The Experts below are selected from a list of 65643 Experts worldwide ranked by ideXlab platform
Brendan Mcgrath - One of the best experts on this subject based on the ideXlab platform.
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improving tracheostomy care in the united kingdom results of a guided quality Improvement Programme in 20 diverse hospitals
BJA: British Journal of Anaesthesia, 2020Co-Authors: Brendan Mcgrath, Sarah E Wallace, James P Lynch, Barbara Bonvento, Barry Coe, Anna Owen, Mike Firn, Michael Brenner, Elizabeth A EdwardsAbstract:Abstract Background Inconsistent and poorly coordinated systems of tracheostomy care commonly result in frustrations, delays, and harm. Quality Improvement strategies described by exemplar hospitals of the Global Tracheostomy Collaborative have potential to mitigate such problems. This 3 yr guided implementation Programme investigated interventions designed to improve the quality and safety of tracheostomy care. Methods The Programme management team guided the implementation of 18 interventions over three phases (baseline/implementation/evaluation). Mixed-methods interviews, focus groups, and Hospital Anxiety and Depression Scale questionnaires defined outcome measures, with patient-level databases tracking and benchmarking process metrics. Appreciative inquiry, interviews, and Normalisation Measure Development questionnaires explored change barriers and enablers. Results All sites implemented at least 16/18 interventions, with the magnitude of some Improvements linked to staff engagement (1536 questionnaires from 1019 staff), and 2405 admissions (1868 ICU/high-dependency unit; 7.3% children) were prospectively captured. Median stay was 50 hospital days, 23 ICU days, and 28 tracheostomy days. Incident severity score reduced significantly (n=606; P Conclusions This guided Improvement Programme for tracheostomy patients significantly improved the quality and safety of care, contributing rich qualitative Improvement data. Patient-centred outcomes were improved along with significant efficiency and cost savings across diverse UK hospitals. Clinical trial registration IRAS-ID-206955; REC-Ref-16/LO/1196; NIHR Portfolio CPMS ID 31544.
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multidisciplinary guidance for safe tracheostomy care during the covid 19 pandemic the nhs national patient safety Improvement Programme natpatsip
Anaesthesia, 2020Co-Authors: Brendan Mcgrath, Michael P W Grocott, N Ashby, M Birchall, P Dean, Catherine Doherty, K Ferguson, J Gimblett, T Jacob, C KerawalaAbstract:The COVID-19 pandemic is causing a significant increase in the number of patients requiring relatively prolonged invasive mechanical ventilation and an associated surge in patients who need a tracheostomy to facilitate weaning from respiratory support. In parallel, there has been a global increase in guidance from professional bodies representing staff who care for patients with tracheostomies at different points in their acute hospital journey, rehabilitation and recovery. Of concern are the risks to healthcare staff of infection arising from tracheostomy insertion and caring for patients with a tracheostomy. Hospitals are also facing extraordinary demands on critical care services such that many patients who require a tracheostomy will be managed outside established intensive care or head and neck units and cared for by staff with little tracheostomy experience. These concerns led NHS England and NHS Improvement to expedite the National Patient Safety Improvement Programme's 'Safe Tracheostomy Care' workstream as part of the NHS COVID-19 response. Supporting this workstream, UK stakeholder organisations involved in tracheostomy care were invited to develop consensus guidance based on: expert opinion; the best available published literature; and existing multidisciplinary guidelines. Topics with direct relevance for frontline staff were identified. This consensus guidance includes: infectivity of patients with respect to tracheostomy indications and timing; aerosol-generating procedures and risks to staff; insertion procedures; and management following tracheostomy.
Steve Onyett - One of the best experts on this subject based on the ideXlab platform.
