Outcomes of unplanned transfers from subacute to acute care

Outcomes of unplanned transfers from subacute to acute care

Death Patient Care

The aim of this study published in Australian Health Review, was to examine the timing and outcomes of patients requiring an unplanned transfer from subacute to acute care within  four Victorian health services from 1 January to 31 December 2010. Data were collected using retrospective audit.
The study found that there is a high rate of unplanned transfers to acute care within 24 h of admission to subacute care and unplanned transfers are associated with high hospital admission and in-hospital mortality rates. Physiological assessment was infrequent and incomplete in most patients who had an unplanned transfer from subacute to acute care. The analysis of the subacute to acute care
interface has highlighted the need to improve systems for recognising and responding to deteriorating patients in subacute care settings.

Considine, Julie, Street, Maryann, Botti, Mari, O’Connell, Bev, Kent, Bridie, and Dunning AM, Trisha (2015). Multisite analysis of the timing and outcomes of unplanned transfers from subacute to acute care. Aust. Health Review 39 (4), 387–394.

Ambitions for Palliative and End of Life Care

Ambitions for Palliative and End of Life Care

Death Palliative care Patient Care

This UK national frameworkurges health organisations and local authorities to act together to improve end of life care for people of all ages. It sets out six principles for how people near the end of their lives should be cared for. The six ‘ambitions’ for palliative and end of life care are:

• Each person is seen as an individual
• Each person gets fair access to care
• Maximising comfort and wellbeing
• Care is coordinated
• All staff are prepared to care               

Emotional harm from disrespect

Emotional harm from disrespect

Injury Patient Care

Emotional harm from disrespect: the neglected preventable harm discusses a different form of harm in health care.  The authors of this paper in BMJ Quality & Safety explain that emotional harms can be understood as harms to a patient's dignity, often caused by a lack of respect.  These type of harms erode trust and damage patient-provider relationships. They also effect patients' physical health. 

The authors conclude that there needs to be a systematic approach to recording and categorising emotional harms so that we can understand how and why they occur and how we can prevent them from happening.  "Ensuring that our profession does not cause preventable harm to our patients requires that we address emotional harms with the same rigor we have applied to physical harms".

Sokol-Hessner L, Folcarelli PH, Sands KEF.  BMJ Quality & Safety. June 17, 2015.  http://dx.doi.org/10.1136/bmjqs-2015-004034 

Avoiding ineffective treatment - Grattan report

Avoiding ineffective treatment - Grattan report

Hospitals Patient Care

Questionable care: avoiding ineffective treatment is a report from Stephen Duckett and Peter Breadon at the Grattan Institute. They argue that some Australian hospitals are still providing treatments that are unnecessary or ineffective and that Australia needs a system to identify these outlier hospitals.

The report looks at five treatments which should not be used on some patients, such as treating osteoarthritis of the knee with an arthroscope, filling a vertebrae with cement to treat fractures and putting patients in pressurised oxygen chambers.  "Expert guidance labels most of these five treatments do-not-do, yet in 2010-11 nearly 6000 people – or 16 people a day – received them."

The authors argue that the these treatments are not managed well by the health system, which often offers incentives for extra, ineffective care.  They call for more awareness and policies to prevent this happening.

Patient Experiences in Australia: Statistics

Patient Experiences in Australia: Statistics

Client relationships Communication Patient Care Public Health Quality

This publication from the Australian Bureau of Statistics presents information from the 2013-14 Patient Experience Survey. The ABS Patient Experience Survey is conducted annually and collects data on access and barriers to a range of health care services, including general practitioners (GPs), medical specialists, dental professionals, imaging and pathology tests, hospital admissions and emergency department visits. It includes data from people that accessed health services in the previous 12 months, as well as from those who did not, and enables analysis of health service information in relation to particular population groups. Data are also collected on aspects of communication between patients and health professionals.

4839.0.55.002 - Patient Experiences in Australia: States and Territories, 2013-14 

Oxford Medical Case Reports

Oxford Medical Case Reports

Health Information Medical education Patient Care

Oxford Medical Case Reports (OMCR) is an open access, peer-reviewed online journal. It publishes original and educational case reports that expand the field of medicine. The journal covers all medical specialties comprising a comprehensive resource for physicians in all fields and at all stages of training. You can either browse the current issue and archive or look through case reports via subject specialty. 

Better Care- always room for improvement.

Better Care- always room for improvement.

Patient Care Quality

It has been noted that better care tends to be found in services that “acknowledge there is always room for improvement – they are proactive, seeking feedback on their services and learning from concerns and complaints".

This report from the English Care Quality Commission (CQC) examines what underpins high quality care. It includes short case studies illustrating some of the qualities shown by care providers that have been rated good or outstanding overall. It also shares the views of some people responsible for care quality and what they have done to drive improvement.

The CQC note that three themes have emerged as drivers of better quality of care:

• Care is person-centred, designed around the individual and includes their involvement.
• The importance of the line-of-sight from senior leadership to the frontline staff and services.
• Good care includes the provider checking on how well they are doing.

Celebrating good care, championing outstanding care.