Rob Bethune
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View article: Reducing Inappropriate Abdominal X-ray Requests in a Surgical Admissions Unit: A Quality Improvement Project
Reducing Inappropriate Abdominal X-ray Requests in a Surgical Admissions Unit: A Quality Improvement Project Open
The project has reduced the inappropriate use of AXRs following the implementation of three interventions.
View article: Repairing disrupted care processes as sources of stability, learning and change in a Finnish hospital: An activity‐theoretical study
Repairing disrupted care processes as sources of stability, learning and change in a Finnish hospital: An activity‐theoretical study Open
Introduction In high‐income countries, it is estimated that one in every 10 patients is harmed while receiving hospital care; 50% of these are preventable. The aim of this study was to deepen our understanding of disruptions of care proces…
View article: Creation of a Patient Information Video to Improve the Patient Experience of the Surgical Assessment Unit
Creation of a Patient Information Video to Improve the Patient Experience of the Surgical Assessment Unit Open
Interventions that improve communication with patients and adjust their expectations play an important role in improving patient satisfaction and their overall perception of care. This can be achieved with a simple patient information vide…
View article: Use of statistical process control in quality improvement projects in abdominal surgery: a PRISMA systematic review
Use of statistical process control in quality improvement projects in abdominal surgery: a PRISMA systematic review Open
Background The use of quality improvement methodology has increased in recent years due to a perceived benefit in effectively reducing morbidity, mortality and length of stay. Statistical process control (SPC) is an important tool to evalu…
View article: Single-shot liposomal bupivacaine in place of rectus sheath catheters to provide non-opiate analgesia after laparotomy: a quality improvement project to reduce the need for ongoing nursing input
Single-shot liposomal bupivacaine in place of rectus sheath catheters to provide non-opiate analgesia after laparotomy: a quality improvement project to reduce the need for ongoing nursing input Open
Opioid-sparing pain management is an integral component of enhanced recovery after colonic and rectal surgery. In our hospital, rectus sheath catheters (RSCs) are routinely placed during emergency laparotomy for colorectal procedures to al…
View article: How Safety Culture Surveys Influence the Quality and Safety of Healthcare Organisations
How Safety Culture Surveys Influence the Quality and Safety of Healthcare Organisations Open
Objectives Safety culture surveys have been widely used in healthcare for more than two decades predominantly as a tool for measuring the level of safety culture (as defined as the beliefs and attitudes that staff express about how their o…
View article: 542 Prolonged VTE Prophylaxis Post Abdominal Cancer Surgery: Is It Necessary?
542 Prolonged VTE Prophylaxis Post Abdominal Cancer Surgery: Is It Necessary? Open
Aim NICE guidance currently recommends extending venous thromboembolism (VTE) prophylaxis to 28 days for patients who have undergone major cancer surgery in the abdomen. Literature highlights controversy around the efficacy of prolonged tr…
View article: Tipping the balance: A systematic review and meta-ethnography to unfold the complexity of surgical antimicrobial prescribing behavior in hospital settings
Tipping the balance: A systematic review and meta-ethnography to unfold the complexity of surgical antimicrobial prescribing behavior in hospital settings Open
Surgical specialties account for a high proportion of antimicrobial use in hospitals, and misuse has been widely reported resulting in unnecessary patient harm and antimicrobial resistance. We aimed to synthesize qualitative studies on sur…
View article: Transanal total mesorectal excision for abdominoperineal resection is associated with poor oncological outcomes in rectal cancer patients: A word of caution from a multicentric Canadian cohort study
Transanal total mesorectal excision for abdominoperineal resection is associated with poor oncological outcomes in rectal cancer patients: A word of caution from a multicentric Canadian cohort study Open
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View article: Improving the uptake of cervical screening in pregnant and recently postnatal women: a quality improvement project
Improving the uptake of cervical screening in pregnant and recently postnatal women: a quality improvement project Open
Background In 2018, cervical screening uptake was at its lowest level since screening began, particularly in those aged 25–35, coinciding with the peak incidence of cervical cancer and average age at first delivery. Problem Retrospective b…
View article: Quality improvement project to improve blood test time to results on the acute surgical unit in North Devon District Hospital
Quality improvement project to improve blood test time to results on the acute surgical unit in North Devon District Hospital Open
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View article: Exploring two distinct gentamicin prescribing protocols in UK hospitals: a mixed-methods realist evaluation
Exploring two distinct gentamicin prescribing protocols in UK hospitals: a mixed-methods realist evaluation Open
Objectives Gentamicin is the aminoglycoside antibiotic of choice in the UK. It has a narrow therapeutic index: underdosing results in inefficacy while overdosing is characterised by nephrotoxicity and ototoxicity. To improve patient safety…
View article: EP.FRI.949 “When it works, it works brilliantly…. on the days that it doesn’t work, it tends to just all kind of crumble” – a qualitative study of patient and staff experience of ambulatory care on the surgical assessment unit
EP.FRI.949 “When it works, it works brilliantly…. on the days that it doesn’t work, it tends to just all kind of crumble” – a qualitative study of patient and staff experience of ambulatory care on the surgical assessment unit Open
Aims To explore patients’ experiences of being managed in an ambulatory manner and to explore medical staff’s experiences and attitudes of emergency ambulatory care. Methods Twenty patients and 12 members of staff (nurses, HCAs, junior doc…
