Search

Purpose: This paper aims to outline the initial pilot use of the client complexity matrix (CCM), an outcome measure developed for an NHS Adult Intellectual Disabilities Intensive Support Team (IST) in the West Midlands of England. Design/methodology/approach: A mixed method approach was used to report the results and evaluate the use of the CCM within this IST. The CCM was trialled for six months between January 2022 and June 2022. CCM scores pre and post IST intervention were analysed via t-test, and qualitative feedback from clinicians is detailed. Findings: Analysis suggests the CCM captures service success showing a significant decrease in complexity and risk post-intervention. Qualitative comments from clinicians were generally positive; however, there were requested changes regarding specific presentations, use of labels/language and for a digital version. Research limitations/implications: The tool is not co-constructed with the client. Because of this IST's caseload, the sample size was small. Only one clinician was asked to complete the CCM pre and post intervention. Future use of the measure will encourage two clinicians to complete the measure to evidence its inter-rater reliability. Each client's specific presentation was not explicitly analysed here. Practical implications: The CCM will be updated using the feedback from clinicians and from the peer review process. Research that examines the generalisability of this measure to other IST services would be beneficial. Originality/value: The CCM appears to fill a gap in outcome measurements for this IST service which looks at breadth and depth of client complexity and risk. [ABSTRACT FROM AUTHOR]

Background: Responding to the COVID‐19 pandemic, Health Education England (HEE) mobilised a group of expert searchers from NHS libraries in England to develop a platform for librarians to share peer reviewed search strategies and results on the Knowledge for Healthcare website. Objectives: (1) To document the origins of the COVID‐19 search bank, (2) evaluate attitudes of NHS librarians in England towards the search bank and (3) identify lessons learned and consider whether the initiative might be developed further. Methods: Structured interviews with the peer reviewers (n = 10) were conducted, and a questionnaire survey of the NHS library community using the search bank was undertaken. Results: The interviews confirmed the value of collaboration. Expert searchers worked in pairs to peer review submitted search strategies. The survey (85 responses) indicated that a majority had used the search bank, and approved of the project, with some differences of opinion on functionality and future developments. Discussion: Collaborative working for the search bank probably saved time for individual NHS librarians. The quality of the searches submitted was variable as were librarians' approaches to presentation and development of search strategies. Peer review benefits from a buddy approach among expert searchers and agreement about feedback provided to contributors. Conclusion: Search strategies are the most useful element of a search bank. Peer review can be challenging and would benefit from a formal structure, but it is professionally rewarding. [ABSTRACT FROM AUTHOR]

Background: Systems to detect and minimise unwarranted variation in clinician practice are crucial to ensure increasingly multidisciplinary healthcare workforces are supported to practise to their full potential. Such systems are limited in English general practice settings, with implications for the efficiency and safety of care.Aim: To evaluate the benefits and limitations of a continuous, risk-based, consultation peer-review system used for 10 years by an out-of-hours general practice service in Bristol, UK.Design and Setting: A qualitative study in South West England.Method: Semi-structured interviews with intervention users (clinicians, peer reviewers, and clinical management), analysed by inductive thematic analysis and integrated into a programme theory.Results: Twenty clinicians were interviewed between September 2018 and January 2019. Interviewees indicated that the intervention supported clinician learning through improved peer feedback, highlighting learning needs and validating practice. It was compared favourably with existing structures of ensuring clinician competence, supporting standardisation of supervision, clinical governance, and learning culture. These benefits were potentially limited by intervention factors such as differential feedback quality between clinician groups, the efficiency of methods to identify learning needs, and limitations of assessments based on written clinical notes. Contextual factors such as clinician experience, motivation, and organisational learning culture influenced the perception of the intervention as a support or a stressor.Conclusion: The findings demonstrate the potential of continuous, risk-based, consultation peer review to support clinicians in an increasingly multidisciplinary general practice workforce to efficiently and safely practise to their full potential. The programme theory provides a theoretical basis to maximise the benefits and accommodate the potential limitations of this methodology. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the status of radiology quality improvement programs in a variety of selected nations worldwide. Methods: A survey was developed by select members of the International Economics Committee of the American College of Radiology on quality programs and was distributed to committee members. Members responded on behalf of their country. The 51-question survey asked about 12 different quality initiatives which were grouped into 4 themes: departments, users, equipment, and outcomes. Respondents reported whether a designated type of quality initiative was used in their country and answered subsequent questions further characterizing it. Results: The response rate was 100% and represented Australia, Canada, China, England, France, Germany, India, Israel, Japan, the Netherlands, Russia, and the United States. The most frequently reported quality initiatives were imaging appropriateness (91.7%) and disease registries (91.7%), followed by key performance indicators (83.3%) and morbidity and mortality rounds (83.3%). Peer review, equipment accreditation, radiation dose monitoring, and structured reporting were reported by 75.0% of respondents, followed by 58.3% of respondents for quality audits and critical incident reporting. The least frequently reported initiatives included Lean/Kaizen exercises and physician performance assessments, implemented by 25.0% of respondents. Conclusion: There is considerable diversity in the quality programs used throughout the world, despite some influence by national and international organizations, from whom further guidance could increase uniformity and optimize patient care in radiology. [ABSTRACT FROM AUTHOR]

