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The drive to improve quality in the education sector is similar to that in health care, and lessons from the schools system are relevant to nursing leadership. This article discusses these shared traits, and details how school improvement was achieved in London and how a model of learning-centred leadership helped to transform pupil attainment in schools that had been performing poorly. Parallels are drawn between the education inspection system undertaken by Ofsted and the hospital inspections undertaken by the Care Quality Commission, and between the practice discipline-based managerial roles of nurse directors and head teachers. The article suggests that a learning-centred approach to improving the quality of patient care is needed, with a focus on the education and continuing professional development of staff. [ABSTRACT FROM AUTHOR]

Background: Despite NICE guidelines, the early management of deep vein thrombosis (DVT) in UK hospitals varies widely. We investigated the variation in clinical pathways used in NHS hospitals in North West England. Methods: A detailed questionnaire was sent to seventeen University or District General hospitals with an Accident and Emergency department. Copies of protocols or patient pathways were requested. Results: 15 hospitals responded despite our repeated requests for information. Of those, four hospitals did not provide any DVT protocol, guideline or service for DVT. In seven (63.6%) hospitals, possible DVT patients were assessed in A&E, and four (36.4%) in Acute Medical Admission Units. During the day, initial assessment was by a Specialist Nurse (SN)/Advance Nurse Practitioner (ANP) in 4 (36.4%) hospitals, by a doctor in 5 out of 11 hospitals (45.5%) and a combination of ANP and doctors in 2 out of 11 (18.2%) hospitals. Out of hours assessment was conducted by a doctor in all 11 hospitals (100%). Two (18.2%) hospitals used the 2003 Wells score, three (27.3%) used the 1997 Wells score and six (54.5%) hospitals used 'in house' modified Wells score. The score required to trigger further investigation varied between different hospitals. Only four (36.4%) hospitals could arrange US imaging within four hours of presentation. Conclusion: This lack of co-ordinated services for the management of DVT in the North West England is likely to reflect national practice. A national programme is urgently needed to ensure patients with suspected DVT are managed using standardised and consistent protocols. [ABSTRACT FROM AUTHOR]

Background: In the catchment area of the Southwest Regional Association (LV) of the German statutory accident insurance (DGUV) there are currently a total of 149 hospitals and clinics which are qualified to carry out inpatient treatment of patients with occupational accident injuries. Before 31 December 2017 at the latest the LV has the intention of auditing all 149 of these hospitals with respect to participation in the new inpatient medical treatment procedure of the DGUV. Accreditation for the new procedures: Applications for accreditation for the severely injured type procedures (SAV) must be accompanied by the necessary documentation on qualifications and instrumentation. For renewed approval for the injury type procedure (VAV) the necessary VAV case numbers must be fulfilled. In both procedures the inspection is oriented to the route taken by severely injured trauma patients whereby the equipment, facilities and process operation will be assessed. The structural alterations also necessitate adjustment in the documentation process which will be correspondingly adapted before 1 January 2014. Hospitals with an unlimited contract in the so-called old VAV or those which employed accident insurance consultants on 31 December 2012, will retain the previous approval over a transition period until 31 December 2017. [ABSTRACT FROM AUTHOR]

No abstract available. Article truncated after 150 words. In the early twentieth century hospitals were unregulated and care was arbitrary, nonscientific and often poor. The Flexner report of 1910 and the establishment of hospital standards by the American College of Surgeons in 1918 began the process of hospital inspection and improvement (1). The later program eventually evolved into what we know today as the Joint Commission. Veterans Administration (VA) hospitals have been inspected and accredited by the Joint Commission since the Reagan administration. The VA hospitals often share reports regarding recent Joint Commission inspections and disseminate the reports as a "briefing". One of these briefings from a recent Amarillo VA inspection was widely distributed as an email attachment and forwarded to me (for a copy of the briefing click here). There were several items in the briefing that are noteworthy. One was on the first page (highlighted in the attachment) where the briefing stated, "Surveyor recommended teaching people ...

