- Article: Moore C, Childs L (2011) A tool to identify falling care quality. Nursing Times; 107: 49/50, 14-16.
- Author: Carolyn Moore is an independent consultant and former director of nursing, who worked on the QuESTT tool, coordinating its development on behalf of NHS South West and directors of nursing across the region; Liz Childs is director of nursing and governance and deputy chief executive, South Devon Healthcare Foundation Trust; she was project director.
After the publication of the Mid Staffordshire Foundation Trust Inquiry (2010), the authors of this article set out to ensure that such failures at ward level could not happen in hospitals in the South West. They wanted to find a simple, robust and accurate way of determining whether falling standards at individual ward level could be predicted and acted on before they happened.
Key points
- It is crucial to systematically question the quality and standards of care
- The best hospitals monitor standards on a ward by ward basis
- The QuESTT tool is effective in identifying the potential for falling standards in care given by a clinical or ward team
- Ward leaders know how they are doing and can provide robust and reliable information from ward to board
- Peer review is a critical part of the validation process
Let’s discuss
- How do you measure standards of care in your ward or department?
- How are the results of these measures fed back to staff?
- How are they used to review and change practice?
- Do staff have ownership of this information? If not how could this be improved?
- How could the Quality, Effectiveness and Safety Trigger Tool (QuESTT) described in this article be used in your clinical area?

From Putting it into practice
How do we put research into practice in the surgery or the hospital ward? Each week we’ll pick out a practice article and pose some topics for debate and you can pose your own questions too …Follow the weekly debates on twitter with #NTjournalclub


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