CaHRU gives QI workshop at East Midlands Quality Improvement Network meeting

EFPC-logo-4-k new versionEast Midlands Academic Health Science Network hosted the latest East Midlands Quality Improvement Network meeting at Trent Vineyard, Nottingham on 17 May 2017 to over 150 delegates. The network has grown from the East Midlands Quality Improvement, Research and Education (ENQuIRE) Network set up as part of the HEI Challenge project between 2015 and 2016, led by the University of Lincoln. There were over 150 attendees at the event chaired by Dr Cheryl Crocker.

 

qin2017There were key notes from Richard Taunt, founder of Kaleidoscope Health & Care on ‘Bridging the disconnect between research and practice’ and Paul O’Neill, director of the East Midlands Leadership Academy on ‘Leading for quality improvement’. This was followed by an inspirational talk from Emma Wiggs, four time gold medallist Paralympian on ‘Improving mindset – improving quality’.

Professor Siriwardena, director of CaHRU then co-led, with Prof Bryn Baxendale of Nottingham University Hospitals NHS Trust, a workshop session on Measurement of Quality Improvement. There were also workshops on human factors, safety and evaluation of QI projects.

QIlogoThe afternoon was devoted to a series of talks on Q, clinical audit and patient involvement in safety. The day ended with a discussion on next steps for the network.

CaHRU/LIH seminar: Causal models and Directed Acyclic Graphs – Professor Graham Law

Graham LawProfessor Graham Law, who recently joined the university and CaHRU as Professor in Medical Statitics, delivered the latest of CaHRU/LIH’s Implementation Science and Research Methods seminar series – on Causal Models and the use of Directed Acyclic Graphs. Professor Law set out the epidemiological context for the seminar. Epidemiology is the study of disease. The scientific methods used within epidemiology aim to discover the determinants of disease. The state of having the disease is the outcome. Causal models seek to examine the factors that contribute to this outcome. Causation is not usually dealt with by statistics. Instead, statistics concerns itself more with associations and relationships between variables.

dagA Directed Acyclic Graph (DAG) comprises variables (nodes) and arrows between nodes (directed edges) such that the graph is acyclic, i.e., it not being possible to start at any node, follow the directed edges in the arrowhead direction, and end up back at the same node. In seeking to represent causation, DAGs typically display a series of factors, mediators and outcomes. Having explained this, Graham split the audience into two groups and challenged them to create their own DAGs to display all the possible factors involved in whether sunlight causes lymphoma. The interactive nature of the seminar engaged the audience. The fun nature of the concluding task made a potentially complicated subject easier for the audience to understand and apply.

By Viet-Hai Phung

CaHRU team attends 999 EMS Research Forum conference in Bristol

EMS999_spaceSix members of the CaHRU team recently attended the 999 EMS Research Forum conference on Wednesday 29th March 2017 at the Bristol Science Centre. The team members attending were Professor Niro Siriwardena, Dr Zahid Asghar, Dr Stephanie Armstrong, Mr Viet-Hai Phung, Laura Simpson and Joseph Akanuwe.

Chiral_logoThe 999 EMS Research Forum is an international partnership bringing together academics and health-care providers with interest in emergency care research. The forum aims to encourage, promote and disseminate research and evidence-based policy and practice in prehospital healthcare. The conference, which was hosted by the South Western Ambulance Service NHS Foundation Trust, included keynote presentations, peer-reviewed presentations, moderated poster presentation sessions and the presentation of prizes and closing remarks.

999EMS_BengerThe conference theme was, “The way forward for Emergency care Research: Inclusion; Collaboration; Sustainability”. The morning was chaired by Professor Jonathan Benger. Keynote speakers included: Professor Ann John of Swansea University Medical School who discussed the emergency care of people who self-harm; Dr Sarah Voss of the University of the West of England, who discussed the social and cultural influences on the design and delivery of collaborative research in emergency care. Other keynote speakers were: Janette Turner of the University of Sheffield, who spoke on the “Ambulance Response Programme”; and Dr Andrew Appelboam with Alex Sharp who presented the, “REVERT to the future: Dissemination and Implementation” study. Last but not the least was Professor Steve Goodacre, Chair of the NIHR Health Technology Assessment Clinical Evaluation and Trials Board, who talked about the way forward with Health Technology Assessment and the HTA programme.

999EMS_CosterThere followed five interesting oral presentations of the highest rated peer-reviewed abstracts submitted. First, Jonathan Chippendale from the East Midlands Ambulance Service NHS Trust, presented a pilot study to assess the feasibility of paramedics delivering antibiotics to ‘red flag’ sepsis patients. Next, Joanne Coster from the University of Sheffield talked about the multi-method consensus development of new ambulance service quality and performance measures. Dr Mathew Booker of the University of Bristol drew on early findings from their prehospital ethnographic study and discussed why primary care problems end up receiving ambulance treatment.