In the study described in this article, the authors performed safety walk-throughs or inspections for 20 clinics located both inside a major medical center clinic (onsite) and away from the main clinic site (offsite). A checklist was used to evaluate compliance with institutional, local, state, and federal guidelines and regulations. The results obtained at onsite clinics were compared with the results from offsite clinics. Findings suggested no overall difference in the number of yes (desirable) answers. A marginally significant difference, however, was observed between the onsite and offsite clinics with regard to knowledge of infection control and waste/infection control questions. The walk-throughs helped create an improved working relationship between clinic personnel and environmental safety personnel, allowed for correction of safety issues, enabled an informal training opportunity, and increased institutional compliance with guidelines and regulations. [ABSTRACT FROM AUTHOR]

Background. Patients hospitalized in resource-poor health care settings are at increased risk for hospital-acquired respiratory infections due to inadequate infrastructure. Methods. From 1 April 2007 through 31 March 2008, we used a low-cost surveillance strategy to identify new onset of respiratory symptoms in patients hospitalized for 172 h and in health care workers in medicine and pediatric wards at 3 public tertiary care hospitals in Bangladesh. Results. During 46,273 patient-days of observation, we recorded 136 episodes of hospital-acquired respiratory disease, representing 1.7% of all patient hospital admissions; rates by ward ranged from 0.8 to 15.8 cases per 1000 patient-days at risk. We identified 22 clusters of respiratory disease, 3 of which included both patients and health care workers. Of 226 of heath care workers who worked on our surveillance wards, 61 (27%) experienced a respiratory illness during the study period. The cost of surveillance was US$43 per month per ward plus 30 min per day in data collection. Conclusions. Patients on these study wards frequently experienced hospital-acquired respiratory infections, including 1 in every 20 patients hospitalized for 172 h on 1 ward. The surveillance method was useful in calculating rates of hospital-acquired respiratory illness and could be used to enhance capacity to quickly detect outbreaks of respiratory disease in health care facilities where systems for outbreak detection are currently limited and to test interventions to reduce transmission of respiratory pathogens in resource-poor settings. [ABSTRACT FROM AUTHOR]

The article presents a study regarding profitability of hospitals in South Korea. Researchers evaluated the standardization of hospitals through the inspections of South Korea Hospital Association. They examined the factors regarding financial performance of hospitals. In addition they suggest hospital employees to provision methods and rules that will profound the financial aspects of medical institutions.

Optimisation in X-ray imaging in order to reduce patient doses during diagnostic X-ray examinations is a complex process given the high level of image quality required. When quality systems are implemented as a basis for optimisation, attention should be paid to the qualifications of the staff and quality control of the equipment and of the X-ray imaging procedures, as well as to the methods used to evaluate the quality of these procedures. Until recently, quality control procedures at health care institutions in Lithuania were limited to the testing of X-ray units. Since film processing is one of the most important factors influencing patient doses and image quality during X-ray examinations, in 2003 the Kaunas department of the Radiation Protection Centre organised inspections of film processing laboratories in 11 health care institutions—hospitals and outpatient departments—in the Kaunas region. Problems of non-compliance with requirements identified during these inspections are discussed in this paper. Most of the health care institutions inspected already had quality assurance programmes. However, the implementation of these programmes was sometimes erratic because of the insufficient attention paid to the film developing processes. The worst situation was found in 4 institutions where the films were developed manually. Only 3 of the 11 departments inspected had sensitometers and densitometers for quality control of the processing. In many eases there was no control of chemicals, film sensitivity and density, or else control was irregular. In only a few departments were the effects of repeated controls investigated and discussed. Despite the current problems occurring in medical X-ray diagnostic departments in Lithuania, the situation is rapidly improving. New equipment is being installed, new devices for quality control are being used and, last but not least, the view of hospital administrators, radiologists and laboratory workers towards quality assurance and quality control is changing. [ABSTRACT FROM AUTHOR]

The article presents a report on the irregularities in hospitals in China. According to the article, irregularities are a social phenomenon that should be addressed seriously. In recent years, people are increasingly of the opinion that irregularities in society are an epidemic. A hospital is a small society completely engulfed in a social environment. To a large extent it reflects the characteristics of that social environment. The climate of society exerts a profound influence over medical practice. Irregularities in the hospital are closely related to irregularities outside and are a manifestation of their contagious nature. A large class-one provincial or municipal hospital of 600 beds usually treats half a million outpatients each year, houses nearly 10,000 inpatients, and receives over 100,000 visitors. With such a large number of people going in and out of the hospital, the germ index in the hospital environment is more than one hundred times higher than in a department store. In China, the ratios of number of hospital beds to the population and number of hospital beds to number of patients are both very low.