Inpatient podiatry services were newly established in the South West of England following a peer review process and recommendations. The formation of the Podiatry InPatient Skills Set (PIPSS) group in 2016 allowed for peer learning and improved inpatient care across Trusts. A multi-centred survey demonstrated the value of inpatient podiatry services as an integral member of the multidisciplinary diabetic foot team (MDFT), as well as improved patient care, discharge planning and education of staff. This article describes the successes and challenges of setting up inpatient podiatry services. [ABSTRACT FROM AUTHOR]

The English Diabetes Footcare Network (EDFN) aims to provide a focus for strategic developments, share best practice and advise relevant stakeholders on all matters relating to service delivery and improvements in England for diabetes-related foot disease. The EDFN wanted to establish if there is a common approach to multidisciplinary foot team (MDFT) service provision and service evaluation across England. A questionnaire was compiled by the EDFN and completed by 13 networks. From the findings, the EDFN have proposed principles for MDFTs that highlight the need for standardised, mandated and fully commissioned MDFT services, integrated foot care systems and service reviews. [ABSTRACT FROM AUTHOR]

Multidisciplinary peer reviews were performed to audit the efficacy of diabetic foot care services in the South West region of England. The resulting peer review recommendations were implemented in practice and have led to a reduction in the incidence of major amputation associated with diabetic foot ulceration. Inequalities and gaps identified in diabetic foot ulcer treatment have led to the reconfiguration of some services and the consideration of future changes to others. Service improvements require cogent commissioning, responsive, locally-sensitive provision of care and adequate funding from clinical commissioning groups. The provision of integrated care by a strong multidisciplinary foot team will result in prompt recognition and treatment of diabetic foot disease and enhance outcomes. [ABSTRACT FROM AUTHOR]

The article offers several nursing news briefs. Topics include examines the BACCN True Colors Wellbeing Funding which is a part of an ongoing commitment to support the Critical Care nursing community and considered the BACCN invited critical care professional nurse advocates to apply for funding to support a work project related to enhance the physical and mental health and wellbeing of nurses within critical care.

