurehosp.3-2s-s42","DOIUrl":"https://doi.org/10.7861/futurehosp.3-2s-s42","url":null,"abstract":"","PeriodicalId":92635,"journal":{"name":"Future hospital journal","volume":"3 Suppl 2","pages":"s42"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465922/pdf/futurehosp-3-2s-s42.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37250688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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