In 2020 the NHS in England set a target of reaching net zero carbon emissions by 2040. Progress has already been made towards this goal, with substantial reductions in the use of environmentally harmful anaesthetic gases, such as desflurane, in recent years. Where an effective replacement already exists, changing practice to use low carbon alternatives is relatively easy to achieve, but much greater challenges lie ahead. The Getting It Right First Time (GIRFT) programme is a clinically-led, data-driven clinical improvement initiative with a focus on reducing unwarranted variation in clinical practice and patient outcomes. Reducing unwarranted variation can improve patient care and service efficiency, and can also support the drive to net zero. In this article we set out what the GIRFT programme is doing to support sustainable healthcare in England, why it is uniquely positioned to support this goal and what the future challenges, barriers, enablers and opportunities are likely to be in the drive to net zero.
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http://dx.doi.org/10.1111/anae.16170 | DOI Listing |
BMC Health Serv Res
January 2025
The University of Sydney, Faculty of Medicine and Health, School of Rural Health, Orange, NSW, 2800, Australia.
Background: Low-value care refers to the provision of health services that confer little or no benefit to patients, or have the potential to incur unwarranted harms. A breadth of literature exists investigating geographical variations in rates of potential low-value interventions for musculoskeletal pain. This scoping review aimed to examine the provision of low-value care for osteoarthritis and lower back pain by degree of rurality (e.
View Article and Find Full Text PDFBreast J
January 2025
Graduate School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
Introduction: Breast cancer management is complex, requiring personalised care from multidisciplinary teams. Research shows that there is unwarranted clinical variation in mastectomy rates between rural and metropolitan patients; that is, variation in treatment which cannot be explained by disease progression or medical necessity. This study aims to determine the clinical and nonclinical factors contributing to any unwarranted variation in breast cancer management in rural patients and to evaluate how these factors and variations relate to patient outcomes.
View Article and Find Full Text PDFBMC Med Inform Decis Mak
December 2024
Information, Decision Enhancement and Analytics Center of Innovation, Salt Lake City Veterans Affairs, Salt Lake City, UT, USA.
Background: This study sought to understand the process of clinical decision-making for suspected pneumonia by emergency departments (ED) providers in Veterans Affairs (VA) Medical Centers. The long-term goal of this work is to create clinical decision support tools to reduce unwarranted variation in diagnosis and treatment of suspected pneumonia.
Methods: Semi-structured qualitative interviews were conducted with 16 ED clinicians from 9 VA facilities demonstrating variation in antibiotic and hospitalization decisions.
Res Health Serv Reg
December 2024
Australian Commission on Safety and Quality in Health Care, Sydney, NSW, Australia.
Mapping, identifying and reducing unwarranted healthcare variation is integral to improving the appropriateness of care - minimising wasteful or unnecessary care and redirecting care to those who could benefit most (J Eval Clin Pract 26: 687-696, 2020). The Australian Atlas of Healthcare Variation series has examined variation in healthcare use since 2015. The findings reported in the Atlas series have led to important system changes.
View Article and Find Full Text PDFPhysiotherapy
October 2024
Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom.
Background: There is increasing burden on musculoskeletal (MSK) First Contact Practitioners (FCPs) working in primary care. One possible solution is to use digital technologies such as clinical decision support systems (CDSS). The primary objective of this study was to understand the potential for MSK FCPs to use a CDSS to support their practice in the United Kingdom.
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