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Ruth Boaden

Publications and source records attributed to Ruth Boaden.

7 recordsLinked to original sources
PubMed2007

Developing bed managers: the why and the how.

AIM: This paper describes and analyses the role of bed managers within hospitals, and how this can be supported through a development programme. BACKGROUND AND KEY ISSUES: Bed management has increased in importance as access targets have developed, and appreciation of the importance of patient flow has grown. The bed management role is usually performed by nurse managers, and can be particularly stressful and managerially complex. Despite calls for training support, little has been available. In response we have developed and delivered a training programme to over 70 staff in the past 2 years. EVALUATION AND CONCLUSIONS: The programme evaluation data is used to show that it has had an impact on the knowledge and skills of the bed managers involved, but also on their subsequent behaviours. These changes have translated into results for the organization and the individual, including staff retention, promotion and fewer cancelled operations. We conclude that the programme is an effective way to enhance the knowledge and skills of bed managers, and that the enhanced profile of bed management raises challenges for nurse managers in many areas of the organization.

Attitude of Health Personnel↗
PubMed2006

Impact of case management (Evercare) on frail elderly patients: controlled before and after analysis of quantitative outcome data.

OBJECTIVES: To determine the impact on outcomes in patients of the Evercare approach to case management of elderly people. DESIGN: Practice level before and after analysis of hospital admissions data with control group. SETTING: Nine primary care trusts in England that, in 2003-5, piloted case management of elderly people selected as being at high risk of emergency admission. MAIN OUTCOME MEASURES: Rates of emergency admission, emergency bed days, and mortality from April 2001 to March 2005 in 62 Evercare practices and 6960-7695 control practices in England (depending on the analysis being carried out). RESULTS: The intervention had no significant effect on rates of emergency admission (increase 16.5%, (95% confidence interval -5.7% to 38.7%), emergency bed days (increase 19.0%, -5.3% to 43.2%), and mortality (increase 34.4%, -1.7% to 70.3%) for a high risk population aged >65 with a history of two or more emergency admissions in the preceding 13 months. For the general population aged > or =65 effects on the rates of emergency admission (increase 2.5%, -2.1% to 7.0%), emergency bed days (decrease -4.9%, -10.8% to 1.0%), and mortality (increase 5.5%, -3.5% to 14.5%) were also non-significant. CONCLUSIONS: Case management of frail elderly people introduced an additional range of services into primary care without an associated reduction in hospital admissions. This may have been because of identification of additional cases. Employment of community matrons is now a key feature of case management policy in the NHS in England. Without more radical system redesign this policy is unlikely to reduce hospital admissions.

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PubMed2006

Developing the electronic health record: what about patient safety?

This paper examines the development of electronic health records within the National Health Service (NHS) by an analysis of a series of pilot projects funded by the Electronic Record Development and Implementation Project (ERDIP), one aspect of the work of the NHS Information Authority (NHSIA) (As of 1 April 2005, the NHSIA ceased to operate. Much of its work is continued by Connecting for Health and the Health and Social Care Information Centre.) The focus of the analysis is on the extent to which identifying and correcting error within health records was explored through these projects. The inherent potential for error and resultant impact on patient safety is highlighted, by considering the context of the record, the content of the record and the process of change from paper-based or piecemeal electronic health records to integrated electronic health records. While the process of change highlights issues of data security and access, it is the variability in starting points for different organizations that possibly poses most risk to patient safety. Issues relating to the content of the record can to some extent be minimized by the effective use of technology, but the tension between coding and qualitative data requires further consideration in terms of its impact on patient safety. This paper concludes that the development of electronic health records has to be viewed within the context of governance and patient safety, and the implications articulated.

Diffusion of Innovation↗
PubMed2006

Copying letters to patients: the view of patients and health professionals.

OBJECTIVE: Government policies and initiatives in England have promoted the involvement of patients in the management of their own health care. Copying clinical letters to patients may improve patients' understanding of their health and the care they receive. Although the National Health Service (NHS) Plan describes copying letters to patients as a 'right', the process of copying letters to patients remains an example of good practice rather than a requirement. We review the literature to explore whether letters should be copied to patients and in what circumstances. METHODS: Review of published literature and evidence from 12 pilot projects funded by the Department of Health (DH) for and against copying letters to patients from the perspective of patients and health professionals. RESULTS: Patients generally find copies of letters beneficial, and tend to be more satisfied with their consultation and report benefits in terms of involvement in their own health care when letters are copied. Health professionals generally have concerns about the relative benefits to the patient and remain concerned about the resource implications of copying letters. CONCLUSIONS: On balance, the limited evidence on copying clinical letters to patients favours copying letters, or at least offering copies, although health professionals are less keen than patients.

Correspondence as Topic↗
PubMed2005

Managing risk: a taxonomy of error in health policy.

This paper discusses the current initiatives on error and adverse events within healthcare, with a particular focus on the NHS, within the context of health policy. One of the key features of the paper is the proposal for an emergent taxonomy of the medical error literature, developed from the ideologies and rationales that underpin their approaches. This taxonomy provides details of three categories--empiricists, organisational rationalists and reformers of professional culture--and these act as an organising framework for the exploration of the potential consequences of current policy on errors and adverse events. This discussion highlights the tension between optimising health outcomes for patients and managing the health system as effectively as possible. In particular, the inherent tension between explicit managerial formulations of risk and implicit risk management strategies associated with medical professionalism are considered.

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PubMedDate not supplied

Implementing the role of the community matron.

About 17.5 million people in the UK are living with a long-term condition. Part of the government strategy to improve outcomes for these people was to introduce the role of the community matron. This article builds on previous research by examining the community matron role across nine PCTs.

Attitude of Health Personnel↗