WP_20170328_17_49_05_RichThe moderated poster sessions involved a five minute presentation with two minutes for questions and answers per poster. Members of the CaHRU team presented high quality posters. Professor Niro Siriwardena led the poster presentation on: a reliability and validity of an Ambulance Patient Reported Experience Measure (A-PREM) pilot study. Dr Zahid Asghar presented the poster on a cross section study which explores factors increasing paramedics’ likelihood of administering analgesia in prehospital pain (EXPLAIN). Dr Stephanie Armstrong presented the poster on: consent as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review.

The conference proved interesting and worthwhile with opportunities to learn and meet potential research collaborators. The presentation of prizes to deserving winners and closing remarks brought the conference to a close.

By Joseph Akanuwe

East Midlands Research Engaging Patients and the Public Event – CaHRU Masterclass on PPI in research in underserved communities

Staff from CaHRU contributed to the recent East Midlands Research Engaging Patients and the Public Event held on Thursday 23rd March 2017 at Leicester Diabetes Centre by giving a masterclass on patient and public involvement (PPI) in research. The event was designed for researchers and lay people interested in PPI supporting research addressing the needs of underserved and seldom heard communities. The event began with a keynote session Viet-Hai at REPP March 2017exploring the regional and local picture of PPI. This was followed by a number of masterclasses.

The masterclass run by staff from CaHRU was given by Dr Jo Middlemass (Research Fellow/Nurse) together with Ms Despina Laparidou (Research Assistant), Mr Viet-Hai Phung (Research Assistant) and Mrs Pauline Mountain, Independent Patient and Public Representative from the Healthier Ageing Patient and Public Involvement (HAPPI) group. The masterclass focussed on PPI with older people and ethnic minority groups. Pauline talked about her involvement in the HAPPI group and connectivity to other carers and related organisations. Viet-Hai spoke about his doctoral study on people from ethnic minority groups from Eastern European countries. Despina discussed reaching carers of people with dementia.

The session was well received by participants and contributed to the overall success of the event. The HAPPI group continue to support studies in primary and prehospital care involving CaHRU and collaborating academic institutions and NHS organisations.

By Jo Middlemass

University of Lincoln hosts Society of Academic Primary Care Trent Regional Conference

The Community and Health Research Unit and University of Lincoln hosted this year’s Trent Regional SAPC Spring sapc_lincoln1Conference at the Hilton Doubletree Hotel on Brayford Wharf in Lincoln. The conference included delegates from the Universities of Lincoln, Nottingham, Leicester and Sheffield and all over our region presenting and learning about the latest in primary care research and educational through orals, posters and workshops.

The conference keynote speakers were Chris Burton, Professor of Primary Care and Head of the Academic Unit of Primary Medical Care at the University of Sheffield, Aneez Esmail, Professor of General Practice at the University of Manchester and Navjoyt Ladher, clinical editor at The BMJ. The conference was chaired by Professor Niro Siriwardena, Professor of Primary and Prehospital Healthcare and opened by Professor Sara Owen, Pro Vice Chancellor and Head of the College of Social Science at the University of Lincoln. Prof Burton, new in post at Sheffield, gave the first keynote in place of Prof Nigel Mathers who was recovering from illness. Everyone wished Prof Mathers well for his convalescence and return to health.

Prof Owen’s opening talk focussed on the rapid development and expansion in science and health research and teaching at Lincoln. Chris Burton’s opening keynote focussed on ‘Complexity’, commonly used, misused and sapc_lincoln2misunderstood in healthcare and research. He described the mathematics of complexity as he had applied it in his research to issues such as frequent health service use and how these were described by ‘heavy-tailed’ or log-log distributions.

There followed a series of excellent morning oral presentations, workshops and posters. Before lunch, Prof Esmail gave another outstanding keynote, ‘The problem with patient safety – challenging orthodoxies’ He certainly did challenge the conventional approach to patient safety and described how conventional attempts to reduce harm, in particularly using a target-driven approach, could lead to poorer outcomes and how it was necessary, even important, to accept some risk for better outcomes.

After lunch and viewing of the excellent posters on display, we were treated to further oral presentations and another educational workshop. The meeting ended with our final keynote from Dr Navjoyt Ladher, clinical editor at the British sapc_lincoln3Medical Journal, who spoke eloquently about ‘Goldilocks medicine’ and the art of getting medicine right, particularly focussing on the harms of medicalisation and overtreatment. She went onto to talk about the editorial process at the BMJ, while encouraging primary care researchers to submit their studies to the journal.

The day ended with prizes awarded to the best poster, ‘Predictors of postpartum return to smoking: a systematic review’ by Sophie Orton, Tim Coleman, Tom Coleman-Haynes and Michael Ussher of Nottingham University, and the best oral presentation, which went to Michael Toze from CaHRU at the University of Lincoln for his doctoral research presentation, ‘Coming out in general practice: the experience of older LGBT patients’. Flowers, wine and a big vote of thanks went to Sue Bowler for her work organising the conference and making the day such a success, supported by the CaHRU team and members of staff from the other institutions involved.

By Niro Siriwardena