This article reflects on the value and outcomes of two projects commissioned by NHS England and Somerset Clinical Commissioning Group. The projects demonstrate how a robust strategy can empower practice nurses (PNs) to change practice and provide a sustainable way forward in appraisals, revalidation and continuous professional development. The project encompassed clinical supervision and its value for PN teams and contributions to appraisal. The projects trained a sufficient number of appraisers for PNs across the geographical areas involved to be able to access an appraiser local to them. The appraisal portfolio developed for the projects has been adopted by many PNs who want to use a system that is easy to access and is an alternative to online portfolios. [ABSTRACT FROM AUTHOR]

Purpose: Mental health service improvement initiatives often involve the setting of targets and monitoring of performance. The purpose of this paper is to describe the application of appreciative enquiry (AE), a radically different but complementary approach to quality assurance and improvement, to specialist mental health services across a health region.Design/methodology/approach: This case study describes a regional quality improvement (QI) project involving 12 early intervention in psychosis (EIP) services in South West England. In total, 40 people were trained in AE interviewing skills and in non-reciprocal peer review visits 59 interviews were conducted involving 103 interviewees including service users, carers, clinicians, managers and commissioners. Immediate verbal feedback was provided and main themes summarised in individual reports to host teams using the following headings: team values, strengths, dreams and development plans. A thematic analysis was conducted on team reports and a project report produced which summarised the stages and results of this regional initiative.Findings: All participants rated the experience as positive; it enhanced staff motivation and led to service development and improvement.Research Limitations/implications: The experiences of these 12 EIP teams may not necessarily be generalisable to other services/regions but this positive approach to service improvement could be widely applied.Practical Implications: AE is applicable in large-scale QI initiatives.Originality/value: To the authors knowledge this is the first time that AE has been applied to large-scale mental health service improvement and innovation. [ABSTRACT FROM AUTHOR]

The Wessex region generally has high rates of major and minor lower-extremity amputation in people living with diabetes. Wessex Clinical Network therefore decided to prioritise reducing amputations and improving the local foot care pathway. To gain a greater understanding of the causes of variation in clinical outcomes, the Wessex Clinical Network has supported comprehensive peer reviews of foot care pathways and the services available to people with diabetes. The aim of this process is to improve services across the region through sharing and learning. As part of the peer review, patients were invited to participate in discovery interviews to provide feedback on their experiences across the care pathway. This article describes patients' individual views of their experience across the pathway, highlighting common themes. [ABSTRACT FROM AUTHOR]

There has been growing concern about the quality of health services, including mental health services, within the world’s and prisons. The purpose of the current qualitative interpretive meta-synthesis (QIMS) is to examine the prison environment and how it influences the mental health services delivered to prisoners. It is the hope of these authors that with this QIMS, knowledge improvements and modifications to current policies and practices can begin to take shape. A total of five studies published between 2003 and 2013 were utilized for this QIMS. Participants in all five studies included males and females incarcerated in England, Wales, and the United States. Three overarching themes were identified after analysis: difficulties with accessing services, difficulties with primary staff, and isolation. In each overarching theme, sub-themes are reviewed in detail. These three broad categories are discussed in relation to the person-in-environment system, demonstrating its application in an incarcerated setting. [ABSTRACT FROM AUTHOR]

