Publications
39 results found
Green SA, Poots AJ, Marcano-Belisario J, et al., 2012, Mapping mental health service access: achieving equity through quality improvement, Journal of Public Health
Background Improving access to psychological therapies (IAPTs) services deliver evidence-based care to people with depression and anxiety. A quality improvement (QI) initiative was undertaken by an IAPT service to improve referrals providing an opportunity to evaluate equitable access.Methods QI methodologies were used by the clinical team to improve referrals to the service. The collection of geo-coded data allowed referrals to be mapped to small geographical areas according to deprivation.Results A total of 6078 patients were referred to the IAPT service during the period of analysis and mapped to120 unique lower super output areas (LSOAs). The average weekly referral rate rose from 17 during the baseline phase to 43 during the QI implementation phase. Spatial analysis demonstrated all 15 of the high deprivation/low referral LSOAs were converted to high deprivation/high or medium referral LSOAs following the QI initiative.Conclusion This work highlights the importance of QI in developing clinical services aligned to the needs of the population through the analysis of routine data matched to health needs. Mapping can be utilized to communicate complex information to inform the planning and organization of clinical service delivery and evaluate the progress and sustainability of QI initiatives.
York-Smith M, Thompson R, Burrell G, et al., 2012, DEVELOPMENT OF A COLLABORATIVE INPATIENT ALCOHOL STRATEGY, Publisher: B M J PUBLISHING GROUP, Pages: A13-A13, ISSN: 0017-5749
AlJuburi G, Laverty AA, Green S, et al., 2012, Trends in hospital admissions for Sickle Cell Disease in England, 2001/02 to 2009/10, Journal of Public Health
Green SA, Aljuburi G, Majeed A, et al., 2012, Characterizing emergency admissions of patients with sickle cell crisis in NHS brent: observational study., JRSM Short Rep, Vol: 3
OBJECTIVES: To characterize emergency admissions for patients with sickle cell crisis in NHS Brent and to determine which patients and practices may benefit most from primary care intervention. DESIGN: Observational study SETTING: Emergency departments attended by residents of the London borough of Brent PARTICIPANTS: Patients with sickle cell disease registered with a general practitioner (GP) in the borough of Brent MAIN OUTCOME MEASURES: Analysis of admissions between January 2008 and July 2010 that included length of stay (average and <2 days versus ≥2 days) by age group and registered GP practice. RESULTS: Thirty six percent of sickle cell disease admission spells resulted in a length of stay of less than two days. Seventy four percent of total bed days are associated with patients with more than one admission during the period of analysis, i.e. multiple admissions. Two general practices in Brent were identified as having the highest number of patients admitted to the emergency department for sickle cell crisis and may benefit most from primary care intervention. DISCUSSION: Patients with short length of stay and multiple admissions may be potentially amenable to primary care intervention. The practices which have the highest numbers of sickle cell disease patients who frequently seek emergency care will be earmarked for an education intervention designed to help further engage general practitioners in the care and management of their sickle cell patients.
Austen C, Patterson C, Poots A, et al., 2012, Using a Local Early Warning Scoring System as a Model for the Introduction of a National System, Acute Medicine, Vol: 11, Pages: 66-73
BackgroundChelsea and Westminster Hospital introduced the Chelsea Early Warning Score (CEWS) in 2007 to aid the recognition of acutely unwell patients. The Royal College of Physicians subsequently recommended a National Early Warning Score (NEWS) for implementation across the NHS. The aim of this study was to evaluate local adherence to CEWS to identify potential obstacles to the consistent implementation of NEWS.MethodEmergency Department (ED) and Acute Assessment Unit (AAU) notes were retrospectively reviewed for a convenience sample of 102 patients admitted to the AAU. Outcome measures were completeness of documentation of CEWS parameters, documentation and accuracy of aggregate CEWS scores. Aggregate NEWS scores were calculated from the documented observations and the calculated CEWS and NEWS scores were compared.ResultsPhysiological observations were documented for all patients attending the ED and AAU. Heart rate, blood pressure, respiratory rate, oxygen saturation and conscious level were documented in over 95% of ED and AAU patients. Urine output was recorded for only 48% of ED and 69% of AAU patients. Aggregate CEWS scores were documented for 66% of ED and 84% of AAU patients. These were calculated accurately in 73% of ED and 79% of AAU patients. Calculation errors were eleven times more likely to result in under-scoring than over-scoring. NEWS scores were significantly higher than CEWS for the same observations and would have resulted in a 71% increase in patients requiring escalation of care in the ED and a 116% increase in AAU.ConclusionConcerns highlighted with CEWS were the incomplete and inaccurate recording of aggregate scores, with underscoring resulting in the potential failure to recognise deteriorating patients. It is anticipated that NEWS will be accompanied by standardised documentation and training across the NHS which will support more complete and accurate recording of physiological data. Furthermore, NEWS appears from this study to be more
Hall S, Kulendran M, Sadek A-R, et al., 2011, Variability in selecting patients to manage in the community: a service evaluation of community matron's case-finding strategies, FAMILY PRACTICE, Vol: 28, Pages: 414-421, ISSN: 0263-2136
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- Citations: 5
Woodward EL, Gilkes AF, Austin SJ, et al., 2008, Gene expression profiling can identify novel MRD markers for AML, 48th Annual Scientific Meeting of the British-Society-for-Haematology, Publisher: WILEY-BLACKWELL, Pages: 43-44, ISSN: 0007-1048
Yin JAL, Daly SB, Sale MA, et al., 2007, Minimal residual disease monitoring by RQ-PCR in core binding factor positive AML allows risk-stratification and predicts relapse: Results of the UK MRC AML-15 trial., 49th Annual Meeting of the American-Society-of-Hematology, Publisher: AMER SOC HEMATOLOGY, Pages: 167A-167A, ISSN: 0006-4971
Mercer K, Giblett S, Green S, et al., 2005, Expression of endogenous oncogenic <i><SUP>V600E</SUP>B-raf</i> induces proliferation and developmental defects in mice and transformation of primary fibroblasts, CANCER RESEARCH, Vol: 65, Pages: 11493-11500, ISSN: 0008-5472
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- Citations: 125
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