Education means learning what works and what doesn’t
The theme of this edition of the Future Healthcare Journal is education. Education which embraces training, learning, leadership and giving a voice to all. It’s hard to think of a set of subjects more relevant to developing an effective workforce for the NHS over the next 10 years and beyond. Drs Jo Szram and Emma Vaux, as associate editors, have done a fantastic job in drawing together a spectrum of articles across these areas and their own editorial puts these papers in context.
In addition to the themed papers we focus on a wide variety of topics. Closely linked to the education theme is a paper by Dr Shuaib Quraishi and colleagues on the new General Medical Council curriculum for internal medicine and the application of ‘capabilities in practice’ rather than the previous use of ‘competencies’.1 The article describes the evolution of the new curriculum and the testing that was integrated into the development process. As this work progresses, trainees and, in particular, all trainers will need to familiarise themselves with developments including assessment methods.
Two papers look at potential service improvements and show how they can be subjected to robust evaluation.
Prof Sarah Lewis et al investigate the impact of adding cost information to pathology results and this led to a small but important (3%) reduction in demand for full blood counts.2 Prof Robert Robinson and his team from Illinois test a simple tool to predict readmissions based on the number of medications a patient is receiving.3 Such a tool would be invaluable but unfortunately the results were not as good as hoped. Other more complex tools exist and we need to continue to strive for ways of reducing readmission.
These two papers emphasise that we have to devote our resources and energies to what works, which also means finding out what doesn’t, and I congratulate both groups for their work.
Delirium is perhaps an unglamorous clinical problem, but it is devastating for patients and their relatives, prolongs length of stay and worsens clinical outcomes. Dr Letitia Dormandy and colleagues undertook a successful quality improvement project to improve use of the 4AT delirium screening tool and empower staff to talk knowledgably with families.4 Their work would certainly seem transferrable to other hospitals.
I would like to return to the subject of ‘digital health’ which has been a theme through previous issues. I recently met with Dr Wajid Hussain, the Royal College of Physicians' (RCP's) new clinical director for digital health whose remit includes keeping the RCP and its members networked with developments in the field. The Future Healthcare Journal is keen to publish full and shorter papers reporting developments and implementations of digital health, as well as authoritative opinion articles in this area. In this issue, Dr Misha Kabir asks the question, ‘Is artificial intelligence (AI) an opportunity or a threat?’5 Her excellent prize-winning article summarises our hopes and fears for AI. As an example The Lancet recently published a paper on using neural networks / machine learning to analyse electrocardiograms.6 If further work confirms the efficacy of this approach it would have significant implications for stroke care and, more importantly, the potential to liberate cardiac physiologists who are in desperately short supply for other tasks. I believe The NHS long term plan will only be viable if we liberate our current workforce from some of their current workload.7
One debate about future healthcare that does seem settled is the future of the medical conference. I have just returned from the European Society of Cardiology congress. Over 34,000 people attended. The mixture of breaking trials, and a huge variety of learning experiences, combined with an unrivalled networking opportunity seems to be more attractive than ever to healthcare professionals. Personal contact, whether in a lecture hall, workshop or around the coffee table remains important. Indeed for many of us we seem to find it easier to talk to our immediate colleagues at a conference than in our usual workplace. I’m sure our own conference, Medicine 2020, will similarly provide both learning and networking opportunities.8 Memo to our managers and leaders – if you want to build teams to effect change, they need time and opportunities to talk to each other away from the crisis management that dominates daily life. Providing opportunities for clinicians to meet seems one area more successfully achieved in smaller hospitals than larger ones, and we will be looking at a number of issues around the future of small and rural hospitals in our first edition of 2020.
Meanwhile I do hope you learn from, are stimulated by and, most importantly, enjoy this edition of the Future Healthcare Journal.
Please note the correction to my June editorial. I omitted to acknowledge the vital contribution of Dr Na’eem Ahmed to the commissioning and associate editing of the June issue, for which I apologise on behalf of all at the journal.
- © Royal College of Physicians 2019. All rights reserved.
References
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- Quraishi S
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- Lewis S
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- Robinson R
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- Dormandy L
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- Kabir M
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- Hendriks JML
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- NHS
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