Aims To investigate the relationship between high diabetes-related lower limb amputation incidence and foot care services in the South-West region of England. Methods The introduction of 10 key elements of foot care service provision in one area of the South-West resulted in stabilization of foot ulcer incidence and sustained reduction in amputation incidence from 2007. Services introduced included administrative support, standardized general practice foot screening, improved community podiatry staffing, hospital multidisciplinary foot clinics, effective care pathways, availability of an orthotist and audit. Peer reviews of the region's diabetes foot care services were undertaken to assess delivery of these service provisions and compare this with major amputation incidence in other regions with data provided by Yorkshire and Humber Public Health Observatory Hospital Episode Statistics. Recommendations were made to improve service provision. In 2015 changes in service provision and amputation incidence were reviewed. Results Initial reviews in 2013 showed that the 3-year diabetes-related major amputation incidence correlated inversely with adequate delivery of diabetes foot care services ( P=0.0024, adjusted R 2 =0.51). Repeat reviews in 2015 found that two or more foot care service improvements were reported by six diabetes foot care providers, with improvement in outcomes. The negative relationship between major amputation incidence and service provision remained strong both in the period 2012-2015 and in the year 2015 only ( P ≤0.0012, adjusted R 2 =0.56, and P= 0.0005, R 2=0.62, respectively). Conclusions Major diabetes-related lower limb amputation incidence is significantly inversely correlated with foot care services provision. Introduction of more effective service provision resulted in significant reductions in major amputation incidence within 2 years. Failure to improve unsatisfactory service provision resulted in continued high amputation incidence. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to report on the use of an innovative peer review approach to identifying and addressing the causes of inappropriate admissions from hospital to nursing homes in South Gloucestershire (SG). It explains the methodology that was developed, the findings of the peer review process and reflects on the effectiveness of the process. Design/methodology/approach – The peer review consisted of two stages. The first stage involved a panel of local stakeholders carrying out an audit of a random selection of cases where people had been assessed as needing permanent nursing or residential care. From this four cases of inappropriate admissions were identified. Stage two involved an externally facilitated process with two peer challenge panels; one of local stakeholders and the other external experts. The two panels analysed the cases of inappropriate admissions, identified the system causes and suggested actions to tackle the issues which were fed back to an audience of local stakeholders. Findings – The combination of case audit and peer review was successful in providing robust challenge to the processes in SG by identifying shortcomings in the system and suggesting actions to improve outcomes. Research limitations/implications – The approach was taken in one Council area and therefore may not be replicable in another area. Practical implications – The case study suggests that a peer review approach using both local and external peers, including providers, is an effective way to identify weaknesses in the health and social care processes. The insights offered by external peers and providers is helpful for councils in identifying where to focus resources and suggests that other areas should consider proactive adaptations to the peer review methodology that is offered as part of the LGA’s programme of sector-led improvement. Social implications – The case study suggests that a peer review approach could have a positive impact on the quality of care and quality of life for older people who are admitted to hospital. Originality/value – The case study offers an innovative and original use of the peer review approach in social care that can be shared with other councils and partners. The Southwest Improvement Board have identified it as of particular interest to other areas seeking to work with partners to identify and implement positive change. [ABSTRACT FROM AUTHOR]

RAE ratings have been criticized as biased in favour of universities that are old, in England, large and represented on the panel. We investigate these accusations for the 1996 and 2001 RAE ratings of economics departments using independent rankings from the academic literature as quality controls. We find RAE ratings to be largely in agreement with the profession's view of research quality as documented by independent rankings, although the latter appear to be more focused on research quality at the top end of academic achievement. Accusations of bias find no support in the data, except for panel membership in 1996. [ABSTRACT FROM AUTHOR]

The Centre for Social Action was commissioned by the Leicester City Council to evaluate its Teenage Pregnancy Prevention Strategy. This was a multi-stage project with a central element of consulting with young people. This article outlines the process that was followed in order to recruit, train and support young people through the process of being peer researchers. Issues covered include retention of interested young people, experiences of training peer evaluators and supporting them throughout the project. The added value of using peer evaluators will be discussed and recommendations given for those wanting to work with young people as researchers in future. [ABSTRACT FROM AUTHOR]

This symposium focussed on issues around peer review, dissemination, documentation and publishing of media research. A mix of papers, presentations and workshops provided stimuli for discussion and the opportunity to explore ways forward on peer review and use of media in publishing research. The debate centred on the problems of framing research questions for genuinely innovative work; of finding a way through the tensions between the requirements of our research, of funding bodies, and our own creative aspirations; on the ways in which dissemination needs to be considered as an integral part of the project, and how the different characteristics of forms of dissemination need to be carefully weighed up when making decisions around publishing. There is a tension between the open space that new media creates and the conventional gate-keeping process traditionally seen as one of the characteristics of the process to guarantee quality. There has been concern about the whole apparatus of peer review and evaluative criteria being brought to bear on media practice, and the ways in which the framing of the work for research application purposes may conflict with an exploratory approach. This symposium gave academics from a variety of higher education institutions the opportunity to further develop thinking on media practice research. [ABSTRACT FROM AUTHOR]

