Standards for head injury management in acute hospitals: evidence from the six million population of the Eastern region

Seeley, Helen; Maimaris, C; Hutchinson, Peter J.; Carroll, G; White, Bryon; Kirker, Stephen; Tasker, Robert C.; Steward, Charles J; Haynes, Katharine; Hardy, D. H.; Pickard, John D.

doi:10.1136/emj.2005.024737

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…However, there have been some successful attempts to strengthen the links between RNUs and the hospitals that they serve, notably in the Eastern region of England,33 with policies in place in other areas to facilitate the swift transfer of all appropriate patients, regardless of RNU bed status.…”

Section: Resultsmentioning

confidence: 99%

Republished paper: The implications of the NICE guidelines on neurosurgical management for all severe head injuries: systematic review

Barratt

Moore²,

Raine³

2010

Postgraduate Medical Journal

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Head injury is an important cause of death among young adults in the UK, and a significant burden on NHS resources. However, management is inconsistent, governed largely by local resources. The latest version of the NICE head injury guidelines suggests that more patients with traumatic brain injury should be transferred to receive specialist care. However, this raises issues about the capacity of regional neurosurgical units, particularly to accommodate patients who do not require surgical intervention. Objectives To critically evaluate the basis of the NICE recommendations about transfer for neurosurgical care, and examine the configuration of specialist services to assess the implications of increasing the existing number of transfers. Methods A systematic literature review was conducted of articles discussing the provision of emergency neurosurgical care for adult head injuries in the UK. Results Fifty-eight papers met the criteria for inclusion in the literature review, including seven papers cited in the NICE guidance. Fifty-one papers related to neurosurgical care, including papers on bed occupancy, transfer times and transfer policies. Conclusions The evidence NICE cited is of variable quality. Much of the research was conducted outside the UK, which raises questions about its relevance to the NHS. Care of traumatic brain injuries in the UK is already hampered by the inadequate capacity of regional neurosurgical units to meet demand, and transferring more patients would be likely to exacerbate this. Increasing the number of transfers could also worsen inequalities of access for other groups, such as elective patients, particularly in areas where facilities are most stretched.

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Section: Resultsmentioning

confidence: 99%

Republished paper: The implications of the NICE guidelines on neurosurgical management for all severe head injuries: systematic review

Barratt

Moore²,

Raine³

2010

Postgraduate Medical Journal

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“…the Galasko report [24] and later studies [29][30][31]). These are designed as a planning and evaluation tool for service planners and providers [32,33]. They support and contribute to the review of quality of services within the national strategic framework [34] and the Society of British Neurological Surgeons [35].…”

Section: Resultsmentioning

confidence: 99%

Action research in developing knowledge networks

Seeley

Urquhart

2008

Health Informatics J

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This paper describes the experiences of the Eastern Head Injury Study in creating a strategic regional head injury service framework using a collaborative action research methodology. The types of data, information and knowledge required to develop and support such a framework for both development and successful implementation are identified. This includes the identification of existing knowledge/information systems, the variability and gaps in these, and how the systems fit together, using a number of evidence-gathering and knowledge-sharing methods. The discussion debates the value of the action research approach and what principles are necessary in developing and maintaining knowledge networks. The project demonstrates that an understanding of the social learning cycle can help in understanding how the pieces fit together, and how the information systems need to be in place to provide the information (or data or knowledge) in the appropriate format to make the learning possible.

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“…Other groups also describe how a regional audit has been used to inform the development of standards of care and sequential national audits have also documented improvements in patient care. 5,20 However, compared to national audits, these regional audits have required no external funding. SpRs undertook this work as part of their protected time and the audit department involved took on this project as part of their ongoing funded work.…”

Section: Discussionmentioning

confidence: 99%

Eight years’ experience of regional audit: an assessment of its value as a clinical governance tool

et al. 2010

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-Strengthening clinical audit is crucial for improving the quality of healthcare provision. The West Midlands Rheumatology Service and Training Committee coordinates an innovative programme of regional audits and the experience of rheumatology healthcare professionals involved was surveyed. This was a questionnairebased study in which respondents rated statements relating to regional audit on Likert scales. Out of 105 staff, 70 replied. There was consensus that results of regional audit have been robust, valid and reliable; regional audits benefit patients and units; provide educational opportunities for specialist registrars (SpRs); and are more efficient than local audit by allowing comparison between units. Opinion was divided about how well informed respondents were and how effective they are at closing the audit loop. Many units reported changes in practice. Regional audit is widely perceived to be a valuable clinical governance tool supporting significant changes to clinical practice, and an excellent training opportunity for SpRs. Recommendations for a successful regional audit scheme are described in this article.

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Standards for head injury management in acute hospitals: evidence from the six million population of the Eastern region

Abstract: A survey of compliance with the head injury standards indicate that, with their whole systems approach and subject to further refinement, they are a useful method for identifying deficiencies in service provision and monitoring for quality of care both within organisations and regionally.

Cited by 7 publications

References 8 publications

Republished paper: The implications of the NICE guidelines on neurosurgical management for all severe head injuries: systematic review

Republished paper: The implications of the NICE guidelines on neurosurgical management for all severe head injuries: systematic review

Action research in developing knowledge networks

Eight years’ experience of regional audit: an assessment of its value as a clinical governance tool

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