Research Projects at the Centre for Implementation Science
Our current research projects include:
Training urologists to improve patient safety
A new course is being developed by researchers in the Centre for Implementation Science (CIS) in collaboration with urologists from Barts Health NHS Foundation Trust tailored for trainee urologists. The course will equip them with the skills to analyse patient safety incidents and concerns around care quality, then to develop collaborative quality improvement work. Urologists who complete this training will then have the skills to share learning and best practice with their peers and urology departments in other NHS trusts.
Researchers from the CIS and Barts Health, jointly with medical education leaders from Kent, Surrey, Sussex and Northwest England and the charitable Urology Foundation, will set up the new programme and evaluate its impact using a range of educational, patient safety and quality improvement validated outcome measures. They will work closely with the CLAHRC South London’s Patient and Public Involvement team and also a newly formed project steering group to ensure that patients, trainees, urologists and education and improvement experts are involved in the planning and delivery of the training. This work is being funded by the Urology Foundation and the training programme is expected to be developed and evaluated by December 2018.
Read more about the patient safety for urology project
Developing and understanding the impact of diverse patient and public involvement in patient safety improvement activities
This research project aims to find out whether involving patients and the public in patient safety can improve outcomes? Serious clinical and service failings in the UK and internationally have increased the calls for patients and the public to be engaged in healthcare to improve patient safety. Stronger patient and public involvement (PPI) in the organisation and delivery of healthcare is now central to health reform in the UK and has been reflected in evidence which shows that when patients and the public are involved they can make a difference to healthcare delivery and planning. However, there is still uncertainty about what involvement is, how it should be done and how to support individuals to genuinely influence decision-making.
This study will help patients to become involved in improving patient safety by working with a diverse range of service users and then researchers and service users will evaluate the impact of their involvement in improving safety within NHS trusts. The project will include a literature review and participatory action research (where patients and researchers reflect and jointly agree actions in conducting research). Qualitative methods such as observation and interviews will be used – as well as strategies for feedback of findings, reflection on their meaning, and implications for subsequent stages of research.
Read more about the patient safety and involvement project
Using smartphone technology to enhance patient safety in surgical care
Research suggests that around one in ten patients entering NHS hospitals will experience an unintended error (termed an ‘adverse event’) in their care. These events can result in harm and have catastrophic implications, not only for the patient and their family, but for the healthcare staff involved and for the NHS organisation as a whole (at both areputational and financial level).
Adverse event rates are higher for surgery than other healthcare specialties. This may be a reflection of the risk profile of the patients receiving surgery; the complexity of the procedure and/or the operating theatre environemnt; or simply higher rates of reporting errors by surgical staff. Either way, improving surgical safety is a priority for NHS England.
This research project aims to explore how we can effectively translate what the evidence tells us about the causes of error in surgery into a format that patients can use to improve their safety. Specifically, the project looks at the use of smartphone apps to address this problem. An app, called MySurgery, has been designed to help patients and their carers understand the risks associated with having surgery and inform them of the specific actions they can take to improve their safety and recovery.
Read more about the study
Evaluating the HARPdoc trial – aimed at helping people with type 1 diabetes avoid hypoglycaemia
Researchers in the Centre of Implementation Science are working closely with researchers in CLAHRC South London’s diabetes theme to help them evaluate two new educational programmes aimed at helping people with type 1 diabetes to avoid hypoglycaemia.
This work is part of the ‘HARPdoc’ randomised controlled trial, which was designed to address the motivations and barriers to hypoglycaemia avoidance. It uses educational and psychological techniques, such as motivational interviewing and cognitive behaviour theory delivered by specially trained diabetes educators to small groups of patients. The trial will be comparing two interventions designed to help change patients’ thoughts and behaviours around hypoglycaemia to improve detection, treatment and prevention.
Postdoctoral research associate Dr Tayana Soukup is leading a process evaluation of the HARPdoc trial, in collaboration with other implementation scientists in the Centre. ‘While the trial is concerned with understanding which intervention is more effective, the process evaluation is focused on understanding the way in which the programmes are implemented and assessing their impact at study sites. Ultimately the aim is to inform the scale-up of the effective programme after the trial is complete,’ says Dr Soukup.
Read more about the evaluation of the HARPdoc trial.
Working with BME faith communities to improve mental health care
Researchers at King’s College London are working on a project with clinicians at South London and Maudsley NHS Foundation Trust to address the stark healthcare inequalities for the Black community in relation to mental health care in Southwark and Lambeth. The incidence of psychosis among black and minority ethnic (BME) groups is up to 14 times higher than for white people, while the prevalence rate is 2.7 times higher in inner city London boroughs (Quassem et al, 2015). In their pathways to care, people in BME communities with a first episode of psychosis are 2.1 times more likely to access care via the police than are their white counterparts (Anderson et al, 2014)(1). Service satisfaction locally is significantly lower among BME groups (NIMHE, 2003; Parkman et al 1999).
The scale of unmet need among people with psychosis, and the common use of faith communities as the first point of contact, indicates a clear requirement for better communication and joint working between NHS services and faith communities. This project aims to create a mental health awareness training package for local Black majority or led churches which is accredited by King’s College London. The research team also hope to train mental health staff at South London and Maudsley to become more aware of different faith communities in their local area and the importance of working alongside faith communities to help people on their journey to recovery.
Read more about the study
Social and psychological determinants of vaccination uptake – linking behavioural data to policy analysis and implementation
Poor uptake of vaccination programmes remains a global health challenge. Every year 60 million frail adults in the EU are not protected against influenza by vaccination. Flu epidemics can cause between 500,000-1,000,000 deaths globally. An estimated 13,000 annual non-maternal adults deaths are due to tetanus infection, although a tetanus-containing booster is recommended every 10 years. The World Health Organisation recently concluded that high-quality behavioural research linked to policy-making and broad partnerships are essential to tackle this challenge. This project offers a novel partnership between academia, the vaccine manufacturing industry and policymakers.
Emilia project: assessing the WHO Mental Global Action Programme intervention guide for use on digital devices
The aim of the Emilia project is to assess if it is possible to produce an e-version of the World Health Organization (WHO) Mental Health Global Action Programme Intervention Guide (e-mhGAP IG) that is easily usable on smartphones and tablet devices by primary care staff in Nepal and Nigeria. The project will assess if this electronic form of guidance is suitable for use in low and middle income countries (LMICs), where over 85% of the world’s population live. The development of the e-mhGAP IG will offer significant improvements over the printed paper version by surpassing limitations such as slow and irregular updating, and will create new opportunities for remote supervision.
Could involving patients and the public in patient safety improve outcomes?
Serious clinical and service failings in the UK and internationally have increased the calls for patients and the public to be engaged in healthcare to improve patient safety. Stronger patient and public involvement (PPI) in the organisation and delivery of healthcare is now central to health reform in the UK and has been reflected in evidence which shows that when patients and the public are involved they can make a difference to healthcare delivery and planning. However, there is still uncertainty about what involvement is, how it should be done and how to support individuals to genuinely influence decision-making.
A research project adopted by CLAHRC South London, ‘Developing and understanding the impact of diverse patient and public involvement in patient safety improvement activities’, will help patients to become involved in improving patient safety by working with a diverse range of service users and then evaluating the impact of their involvement in improving safety within NHS trusts.