How ward staff engage with the implementation of a patient safety intervention

A patient safety intervention was tested in a 33-ward randomised controlled trial | BMJ Open

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Objectives: No statistically significant difference between intervention and control wards was found. We conducted a process evaluation of the trial and our aim in this paper is to understand staff engagement across the 17 intervention wards.

Findings: First, there were palpable differences in the ways that the 17 ward teams engaged with the key components of the intervention. Five main engagement typologies were evident across the life course of the study: consistent, partial, increasing, decreasing and disengaged. Second, the intensity of support for the intervention at the level of the organisation does not predict the strength of engagement at the level of the individual ward team. Third, the standardisation of facilitative processes provided by the research team does not ensure that implementation standardisation of the intervention occurs by ward staff.

Conclusions: A dilution of the intervention occurred during the trial because wards engaged with Patient Reporting and Action for a Safe Environment (PRASE) in divergent ways, despite the standardisation of key components. Facilitative processes were not sufficiently adequate to enable intervention wards to successfully engage with PRASE components.

Full reference: Sheard, L. et al (2017) Exploring how ward staff engage with the implementation of a patient safety intervention: a UK-based qualitative process evaluation. BMJ Open. 7:e014558

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Towards affordable healthcare: Why effective innovation is key

This major new report, supported by EY has found that whilst the UK is well placed to innovate to improve health outcomes and reduce costs, the UK is often not doing enough with the tools at its disposal | ILC

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Image source: ILC

With the NHS committed to achieving efficiency savings of £22 billion through productivity gains of 2 to 3% between 2015 – 2020-202, ‘Towards affordable healthcare: Why effective innovation is key’ explores how health care innovations currently employed at home and abroad could increase productivity and reduce costs.

The report showcases seven outstanding global and UK-based innovations with a strong evidence base of demonstrable success, and calculates the savings that could be achieved by implementing them across the UK. Home grown innovations include:

  • The UK’s Memory First Project, an integrated dementia service run by a consortium of GPs across Staffordshire. Savings if working methods applied nationally: up to £38 million between 2019 – 2030.
  • Manchester Royal Infirmary’s programme of providing the training and equipment to perform home dialysis. Savings if programmed applied nationally: up to £5.6 billion between 2014 – 2030.

The report concludes however the UK is often not doing enough with the tools at its disposal to implement such innovations. Social care is underfunded and fragmented, which has consequences also for NHS costs, and funding mechanisms within the health system can often discourage innovation; there continues to be a slow uptake in the UK of new drugs and treatments, with adoption speed varying across the country.

Reward In The NHS: Good Practice And Innovation Taking Place Across The NHS

In this report, we share the key areas being taken forward and look at how organisations are changing their approach to reward | NHS Employers

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Image source: NHS Employers

This report captures the themes, good practice, and innovation that have emerged from NHS Employers’ Total Reward Engagement Network over the last year. It focuses on key elements of reward and how organisations are changing their approach to reward.

Read the full report here

Compassionate leadership in health care

Caring to change:  How compassionate leadership can stimulate innovation in health care | Kings Fund

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This paper looks at compassion as a core cultural value of the NHS and how compassionate leadership results in a working environment that encourages people to find new and improved ways of doing things.  It describes four key elements of a culture for innovative, high-quality and continually improving care and what they mean for patients, staff and the wider organisation: inspiring vision and strategy; positive inclusion and participation; enthusiastic team and cross-boundary working; and support and autonomy for staff to innovate. It also presents case studies of how compassionate leadership has led to innovation. This work was supported by the Health Foundation.

Download the full report here

Related Kings Fund blog: Compassionate leadership – more important than ever in today’s NHS

Mental health patients to benefit from new digital services

Seven areas across England are set to trail-blaze digital services for mental health patients, which will include innovative apps to improve care and online access to ‘real-time’ patient records. | NHS England

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NHS England has announced funding for seven mental health trusts to enable them to pioneer digital services for mental health patients.  It is intended that all key professionals involved in a patient’s care have access to real-time records – from triage and initial assessment, through to admissions or referrals, as well as transfer between services and follow up care.

The trusts will also develop remote, mobile and assistive technologies to empower patients to manage their conditions and enable family and carers to provide the best possible support.

The trusts will have up to £70m to invest in digital services – consisting £35m with additional match funding from themselves of £35m – in order to become ‘Global Digital Exemplars for Mental Health’ helping the organisations become world-leading in the use of IT, providing knowledge and expertise to the wider NHS in order to reduce time and costs for others.

This is all part of the NHS’ plan to harness technology to improve services and become more efficient.

Knowledge transfer partnership programme announced

Knowledge Transfer Partnership announced at CSO Conference ‘Bringing Science and Innovation to the Heart of the NHS’

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NHS England is set to launch its first Knowledge Transfer Partnership Programme, a 12 month development programme, aimed at clinical leaders in healthcare science.  Successful applicants who secure a place will work with other leading healthcare scientists and build long-term collaborations across clinical, research and industry sectors, whilst identifying new approaches to measuring improved outcomes, ultimately for NHS patients.

Transforming community care with digital technologies

Chris Gregory, head of clinical systems for LGSS Local Health and Care Shared Service explains how mobile solutions are transforming the work of community-based health teams | NHE

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As the IT provider to Northamptonshire Healthcare NHS FT, LGSS has been involved in delivering mobile working solutions to a number of community-based health teams, including health visitors and district nurses, and for providing similar solutions in local government.

The trend towards delivering care closer to home to meet both patient aspirations, and the need to deliver savings through the reduction of estate, means that increasing levels of flexible working are being demanded across the NHS. If done successfully, mobile working can help to deliver the type of service that patients tell us they would like from their health service.

As with many IT services we’ve had a few attempts at delivering practical mobile working solutions, each based on and constrained by the technology available at the time. Prior to our latest deployment, we asked staff what they needed from a mobile device. Overwhelmingly, those who responded wanted:

  • A small form factor: There is plenty of other equipment a district nurse needs to carry so devices need to be small, as light as possible and certainly no more awkward to carry than the files of paper notes previously used
  • Sufficient battery life to get through an entire working day
  • A fast start-up: Ensuring that as little of the precious contact time with the patient was spent waiting for the technology
  • Versatility: Multiple means of inputting data, suggesting the need for both touchscreen and keyboard input

Read the full article here