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Article on patient experiences of ambulance care published in Ambulance Today

photo2italiccolourWORDSAn article entitled, ‘Feeling reassured: the glue that holds together patients’ experiences of ambulance service care’ was published in the autumn (September) issue of Ambulance Today. The article by Prof Niro Siriwardena and Fiona Togher, based on work undertaken as part of the National Institute for Health Research funded five-year Programme for Applied Health Research co-led by Prof Siriwardena together with doctoral research by Fiona Togher, describes findings from a recent paper published in Health Expectations.

NThe article, ‘Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study’, describes how healthcare quality incorporates the important of patient experience as well as safe and effective clinical care and what patients feel contributes to a good experience. The original study involved 22 patients who had recently experienced care from the ambulance service together with eight spouses. The interviews revealed that the ability of ambulance staff to reassure patients was the ‘glue’ that held together patients’ experiences: if patients did not feel reassured during their care this adversely affected their overall experience.

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2015/09/Siriwardena-Togher-Feeling-reassured-AT-2015.pdf” responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]Patients expected the clinical care delivered by ambulance staff to be safe and effective, but what affected their experience and their feeling of being reassured were other aspects of care such as professionalism (demeanour and conduct), good communication (sensitive to the needs of patients and their relatives), responsiveness (timeliness that met needs rather than simply a rapid response), and continuity (effective handover to hospital or community pathways). The research is part of the Prehospital and Emergency Quality and Outcomes (PEQO) workstream at CaHRU and has contributed to Fiona’s doctoral research on the development of a Patient Reported Experience Measure (PREM) for use in NHS ambulance services.

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CaHRU presents at European Forum for Primary Care Conference in Amsterdam

EFPC-logo-4-k new versionMembers of CaHRU, Dr Coral Sirdifield, Ana Godoy and Prof Niro Siriwardena attended the annual conference of the European Forum for Primary Care (EFPC), ‘Integrated primary care: research, policy and practice’, at the Tobacco Museum in Amsterdam from 30 August to 1 September 2015 to meet with colleagues and present an invited workshop on patient experience at the meeting. Niro Siriwardena is a member of the advisory board of the EFPC and attended a board meeting on the day before the conference.

Coral Ana Niro3The workshop, entitled ‘QUALICOPC in the UK, the patient perspective, took place on the first afternoon of the conference and was informed by work from CaHRU on the EU funded Quality and Costs of Primary Care in Europe (QUALICOPC) study. The session was well attended, enabling participants to discuss different approaches for measuring patient satisfaction with primary care and how satisfaction could be improved. Coral and Ana presented an innovative approach called Importance-Performance Analysis, using the QUALICOPC data from England, to demonstrate how the technique could help practitioners, researchers and policy makers to identify where one most needed to focus to improve patient satisfaction.

riverboatThe conference included excellent keynotes from Prof Chris van Weel, Emeritus Professor of General Practice at Nijmegen (‘The history of Dutch General Practice or: how Primary Care saved the nation’), Dr Isabel Moulon from the European Medicine Agency (‘Bridging the gap between medicine development and clinical practice: is primary care out of the picture?’), Ellen Nolte from the European Observatory on Health Systems and Policies (‘Integrating care: what we know and what we do not know’), Prof John Øvretveit of the Karolinska Institute (‘Priorities for actionable research to speed and spread improvements in caring for chronic illnesses’), Dr Tonka Poplas Susič and Metka Žitnik Šircelj (‘Model practices in family medicine in Slovenia’) and a closing summary from Prof Marc Bruijnzeels of the Jan van Es Institute (‘Challenges for the future of integrated primary care’). A range of parallel research, debate and workshop sessions, lunch on a riverboat and an excellent conference dinner provided a full, interesting and enjoyable programme for delegates.