An explanation of the principles of peer review, charting the development of peer review to date and providing a guide to practitioners in preparing for the new ways of working with the Legal Services Commission focussing on clinical negligence. [ABSTRACT FROM AUTHOR]

This paper examines the introduction of peer review of teaching in a pre‐1992 university in England. The paper first considers the theoretical dimensions. Peer review of teaching is generally seen as a quality enhancement rather than a quality assurance instrument and a powerful means of encouraging the continuing professional development of individual lecturers. However, the paper identifies that where peer review of teaching is not seen in these terms, but rather as just one of many impositions by external agencies, universities face the major challenge of changing organisational culture and influencing the assumptions, beliefs, values and behaviours of academic staff. The second part of the paper discusses a case study of the implementation and impact of peer review of teaching in a large and very diverse university. This study highlights the theoretical concepts discussed and helps to conceptualise the problems associated with formative peer review of teaching in higher education. [ABSTRACT FROM AUTHOR]

Evaluates the Subject Review process commissioned by the Higher Education Funding Council for England and organized by the Quality Assurance Agency from 2000 to 2001. Reviews conducted in two subject areas; Discussion of the peer review process; Training program required for reviewers.

The article presents an assessment of case studies presented by candidates for the Membership Examination in Orthodontics (M.Orth.) at the Royal College of Surgeons of England in 1995 and 1996. It presents information on the eligibility requirements of the examinations and case studies, Index of Orthodontics Treatment Need (IOTN), and Peer assessment Rating (PAR) mechanism. In the study, the 80 percent case studies of 1995 and 94 percent cases of 1996 were found to have IOTN score 4 and 5.

Presents a case study on the use of peer assessment in higher education in the School of Music at Kingston University in England. Rationale of peer assessment systems; Guidelines established for the management of peer assessment; Evaluation of the effectiveness of peer assessment; Significance of peer assessment in encouraging skills of self-critical awareness.

Background: Stereotactic subcaudate tractotomy (SST) is the only type of psychosurgery performed at the Geoffrey Knight Unit, London, where nearly 1300 operations have been done since 1961. Statistically reliable data are not available to prove the effectiveness of SST. A detailed statement about contemporary psychosurgery is given.Method: Relevant publications from the Unit and via Medline are discussed. The outcome figures are reviewed. The outcome is assessed at the Unit in global and clinical terms, associated with results of self-completed questionnaires.Results: SST allows 40-60% of patients to live normal or near-normal lives, perhaps with continuation of medication. A reduction in suicide rate to 1% post-operatively, from 15% in cases of uncontrolled affective disorders is seen.Conclusion: As a treatment of last resort, no controlled trial against a comparable treatment is possible. It appears reasonable to offer SST to patients with suicidal and deluded depression or with frequently swinging moods, not responding to other treatments. [ABSTRACT FROM AUTHOR]

The article discusses the development of a peer-appraisal system by nurse partners in England, as well as its benefits and possible limitations. The process was based upon support and respect, and maintenance of confidentiality. It includes feedback from colleagues and patients, significant events, audits, deliberation, courses, teaching, presentations and publications. The appraisal and the associated documentation demonstrates that a certain level of competency has been achieved.