The article offers information on the importance of surgical death investigation. Topics discussed include purpose of death investigations such as improving care and ensuring patient safety; mortality audits improve patient safety and reveal system failures; and importance of hospital internal investigations for providing concern among surgeons as they were synonymous with misconduct determinations.

Gives advice to nurses on their practice. Use of Salem sump tubes for nasogastric feedings; Coping with nervousness in taking certification examinations for pediatric nurses; Rational for the Joint Commission on Accreditation of Healthcare Organizations' announcement of the date of their hospital inspections.

The article reports on the investigation of tuberculosis contact at hospitals in Okaloosa County, Florida in 2014. Topics discussed include the trend of tuberculosis transmission at hospitals, the risk assessments of the disease, its diagnosis, its environmental factors, and the tuberculin skin test conversions.

The article focuses on the move by majority of surgeons in England to allow the publication of their individual outcome data from surgical units despite misgivings. It mentions some concerns raised over the publication including the accuracy of the risk adjustment, risk-averse behaviour and deadline, the importance of transparency in improving the standards for the delivery of care and training, and the decision of the Care Quality Commission (CQC) to involve clinicians in hospital inspections.

Background: Over the last decades, the patient perspective on health care quality has been unconditionally integrated into quality management. For several years now, patient rating sites have been rapidly gaining attention. These offer a new approach toward hearing the patient's perspective on the quality of health care.Objective: The aim of our study was to explore whether and how patient reviews of hospitals, as reported on rating sites, have the potential to contribute to health care inspector's daily supervision of hospital care.Methods: Given the unexplored nature of the topic, an interview study among hospital inspectors was designed in the Netherlands. We performed 2 rounds of interviews with 10 senior inspectors, addressing their use and their judgment on the relevance of review data from a rating site.Results: All 10 Dutch senior hospital inspectors participated in this research. The inspectors initially showed some reluctance to use the major patient rating site in their daily supervision. This was mainly because of objections such as worries about how representative they are, subjectivity, and doubts about the relevance of patient reviews for supervision. However, confrontation with, and assessment of, negative reviews by the inspectors resulted in 23% of the reviews being deemed relevant for risk identification. Most inspectors were cautiously positive about the contribution of the reviews to their risk identification.Conclusions: Patient rating sites may be of value to the risk-based supervision of hospital care carried out by the Health Care Inspectorate. Health care inspectors do have several objections against the use of patient rating sites for daily supervision. However, when they are presented with texts of negative reviews from a hospital under their supervision, it appears that most inspectors consider it as an additional source of information to detect poor quality of care. Still, it should always be accompanied and verified by other quality and safety indicators. More research on the value and usability of patient rating sites in daily hospital supervision and other health settings is needed. [ABSTRACT FROM AUTHOR]

The article discusses the Dr. Foster Good Hospital Guide, which triggered a crisis of confidence in the system for inspecting hospitals established and reformed by the British government. The publication of the guide has resulted in the resignation of Barbara Young as chairwoman of the Care Quality Commission (CQC). The guide was written by two journalists, who warned on the poor state of British hospitals. Critics of the guide argue that the authors of the guide adopted a flawed method which resulted in misrepresentation of hospital performance.

The article relates the steps taken by the Ridge Surgery Center to prepare for the inspection led by a surveyor in Seneca, South Carolina.

Evaluates the preregistration posts of medical consultants of the National Health Service in Great Britain. Inspection of hospital facilities and units; Assessment of the experience of the house officer; Preparation of the preregistration house officer of a report every six months.

Comments on the procedure of hospital inspection in United States. Presence of several problems in hospitals; Details of hospital inspection; Role of Joint Commission on Accreditation of Hospitals in maintenance of quality of patient care in hospitals; Responses of the Commission on complaints.