View article: Categories of context in realist evaluation
Categories of context in realist evaluation Open
Realist evaluation has become widespread partly because of its sensitivity to the influence of contexts on policy implementation. In many such evaluations, the range of contexts considered relevant nevertheless remains disparate and under-…
View article: Comment on: Decrease in primary but not in secondary abdominal surgery for Crohn’s disease: nationwide cohort study, 1990--2014
Comment on: Decrease in primary but not in secondary abdominal surgery for Crohn’s disease: nationwide cohort study, 1990--2014 Open
Dear EditorWe read with interest the study by Kalman et al about trends in the incidence of surgery for Crohn’s disease (CD) in the Swedish population over a 24-year period1. The authors concluded that the 5-year cumulative incidence of pr…
View article: ‘I’ve got a little list’—the scourge of a surgical junior. A quality improvement project to change the surgical patient list in a district general hospital
‘I’ve got a little list’—the scourge of a surgical junior. A quality improvement project to change the surgical patient list in a district general hospital Open
Background Junior doctors at the Royal Devon and Exeter Hospital spend hours every day creating and updating patient lists for all surgical specialties on Microsoft Excel spreadsheets. This not only consumes time that should be spent on cl…
View article: Effect of preoperative oral antibiotics in combination with mechanical bowel preparation on inflammatory response and short-term outcomes following left-sided colonic and rectal resections
Effect of preoperative oral antibiotics in combination with mechanical bowel preparation on inflammatory response and short-term outcomes following left-sided colonic and rectal resections Open
This article is freely available via Open Access. Click on the Publisher URL to access it via the publisher's site.
View article: Comment on: Randomized controlled trial of plain English and visual abstracts for disseminating surgical research via social media
Comment on: Randomized controlled trial of plain English and visual abstracts for disseminating surgical research via social media Open
This article is freely available via Open Access. Click on the publisher URL to access it via the publisher's site.
View article: Bleeding issue: a quality improvement project on the phlebotomy service at the Royal Devon and Exeter Hospital
Bleeding issue: a quality improvement project on the phlebotomy service at the Royal Devon and Exeter Hospital Open
Blood tests form an important part of a patient’s journey through hospital; they play a vital role in decision-making. At our large distric general hospital (DGH), it was identified that proportion of blood tests requested to be taken by p…
View article: Problem with p values: why p values do not tell you if your treatment is likely to work
Problem with p values: why p values do not tell you if your treatment is likely to work Open
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View article: Pharmacist‐led, video‐stimulated feedback to reduce prescribing errors in doctors‐in‐training: A mixed methods evaluation
Pharmacist‐led, video‐stimulated feedback to reduce prescribing errors in doctors‐in‐training: A mixed methods evaluation Open
Aims To develop and evaluate a feasible, authentic pharmacist‐led prescribing feedback intervention for doctors‐in‐training, to reduce prescribing errors. Methods This was a mixed methods study. Sixteen postgraduate doctors‐in training, ro…
View article: Empowering junior doctors: a qualitative study of a QI programme in South West England
Empowering junior doctors: a qualitative study of a QI programme in South West England Open
Aim To explore how the South-West Foundation Doctor Quality Improvement programme affected foundation year 1 (F1) doctors’ attitudes and ability to implement change in healthcare. Methods Twenty-two qualitative interviews were carried out …
View article: E-referrals: improving the routine interspecialty inpatient referral system
E-referrals: improving the routine interspecialty inpatient referral system Open
Interspecialty referrals are an essential part of most inpatient stays. With over 130 referrals occurring per week at the Royal Devon and Exeter Hospital, the process must be efficient and safe. The current paper-based ’white card' system …
View article: Faecal calprotectin effectively excludes inflammatory bowel disease in 789 symptomatic young adults with/without alarm symptoms: a prospective UK primary care cohort study
Faecal calprotectin effectively excludes inflammatory bowel disease in 789 symptomatic young adults with/without alarm symptoms: a prospective UK primary care cohort study Open
Summary Background Primary care faecal calprotectin testing distinguishes inflammatory bowel disease ( IBD ) from functional gut disorder in young patients presenting with abdominal symptoms; however, previous evaluations have excluded pat…
View article: P413 Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for Crohn's disease
P413 Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for Crohn's disease Open
Background: Despite data reporting that exclusive enteral nutrition (EEN) improves nutritional status and inflammation in patients with Crohn's disease, few studies have reported its systematic use in the perioperative setting. EEN involve…
View article: Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn's disease
Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn's disease Open
Summary Background Few studies have reported the systematic use of exclusive enteral nutrition in the perioperative setting. Aim To test the hypothesis that exclusive enteral nutrition provides a safe and effective bridge to surgery and re…
View article: What happens when we do not operate? Survival following conservative bowel cancer management
What happens when we do not operate? Survival following conservative bowel cancer management Open
Introduction While surgery is the cornerstone of bowel cancer treatment, it comes with significant risks. Among patients aged over 80 years, 30-day mortality is 13%–15%, and additionally 12% will not return home and go on to live in suppor…