Context: It has been suggested that early announcements of research works to be published in peer-reviewed journals may diminish newsworthiness of scientific articles, but this issue has not been widely studied.Objective: To analyze the impact on the news media, in terms of volume and prominence of coverage, of a scientific article published in peer-reviewed journals about issues with relevance to public health compared with the impact of preliminary release of information on the same issue.Design: Analysis of press coverage of Creutzfeldt-Jakob disease (CJD) and bovine spongiform encephalopathy (mad cow disease) in the 7 newspapers with the widest circulation in Italy, between March 20, 1996, when the British secretary of state for health announced the identification of 10 cases of a new-variant CJD, described April 6, 1996, in The Lancet, and May 10, 1996. Related newspaper articles were identified by hand search.Main Outcome Measures: Numbers of newspaper articles published before and after publication of the Lancet article.Results: We collected 535 articles, of which 62 (11.6%) appeared on the front page. The number of articles published daily peaked on March 26 with 48 items and 1 article on the front page of all the newspapers. A total of 386 (72%) of the 535 articles and 56 (88.7%) of the 62 published on the front page were published in the first 2 weeks of the study period, before the Lancet publication.Conclusions: Our analysis suggests that, in the case of issues of public health importance, when peer-reviewed research is published after a health risk is disclosed to the public, its impact in the media is small. Coordination between news release by public health authorities and publication by peer-reviewed journals may improve the quality of public information. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at a symposium on the peer review of media practice co-sponsored by the Journal of Media Practice held at the University of Salford in Lancashire, England in June 2006 is presented. Agendum dealt with the role of research community to shape any guidelines that emerge as standard practice among the broader research community.

Deals with the UK Serials Group and Counting Online Usage of NeTworked Electronic Resources (COUNTER) usage statistics training seminar held at the University of Oxford in England on December 9, 2005. Explanation given by Peter Shepherd on the origins and goals of COUNTER; Discussion given by Mike Hannant on the benefits of COUNTER for publishers; Presentation given by Jonathan McAslan on the role of usage statistics in journals review at Aberdeen, Scotland.

Focuses on the relevance of self-assessment on effective medical audit in Wessex, England. Interpretations of the concept of medical audit; Problems encountered with peer review; Need to develop both insight and self-esteem for making audit educational; Educational principles for the audit.

Introduction: Peer observation of teaching is important in the development of educators. The foundation curriculum specifies teaching competencies that must be attained. We created a developmental model of peer observation of teaching to help our foundation doctors achieve these competencies and develop as educators. Methods: A process for peer observation was created based on key features of faculty development. The project consisted of a pre-observation meeting, the observation, a post-observation debrief, writing of reflective reports and group feedback sessions. The project was evaluated by completion of questionnaires and focus groups held with both foundation doctors and the students they taught to achieve triangulation. Results: Twenty-one foundation doctors took part. All completed reflective reports on their teaching. Participants described the process as useful in their development as educators, citing specific examples of changes to their teaching practice. Medical students rated the sessions as better or much better quality as their usual teaching. Discussion: The study highlights the benefits of the project to individual foundation doctors, undergraduate medical students and faculty. It acknowledges potential anxieties involved in having teaching observed. Conclusion: A structured programme of observation of teaching can deliver specific teaching competencies required by foundation doctors and provides additional benefits. [ABSTRACT FROM AUTHOR]

The article reports on the issue concerning the method used by post-publication peer review Faculty of 1000 (F1000) in ranking scholarly journals in London, England which relies on the scores awarded to individual scientific papers. It states that such scores could be changed based on the interests and enthusiasms of reviewers. However, F1000's associate editor Richard Grant says that these rankings provide valuable measure to authors complementary to journal league tables on citation impact.

The article focuses on the educational options for clinical nurse specialists (CNSs) in England which would be helpful for their peer review process. It states that the master's programme, which involves clinically focused modules offer, would benefit CNSs to achieve evidence for the national cancer peer review programme. It adds that the three-day National Health Service (NHS) Connected national communication skills programme is also offered for the educational preparation of CNSs.

This article presents a calendar of events in London, England during the fall of 2006. The "British Medical Journal" (BMJ) is running a series of workshops designed to provide an overview of how to approach peer reviewing. On November 21, Trish Groves, the deputy editor of BMJ, is planning a workshop, and on November 22, Dr. Tessa Richards, assistant editor at BMJ, will be holding a workshop as well.

The article reports on a proposed legislation in England to make judges pay the costs in mistrials. The idea of having such law was formed due to the cancellation of the Jubilee Line Fraud trial which had proceeded for 21 months at an estimated cost of £60,000,000. A recommendation was issued which states that a comprehensive review mechanism for failed trials must be formed which might include peer review of judges.