Yes / Background: There have been concerns about the quality and safety of NHS hospital services since the
turn of the millennium. This study investigated the progress that acute NHS hospital trusts have made in
developing and using technology infrastructures to enable them to monitor quality and safety following the
publication in 2013 of the second Francis report on the scandal at Mid Staffordshire NHS Foundation Trust
(The Mid Staffordshire NHS Foundation Trust Public Inquiry. Chaired by Sir Robert Francis QC. Report of the
Mid Staffordshire NHS Foundation Trust Public Inquiry. HC 898. London: The Stationery Office; 2013).
Methods: A telephone survey of 15 acute NHS trusts in the Yorkshire and the Humber region, and a
review of board papers of all acute NHS trusts in England for January 2015, were undertaken. The
telephone survey was used to identify trusts for a larger field study, which was undertaken in four acute
NHS trusts between April 2015 and September 2016. The methods included the direct observation of the
use of whiteboards and other technologies on two wards in each trust, an observation of board quality
committees, semistructured interviews and an analysis of the quality and safety data in board papers.
Published sources about national and local agencies were reviewed to identify the trust quality and safety
data that these agencies accessed and used. An interview programme was also undertaken with those
organisations. The Biography of Artefacts approach was used to analyse the data.
Findings: The data and technology infrastructures within trusts had developed over many years. The
overall design had been substantially determined by national agencies, and was geared to data processing:
capturing and validating data for submission to national agencies. Trust boards had taken advantage of
these data and used them to provide assurance about quality and safety. Less positively, the infrastructures
were fragmented, with different technologies used to handle different quality and safety data. Real-time
management systems on wards, including electronic whiteboards and mobile devices, were used and
valued by nurses and other staff. The systems support the proactive management of clinical risks. These
developments have occurred within a broad context, with trusts focusing on improving the quality and
safety of services and publishing far more data on their performance than they did just 3 years earlier.
Trust-level data suggest that quality and safety improved at all four trusts between 2013 and 2016. Our
findings indicate that the technology infrastructures contributed to these improvements. There remains
considerable scope to rationalise those infrastructures. / National Institute for Health Research Health Services and Delivery Research programme.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/17763 |
| Date | 04 March 2020 |
| Creators | Keen, J., Nicklin, E., Long, A., Randell, Rebecca, Wickramasekera, N., Gates, C., Ginn, C., McGinnis, E., Willis, S., Whittle, J. |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Published version |
| Rights | © Queen’s Printer and Controller of HMSO 2018. This work was produced by Keen et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK. |
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