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Background Digital health technologies (DHTs), such as electronic health records and prescribing systems, are transforming health care delivery around the world. The quality of information in DHTs is key to the quality and safety of care. We developed a novel clinical information quality (CLIQ) framework to assess the quality of clinical information in DHTs. Objective This study explored clinicians’ perspectives on the relevance, definition, and assessment of information quality dimensions in the CLIQ framework. Methods We used a systematic and iterative eDelphi approach to engage clinicians who had information governance roles or personal interest in information governance; the clinicians were recruited through purposive and snowball sampling techniques. Data were collected using semistructured online questionnaires until consensus was reached on the information quality dimensions in the CLIQ framework. Responses on the relevance of the dimensions were summarized to inform decisions on retention of the dimensions according to prespecified rules. Thematic analysis of the free-text responses was used to revise definitions and the assessment of dimensions. Results Thirty-five clinicians from 10 countries participated in the study, which was concluded after the second round. Consensus was reached on all dimensions and categories in the CLIQ framework: informativeness (accuracy, completeness, interpretability, plausibility, provenance, and relevance), availability (accessibility, portability, security, and timeliness), and usability (conformance, consistency, and maintainability). A new dimension, searchability, was introduced in the availability category to account for the ease of finding needed information in the DHTs. Certain dimensions were renamed, and some definitions were rephrased to improve clarity. Conclusions The CLIQ framework reached a high expert consensus and clarity of language relating to the information quality dimensions. The framework can be used by health care managers and institutions as a pragmatic tool for identifying and forestalling information quality problems that could compromise patient safety and quality of care. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2021-057430

In the era of COVID-19, the introduction of novel teaching methods to support socially distanced learning will provide a new key element in developing medical education. Virtual reality (VR) is an innovative teaching method which can be used in a variety of clinical settings to enhance learning. The objective of this teaching study was to compare whether teaching using VR was more effective than traditional teaching methods in undergraduate medical students. The second objective was to assess whether VR was an appropriate teaching method for elderly care topics. The experimental teaching study was conducted between September 2019 and …

Background Availability of anticipatory medications for common end of life (EOL) symptoms is a quality indicator measured in recent hospital care of the dying audits. Local results from the 2013 audit demonstrated poor uptake of anticipatory prescribing. In 2014, the Trust moved to electronic patient records and prescribing across the acute trust. Working in partnership with the informatics leads for pharmacy and medicine,the palliative care team utilised the capabilities of 9Cerner9s9 electronic patient prescribing system to develop an 9order-set9 of 5 medications, commonly needed at the end of life. The system went live in May 2015 and an early induction session to the new junior doctors was delivered in August 2015. Aims To evaluate prescribing of anticipatory 9as required9 EOL medications, following the introduction of the palliative care 9order-set9. Methods A retrospective review of anticipatory, 9as required9, prescribing for a 1 month period was undertaken 12 months after introducing the prescribing 9order-set9. Criteria applied as for the 2013 National Hospital audit. Results were compared with local results from 2013. Baseline information from 2013 showed that the Trust under-performed for prescribing for all symptoms: (Agitation- 23%, Breathlessness- 20%, Nausea- 14%, Pain- 27%, and Secretions- 7%). Twelve months after implementation of the 9order- set9 the results were: (Agitation- 68%, Breathlessness- 74%, Nausea- 68%, Pain- 74%, and Secretions- 65%). These results are all above the national average from the 2016 RCP: National End of life care audit. Conclusions Introduction of an electronic palliative care prescribing 9order-set9 for anticipatory EOL medications, has demonstrated considerable improvement in the uptake of anticipatory prescribing for dying patients. This in conjunction with an early palliative care induction education session for junior doctors has demonstrated significant improvements in the quality of prescribing in the end of life phase of life for patients in an acute hospital.

An integrated care organisation in south London reviewed unplanned admissions. Many admissions in individuals over the age of 65 years had short length of stays (under 2 days), suggesting that they possibly could have been managed out of the hospital with the appropriate support. Following consultation with existing teams and service user feedback, the acute trust, CCG and local authority collaborated in developing a service model that would ensure that patients’ needs were met within the community in …

When offering treatment to a patient with capacity they should be informed of the risks and benefits of therapy and consent should be obtained. For patients without capacity, treatment is given in their ‘best interests’. Achieving and assessing capacity to consent for treatment in the presence of acute illness can be difficult and especially so in patients suffering with acute stroke. This article presents patients’ and doctors’ perspectives on assessing capacity to consent to thrombolytic therapy for stroke.