Scaling up Quality Improvement for Surgical Teams (QIST)-avoiding surgical site infection and anaemia at the time of surgery: a cluster randomised controlled trial of the effectiveness of quality improvement collaboratives to introduce change in the NHS.

Background: The aim of this trial was to assess the effectiveness of quality improvement collaboratives to implement large-scale change in the National Health Service (NHS) in the UK, specifically for improving outcomes in patients undergoing primary, elective total hip or knee replacement.

Methods: We undertook a two-arm, cluster randomised controlled trial comparing the roll-out of two preoperative pathways: methicillin-sensitive Staphylococcus aureus (MSSA) decolonisation (infection arm) and anaemia screening and treatment (anaemia arm). NHS Trusts are public sector organisations that provide healthcare within a geographical area.

Scaling up Quality Improvement for Surgical Teams (QIST) - avoiding surgical site infection and anaemia at the time of surgery: protocol for a cluster randomised controlled trial.

Background: Measures shown to improve outcomes for patients often fail to be adopted into routine practice in the NHS. The Institute for Health Improvement Breakthrough Series Collaborative (BSC) model is designed to support implementation at scale. This trial aims to assess the effectiveness and cost-effectiveness of quality improvement collaboratives (QICs) based on the BSC method for introducing service improvements at scale in the NHS.

Risk, governance and the experience of care.

Drawing on perspectives from the governmentality literature and the sociology of risk, this article explores the strategies, tools and mechanisms for managing risk in acute hospital trusts in the United Kingdom. The article uses qualitative material from an ethnographic study of four acute hospital trusts undertaken between 2008 and 2010 focusing on the provision of dignified care for older people. Extracts from ethnographic material show how the organisational mechanisms that seek to manage risk shape the ways in which staff interact with and care for patients.

From Right place--Wrong person, to Right place--Right person: dignified care for older people.

Objectives: To examine: older people's and their relatives' views of dignified care; health care practitioners' behaviours and practices in relation to dignified care; the occupational, organizational and cultural factors that impact on care; and develop evidence-based recommendations for dignified care.

Methods: An ethnography of four acute trusts in England and Wales involving semi-structured interviews with recently discharged older people (n = 40), their relatives (n = 25), frontline staff (n = 79) and Trust managers (n = 32), complemented by 617 hours of non-participant observation in 16 wards in NHS trusts.

Results: 'Right Place - Wrong Person' refers to the staffs' belief that acute wards are not the 'right place' for older people.

The value of nurses' codes: European nurses' views.

Nurses are responsible for the well-being and quality of life of many people, and therefore must meet high standards of technical and ethical competence. The most common form of ethical guidance is a code of ethics/professional practice; however, little research on how codes are viewed or used in practice has been undertaken. This study, carried out in six European countries, explored nurses' opinions of the content and function of codes and their use in nursing practice.

Views on dignity in providing health care for older people.

Aim: The aim of this study was to explore the salience and meaning of dignity and dignified care for care providers and the implications for the proviosion of care. The project forms part of an international study being undertaken in different European countries comparing health and social care workers' views on dignity.

Method: Focus groups were chosen as the primary method of data collection.

"Tu" or "Vous?" A European qualitative study of dignity and communication with older people in health and social care settings.

Objective: To examine the experiences of communication between older people and health and social care providers in six European countries.

Methods: Focus groups were carried out with groups of older people (91 focus groups, 391 participants), and health and social care professionals (85 focus groups, 424 participants), in order to gain insights into concepts of good communications. Data collection and analysis continued concurrently according to the method of constant comparison.

Dignity in older age: what do older people in the United Kingdom think?

Background: Dignity is a complex concept and there is little empirical research to show how older people view dignity. This study, using qualitative methods, explored the concept of dignity from the older person's perspective.

Methods: 15 focus groups and two individual interviews were conducted in 12 different settings, with a total of 72 participants.

Living well through chronic illness: the relevance of virtue theory to patients with chronic osteoarthritis.

Objective: Virtues and vices possessed by patients may affect their quality of life and how well they cope with disease. The objective of this study is to assess the relevance of the concept of virtue and vice to patients with chronic arthritis.

Methods: Aristotle's theory of virtue and vice was used to construct a guide for in-depth interviews, carried out with 5 patients with chronic osteoarthritis.