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NIHR Signal Impact of a national quality improvement programme for hospital wards is unclear
The Productive Ward quality improvement programme has shown some procedural changes on hospital wards in England in the 10 years since it was introduced. But evidence to show any sustained changes to the experiences of staff or patients is hard to find. This NIHR-funded study used quantitative and qualitative methods to evaluate the programme in six acute hospitals in England. It found some evidence of a lasting impact, such as wards continuing to display metrics and using equipment storage sys...
NIHR Signal Online patient feedback is mostly positive — but is not being used effectively
People are increasingly reading online feedback from other patients to gauge service qualitybut fewer people go online to write feedback themselves. Health organisations and professionals are not currently effective at using this feedback to improve services. These findings come from an NIHR-funded study which used five research streams to provide an overview of online patient feedback in the NHS. Healthcare professionals rarely encourage online patient feedback and may be sceptical about it. ...
NIHR Signal Working in groups with ongoing support is valued by people with severe obesity trying to lose weight
People with severe obesity, a BMI of 35kg/m² or more, value the support and motivation they get from weight management programmes that include group-based interventions. However, commissioners and service managers should consider how to maintain adequate support and motivation once programmes end. Although previous studies have assessed the impact of non-surgical weight management programmes for obese adults, this is the first qualitative review to focus on the opinions of providers and ad...
NIHR Signal A workplace voucher reward scheme failed to boost physical activity
Staff enrolled on a workplace reward scheme to encourage them to become more physically active took fewer steps per day than their colleagues in the control group after six months. Employees at two public sector organisations in Northern Ireland took part in the Physical Activity Loyalty scheme, which worked in a similar way to a high street loyalty card. Their activity levels during the workday were monitored using key fobs and remote sensors. The participants were rewarded for physical activi...
NIHR Signal Patients, in theory, might prefer GP-led care to self-management for high blood pressure
Patients offered the pros and cons of different monitoring options appear reluctant to self-manage high blood pressure, and prefer frequent monitoring by a GP, pharmacist or via telehealth (where readings are sent to health professionals and medicines managed remotely). The small online survey, completed by 167 patients, was used to explore how patients might feel about moving away from GP-led care to other care models not currently routinely offered in the UK. Perhaps surprisingly, patients, i...
NIHR Signal Clinicians prescribe antibiotics for childhood respiratory tract infection based on assessment, rather than parental expectation
Implied parental expectation of antibiotic prescription does not appear to affect clinician prescribing for childhood respiratory tract infection in primary care. Parents typically accept clinicians’ treatment recommendations based on symptoms and signs, with a minority seeking further home care advice. This NIHR-funded analysis of 56 videoed primary care consultations is the first such study to be carried out in the UK, covering diverse populations from both deprived and affluent neighbo...
NIHR Signal Better strategies are needed to reduce preventable patient harm in healthcare
About 6% of patients in healthcare settings internationally experience harm that could have been prevented. Around one in eight of these cases result in severe harm, causing permanent disability or death. Drug errors, therapeutic management incidents and incidents involving invasive clinical procedures are the most common causes of preventable patient harm. Higher rates of harm were seen in intensive care and surgical departments than in general hospital settings. This NIHR-funded review poole...
NIHR Signal Enhanced communication and staff training could improve the experience of maternity services for asylum-seeking women
Pregnant asylum seekers experience significant barriers to accessing maternity services in the UK. A review found that these barriers often relate to language differences and practical challenges associated with their status. Provision of interpreter services and training for health care professionals could improve maternity support for these women. Pregnant women seeking asylum have often experienced significant trauma. Many arrive in the country having received no maternity care and experienc...
NIHR Signal Packages of care interventions ‘not effective’ to reduce repeat admissions for COPD
Care bundles for COPD are difficult to implement, and their introduction in NHS hospitals does not reduce repeat admissions, deaths or use of resources when used on or after admission. Care bundles are packages of interventions which, in other situations, can improve care. COPD care bundles include: checking inhaler technique and medication use providing a written plan for COPD management and supply of emergency medicines assessing willingness to stop smoking assessing suitability for pul...
NIHR Signal Routine engagement in end of life planning can improve health outcomes for people with heart failure
Interventions that encourage healthcare professionals to engage in advance care planning with heart failure patients can work more effectively than stand-alone training activities in improving health outcomes. Approaches that involve patients to change clinicians’ professional practice behaviours, the use of reminder systems and educational meetings may offer the best potential. There is no cure for heart failure, and palliative care is known to help this patient group. Advance care plann...
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