This section offers news briefs on the Royal College of Surgeons of England as of September 2013. It mentions a report from the Health Select Committee highlighting the need for a restructure of the provision of urgent and emergency care to be able to address patient need in the longer term and the plan of Chief Inspector Mike Richards to inspect hospitals with larger teams starting in August in response to a report expecting higher mortality rates.

Following publication in 2013 of the report by Robert Francis QC into care at the Mid Staffordshire Foundation Trust, the Care Quality Commission (CQC) has introduced a new and radically different approach to hospital inspection. This involves much larger teams (typically 30 or more people) including clinicians, experts by experience and CQC staff. Eight core services are assessed against five key questions (domains): Are services safe? Effective? Caring? Responsive to patients' needs? Well led? Each domain of each core service is rated on a four point scale: Outstanding, Good, Requires Improvement or Inadequate. To date 65 (40%) of the 160 acute trusts in England have been inspected, the aim being to inspect all trusts by December 2015. The most important single finding is the huge variation in quality of care that the inspection teams have identified within the NHS. Informal feedback suggests that the new approach to inspection represents a significant improvement on previous CQC inspections, though further improvement is imperative.

The article reports on a new inspectorate in Scotland called the Care Environment Inspectorate. The inspectorate, which is based in NHS! Quality Improvement Scotland, will carry out random and planned inspections of every Scottish acute hospital to ensure that they are adhering to the highest standards of infection prevention and cleanliness. The inspectorate will have a chief inspector who will be responsible for ensuring that each hospital inspection is rigorous and thorough.

The article discusses the medical liability of hospitals when they fail to manifest that they are reaching to minimize the risk of nosocomial infections in the U.S. According to Tanya Goldberg, a partner in the law firm Borden Ladner Gervais LLP, the degree of liability would probably depend on the point to which a hospital has enforced policies and procedures. Goldberg added that hospitals should instill a culture of infection prevention and track their rates of nosocomial infection to verify their progress and distinguish areas for improvement.

This article announces the formation of the Care Quality Commission by the Department of Health in Great Britain. The watchdog agency could close English hospitals in 24 hours if needed to fight against healthcare-acquired infections. The agency has the power to carry out inspections, fine violators of hygiene practices and covers both private hospitals and healthcare providers in the National Health Service (NHS). Health secretary Alan Johnson says the tougher stance is designed to protect patients from infections but some critics are saying the replacement of the two-year-old Healthcare Commission with this agency is too much reorganization.

Presents a humorous story about the inspection of a dog's facility by a State of California Animal Hospital Inspection and Veterinary Staff Competence Evaluating Committee agent.

Offers a look at problems in the management of the British National Health Service (NHS). Assessment of the performance of the NHS based on targets; Problems with targets for patient waiting times, patients in emergency departments and for ambulance response times; Combination of randomness with inspection systems.

Two inspection bodies for health and social care were among the cornerstones of the new Health and Social Care Bill published by health secretary Alan Milburn March 2003. The Commission for Healthcare Audit and Inspection and the Commission for Social Care Inspection will have powers to inspect standards, audit spending and report on the quality of health and social care provision across the public, private and voluntary sectors.Milburn said the‘ tough and independent’ inspectorates would ensure that‘ every penny of taxpayers' money invested gets the best value for patients’. For the first time private sector health care will also be subject to the same inspection regime as NHS hospitals.

Provides information on the launching of Great Britain's Commission for Health Improvement, a government agency that will inspect hospital and general practice in England and Wales. Comments from British Prime Minister Tony Blair; Role of Dame Deidre Hine as chairman of the commission; Function of the agency.

Deals with issues arising from the publication of performance tables for hospitals in England. Argument of the concerned hospitals; Explanation from Professor Harvey Goldstein, a researcher who has studied educational league tables and surgeons' league tables; Impact of hospital evaluation on quality of care.

Reports on the British Department of Health's publication of performance indicators for the evaluation of hospitals' performance in England. Details on the results of hospital evaluation; Expectations of Frank Dobson, the British secretary of state for health; Views of doctors and health managers on the initiative.