I once had a job in the NHS helping clinicians improve patient care. The job involved comparing the outcomes of existing practice with (if any) best practice from other hospitals (internationally). Changes were made to existing protocols and then re-assessed. Any improvements to ‘best practice’ would then be published for others to benefit from.
Some of theses topics included “Importance of Early & Appropriate Sitting Posture for Stroke Presenting with Stroke”, “Effectiveness of Barium Needle Therapy in Breast Cancer” and “Protocols for Secondary Sedation of Children in Day Case Surgery”.
One of the most memorable study I recall was that based on the nurtitional gain/loss whilst in hospital. An unusually large number of patients (quite often the elderly) were leaving hospital in a worse nutritional condition.
That was over 20 years ago! No change today (http://uk.news.yahoo.com/concerns-elderly-patients-care-210230776.html):
“Half of hospitals are failing to provide good nutrition to elderly patients while 40% do not offer dignified care, figures from unannounced inspections show.
Of 100 hospitals investigated by the Care Quality Commission (CQC), 49 were found to have minor, moderate or major concerns about nutritional standards for elderly people.
In two hospitals, Alexandra Hospital (part of the Worcester Acute Hospitals NHS Trust) and Sandwell General Hospital (part of Sandwell and West Birmingham Hospitals NHS Trust), inspectors had major concerns about the way people were fed and given drinks.
Another 15 hospitals resulted in moderate concerns and a further 32 were listed with minor concerns.
Overall, there were minor concerns about the dignity and respect provided to patients in 28 hospitals while a further 12 were told of moderate concerns in this area.
Just 45 hospitals out of 100 were listed with no concerns whatsoever about dignity, respect or nutritional standards for elderly people.
The figures for England, compiled from reports published over the summer, will be officially released next week by the CQC.
At Sandwell General Hospital, inspectors found serious issues with nutrition, especially for people who needed help with eating.
Staff did not check whether patients had eaten and did not keep track of their fluid intake.
One nurse said: “Sometimes I am the only staff member to feed on the ward. How can I feed all these people?” ”