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the core service Improvement Programme for mental health crisis resolution teams results from a cluster randomised trial
British Journal of Psychiatry, 2020Co-Authors: Brynmor Lloydevans, David Osborn, Louise Marston, Danielle Lamb, Gareth Ambler, Rachael Hunter, Oliver Mason, Sarah A Sullivan, Claire Henderson, Steve OnyettAbstract:BACKGROUND Crisis resolution teams (CRTs) offer brief, intensive home treatment for people experiencing mental health crisis. CRT implementation is highly variable; positive trial outcomes have not been reproduced in scaled-up CRT care. AIMS To evaluate a 1-year Programme to improve CRTs' model fidelity in a non-masked, cluster-randomised trial (part of the Crisis team Optimisation and RElapse prevention (CORE) research Programme, trial registration number: ISRCTN47185233). METHOD Fifteen CRTs in England received an intervention, informed by the US Implementing Evidence-Based Practice project, involving support from a CRT facilitator, online implementation resources and regular team fidelity reviews. Ten control CRTs received no additional support. The primary outcome was patient satisfaction, measured by the Client Satisfaction Questionnaire (CSQ-8), completed by 15 patients per team at CRT discharge (n = 375). Secondary outcomes: CRT model fidelity, continuity of care, staff well-being, in-patient admissions and bed use and CRT readmissions were also evaluated. RESULTS All CRTs were retained in the trial. Median follow-up CSQ-8 score was 28 in each group: the adjusted average in the intervention group was higher than in the control group by 0.97 (95% CI -1.02 to 2.97) but this was not significant (P = 0.34). There were fewer in-patient admissions, lower in-patient bed use and better staff psychological health in intervention teams. Model fidelity rose in most intervention teams and was significantly higher than in control teams at follow-up. There were no significant effects for other outcomes. CONCLUSIONS The CRT service Improvement Programme did not achieve its primary aim of improving patient satisfaction. It showed some promise in improving CRT model fidelity and reducing acute in-patient admissions.
Brynmor Lloydevans - One of the best experts on this subject based on the ideXlab platform.
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the core service Improvement Programme for mental health crisis resolution teams results from a cluster randomised trial
British Journal of Psychiatry, 2020Co-Authors: Brynmor Lloydevans, David Osborn, Louise Marston, Danielle Lamb, Gareth Ambler, Rachael Hunter, Oliver Mason, Sarah A Sullivan, Claire Henderson, Steve OnyettAbstract:BACKGROUND Crisis resolution teams (CRTs) offer brief, intensive home treatment for people experiencing mental health crisis. CRT implementation is highly variable; positive trial outcomes have not been reproduced in scaled-up CRT care. AIMS To evaluate a 1-year Programme to improve CRTs' model fidelity in a non-masked, cluster-randomised trial (part of the Crisis team Optimisation and RElapse prevention (CORE) research Programme, trial registration number: ISRCTN47185233). METHOD Fifteen CRTs in England received an intervention, informed by the US Implementing Evidence-Based Practice project, involving support from a CRT facilitator, online implementation resources and regular team fidelity reviews. Ten control CRTs received no additional support. The primary outcome was patient satisfaction, measured by the Client Satisfaction Questionnaire (CSQ-8), completed by 15 patients per team at CRT discharge (n = 375). Secondary outcomes: CRT model fidelity, continuity of care, staff well-being, in-patient admissions and bed use and CRT readmissions were also evaluated. RESULTS All CRTs were retained in the trial. Median follow-up CSQ-8 score was 28 in each group: the adjusted average in the intervention group was higher than in the control group by 0.97 (95% CI -1.02 to 2.97) but this was not significant (P = 0.34). There were fewer in-patient admissions, lower in-patient bed use and better staff psychological health in intervention teams. Model fidelity rose in most intervention teams and was significantly higher than in control teams at follow-up. There were no significant effects for other outcomes. CONCLUSIONS The CRT service Improvement Programme did not achieve its primary aim of improving patient satisfaction. It showed some promise in improving CRT model fidelity and reducing acute in-patient admissions.
Felicia Mccormick - One of the best experts on this subject based on the ideXlab platform.
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evaluating the focus on normal birth and reducing caesarean section rates rapid Improvement Programme a mixed method study in england
Midwifery, 2015Co-Authors: Joyce Marshall, Helen Spiby, Felicia MccormickAbstract:Abstract Background caesarean section plays an important role in ensuring safety of mother and infant but rising rates are not accompanied by measurable Improvements in maternal or neonatal mortality or morbidity. The ‘Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme' was a facilitative initiative developed to promote opportunities for normal birth and reduce caesarean section rates in England. Objective to evaluate the ‘Focus on Normal Birth and Reducing Caesarean section Rates' Programme, by assessment of: impact on caesarean section rates, use of service Improvements tools and participants׳ perceptions of factors that sustain or hinder work within participating maternity units. Design a mixed methods approach included analysis of mode of birth data, web-based questionnaires and in-depth semi-structured telephone interviews. Participants twenty Hospital Trusts in England (selected from 68 who applied) took part in the ‘Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme' initiative. In each hospital Trust, the head of midwifery, an obstetrician, the relevant lead for organisational development, a supervisor of midwives, or a clinical midwife and a service user representative were invited to participate in the independent evaluation. Methods collection and analysis of mode of birth data from 20 participating hospital Trusts, web-based questionnaires administered to key individuals in all 20 Trusts and in-depth semi-structured telephone interviews conducted with key individuals in a sample of six Trusts. Findings there was a marginal decline of 0.5% (25.9% from 26.4%) in mean total caesarean section rate in the period 1 January 2009 to 31 January 2010 compared to the baseline period (1 July–31 December 2008). Reduced total caesarean section rates were achieved in eight trusts, all with higher rates at the beginning of the initiative. Features associated with lower caesarean section rates included a shared philosophy prioritising normal birth, clear communication across disciplines and strong leadership at a range of levels, including executive support and clinical leaders within each discipline. Conclusions it is important that the philosophy and organisational context of care are examined to identify potential barriers and facilitative factors.
