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Background: Substantial resources are invested by Health Departments worldwide in introducing National Clinical Audits (NCAs). Yet, there is variable evidence on the NCAs' effectiveness and little is known on factors underlying the successful use of NCAs to improve local practice. This study will focus on a single NCA (the National Audit of Inpatient Falls -NAIF 2017) to explore: (i) participants' perspectives on the NCA reports, local feedback characteristics and actions undertaken following the feedback underpinning the effective use of the NCA feedback to improve local practice; (ii) reported changes in local practice following the NCA feedback in England and Wales. Methods: Front-line staff perspectives were gathered through interviews. An inductive qualitative approach was used. Eighteen participants were purposefully sampled from 7 of the 85 participating hospitals in England and Wales. Analysis was guided by constant comparative techniques. Results: Regarding the NAIF annual report, interviewees valued performance benchmarking with other hospitals, the use of visual representations and the inclusion of case studies and recommendations. Participants stated that feedback should target front-line healthcare professionals, be straightforward and focused, and be delivered through an encouraging and honest discussion. Interviewees highlighted the value of using other relevant data sources alongside NAIF feedback and the importance of continuous data monitoring. Participants reported that engagement of front-line staff in the NAIF and following improvement activities was critical. Leadership, ownership, management support and communication at different organisational levels were perceived as enablers, while staffing level and turnover, and poor quality improvement (QI) skills, were perceived as barriers to improvement. Reported changes in practice included increased awareness and attention to patient safety issues and greater involvement of patients and staff in falls prevention activities. Conclusions: There is scope to improve the use of NCAs by front-line staff. NCAs should not be seen as isolated interventions but should be fully embedded and integrated into the QI strategic and operational plans of NHS trusts. The use of NCAs could be optimised, but knowledge of them is poor and distributed unevenly across different disciplines. More research is needed to provide guidance on key elements to consider throughout the whole improvement process at different organisational levels. [ABSTRACT FROM AUTHOR]

Discusses the relative effectiveness of different forms of communicating change to a dispersed and part-time workforce in home care service in London, England. Changes made in the public sector and home care services; Communication methods and forms; Demonstration that home care workers seek to be informed about key issues affecting the service.

The article focuses on Royal College of Nursing (RCN) general secretary Peter Carter's view that nurse leaders could adapt aspects of goose-style teamwork in London, England. Carter perceives that nurse innovators should look to the animal world for inspiration in leading their teams. He explains that geese rotate the leader in the flying group to lessen tiredness. He argues that communication is significant in ensuring effective teamwork and leadership.

Information about various topics discussed during the meeting of the Council of the Royal College of Veterinary Surgeons (RCVS) on June 7, 2007 at the Belgravia House in Horseferry Road in London, England is presented. It highlights the discussion of the forthcoming medicines legislation that will require the registration of practice premises. It also features the call for better communication between practices and clients to decrease complaints.