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CaHRU Summer 2015 Newsletter

The latest edition of the CaHRU Newsletter (Summer 2015) was published this week. The newsletter presents the work of the research centre over the previous three months and includes articles from the CaHRU blog covering publications, conferences and funding. The newsletter is produced by Sue Bowler, CaHRU administrator.[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2015/09/CaHRU-Newsletter-Summer-2015.pdf” responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

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East Midlands Universities Association (EMUA) Student Conference 2015: Impact & Collaboration

fionaOn Thursday 3rd September 2015 I was fortunate enough to attend the EMUA Student Conference hosted by The Graduate School at the University of Lincoln. The annual conference provides an excellent opportunity for postgraduate students across the region to network and present their research to their peers in a supportive, inquisitive and encouraging environment.

There was representation from the Universities of Lincoln, Loughborough, Leicester, Derby, Nottingham and De Montfort University, Leicester. The multi-disciplinary nature of the conference meant that students were able to learn about research that could be similar to their own work in terms of subject but also could be completely different in topic and methodology.

The morning began with a fascinating key note from Dr Helen Zulch from the School of Life Sciences at the University of Lincoln. Dr Zulch talked about ‘scholarship and the many faces of impact’ and drew upon her own research expertise in veterinary behavioural medicine as an example of how academic research can impact on both society and individuals. One of the key messages of the presentation was that ‘whatever our motivation, the knowledge and experience that we gain through our research has the potential to impact on others’. Dr Zulch highlighted the fact that even if our research legacy is simply that we instilled an interest and motivation in others to pursue a research career then this is something to be proud of.

IMAG0510Throughout the day there were parallel sessions of oral presentations given by the student delegates. I attended some really interesting talks around subjects as diverse as ‘The gay tree of life: an interdisciplinary approach to homosexuality research’ to ‘Stakeholder perspectives of collaborative working and street works management’. I gave a presentation entitled: ‘Engaging with patients and NHS staff to develop a Patient Reported Experience Measure (PREM) for use in NHS ambulance services’. The theme of the conference ‘impact and collaboration’ enabled me to concentrate on an element of the research process that I hadn’t previously considered in much detail. The opportunity to focus in on this within my presentation will be beneficial during those crucial thesis writing days!

The conference concluded with four finalists (at university level) of the three minute thesis competition presenting to the whole delegation. The aim of the competition is for students to effectively explain their research in ‘language appropriate to a non-specialist audience’. It draws upon their communication skills and ability to ‘cut to the chase’. The presentations were outstanding and the way in which the students drew the audience in with their engagement skills was fantastic.

Overall, I came away from the conference having made several new contacts, gained renewed confidence in my work and an optimistic view of PhD life in the East Midlands. The Graduate School here at the University of Lincoln did a great job of organising the day and ensuring that everything ran smoothly so thank you graduate school! I look forward to next year’s conference…

Fiona Togher

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New study from CaHRU shows link between flu vaccination and reduction in stroke

ipvastia_team2The latest study from CaHRU is published online in Vaccine this month. The study, ‘Influenza vaccine and risk of stroke: self-controlled case series study‘, was co-authored by Dr Zahid Asghar and Professor Niro Siriwardena from CaHRU together with Carol Coupland, professor of medical statistics at Nottingham University. The study used a self-controlled case series design with data from the General Practice Research Database (GPRD) on adult patients aged 18 years and above with fatal or non-fatal stroke during 8 years from September 2001 to May 2009.

h1n1Statistical analysis was used to compute incidence of stroke after flu vaccination compared with incidence during a baseline period in almost 18000 people who received one or more influenza vaccinations and experienced a first stroke during the observation period. The incidence (incidence rate ratio: IRR) of stroke was significantly reduced in the first 59 days following flu vaccination compared with the baseline period. We found reductions in stroke incidence of 55% in the first 1–3 days after vaccination, 36% at 4–7 days, 30% at 8–14 days, 24% at 15–28 days and 17% at 29–59 days after vaccination. Early vaccination between 1 September and 15 November was associated with a greater reduction in incidence of stroke compared to later vaccination given after mid-November.

Flu vaccination was associated with a reduction in incidence of stroke, which confirms findings from previous studies showing possible protective effects of flu vaccination for both heart attack and stroke. This association needs further confirmation with experimental (randomised controlled) trials.