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evaluating the focus on normal birth and reducing caesarean section rates rapid Improvement Programme a mixed method study in england
Midwifery, 2015Co-Authors: Joyce Marshall, Helen Spiby, Felicia MccormickAbstract:Abstract Background caesarean section plays an important role in ensuring safety of mother and infant but rising rates are not accompanied by measurable Improvements in maternal or neonatal mortality or morbidity. The ‘Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme' was a facilitative initiative developed to promote opportunities for normal birth and reduce caesarean section rates in England. Objective to evaluate the ‘Focus on Normal Birth and Reducing Caesarean section Rates' Programme, by assessment of: impact on caesarean section rates, use of service Improvements tools and participants׳ perceptions of factors that sustain or hinder work within participating maternity units. Design a mixed methods approach included analysis of mode of birth data, web-based questionnaires and in-depth semi-structured telephone interviews. Participants twenty Hospital Trusts in England (selected from 68 who applied) took part in the ‘Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme' initiative. In each hospital Trust, the head of midwifery, an obstetrician, the relevant lead for organisational development, a supervisor of midwives, or a clinical midwife and a service user representative were invited to participate in the independent evaluation. Methods collection and analysis of mode of birth data from 20 participating hospital Trusts, web-based questionnaires administered to key individuals in all 20 Trusts and in-depth semi-structured telephone interviews conducted with key individuals in a sample of six Trusts. Findings there was a marginal decline of 0.5% (25.9% from 26.4%) in mean total caesarean section rate in the period 1 January 2009 to 31 January 2010 compared to the baseline period (1 July–31 December 2008). Reduced total caesarean section rates were achieved in eight trusts, all with higher rates at the beginning of the initiative. Features associated with lower caesarean section rates included a shared philosophy prioritising normal birth, clear communication across disciplines and strong leadership at a range of levels, including executive support and clinical leaders within each discipline. Conclusions it is important that the philosophy and organisational context of care are examined to identify potential barriers and facilitative factors.
Torbjorn H Netland - One of the best experts on this subject based on the ideXlab platform.
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company specific production systems and competitive advantage a resource based view on the volvo production system
International Journal of Operations & Production Management, 2013Co-Authors: Torbjorn H Netland, Arild AspelundAbstract:Purpose – In order to improve competitiveness on a global scale, multinational enterprises increasingly develop a company-specific production system (XPS) and deploy it in their worldwide operations. An XPS is synonymous with a tailored corporate-wide Improvement Programme. The purpose of this paper is to explore the circumstances under which an XPS can provide a competitive advantage. Design/methodology/approach – The paper uses an explorative case study methodology to investigate the link between the establishment of an XPS and competitive advantage. Specifically, the paper investigates the part of the Volvo Group's globally implemented Volvo production system (VPS) that aim to improve the manufacturing processes worldwide. Due to its historical trajectories, Volvo constitutes a unique case for studying the trend and effects of XPS. The resource-based view of the firm provides the theoretical foundation for the analysis. Findings – The paper concludes with four research propositions. P1: In industries w...
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exploring the phenomenon of company specific production systems one best way or own best way
International Journal of Production Research, 2013Co-Authors: Torbjorn H NetlandAbstract:This explorative study investigates the phenomenon of the company-specific production system (XPS). It has been a strong and recent trend across many manufacturing industries to develop and deploy such a corporate Improvement Programme. Five propositions regarding the uniqueness of XPSs are derived from universalistic versus contingent perspectives on Improvement Programmes. The main XPS principles of 30 renowned multinationals are analysed for similarities and differences. In conclusion, XPSs largely represent variants of the same in content. They represent an own-best-way approach to the one-best-way paradigm. Even though a tight relationship to the Toyota Production System (TPS) and lean production is established, the findings raise a red flag that XPSs might suffer under a too rigid, path-dependent development process from what has become an overly technical understanding of the TPS. This study also questions whether modern manufacturers have sufficiently integrated other essential elements of modern ...
