Despina Laparidou, Research Assistant at CaHRU, together with Antony Chuter, a patient representative for Scaling Up PINCER (pharmacist-led information technology intervention for reducing clinically important errors) recently attended the International Society for Quality in Health Care (ISQua) Conference at the Queen Elizabeth II Conference Centre in London (1st – 4th October 2017) and presented the preliminary findings of the Scaling Up PINCER project, funded by the Health Foundation.
The Main Conference offered a combination of exciting plenaries, short oral presentations and longer themed sessions, while poster and e-poster presentations were also presented throughout the duration of the conference. One of the most interesting sessions was the “A Mile in My Shoes”. A Mile in My Shoes is an interactive shoe shop that invited delegates to “(literally) step into someone else’s shoes and embark on a mile-long physical, emotional and imaginative journey to see the world through their eyes”. The session involved listening to, while wearing their shoes at the same time, unique audio stories from people working within health and social care, sharing their experiences and showing the remarkable contribution and challenges faced by those working in, and using, our health and social care system.
Despina and Antony gave their presentation on the morning of Tuesday 3rd October during a session on “Health Foundation Improving Quality in Community Health Services” and was very well received by the audience. PINCER is a pharmacist-led information technology intervention for reducing clinically important errors in medication management in general practices and the study’s preliminary results show early indications of improvement in most of the study’s safety indicators for gastrointestinal bleed, stroke, heart failure and acute kidney injury, but not for the two asthma indicators. The session, chaired by Will Warburton from The Health Foundation, also showcased studies, such as the “Ophelia Project” on improving health literacy for vulnerable people in the community, and “Making Waves” on Promoting a positive experience for people with COPD.
The Conference came to an end with Wednesday’s plenary and the promise to meet again in 2018 for an even more exciting ISQua Conference in Malaysia!
By Despina Laparidou
Three members of the CaHRU team, Professor Niro Siriwardena, Dr Stephanie Armstrong and Greg Whitley (paramedic and doctoral student) led an interactive exploration of the latest research and innovation in ambulance care in a session entitled ‘Innovations in ambulance service care: ‘bangs, brains and hearts’ as part of the Lincoln Get Hold of Technology and Science (LiGHTS) Expo on 29 September 2017.
The seminar was presented twice to around 40 members of the public in all aged 7 to 60+ years. It explored the kind of care we can expect currently from ambulance services. The team explained how today’s ambulance service is about far more than transporting people to hospital. Prof Siriwardena discussed how ambulance services should be measured using an animation from the Prehospital Outcomes for Evidence Based Evaluation (PhOEBE) programme. Steph Armstrong discussed ‘Why do ambulance research and how difficult is it?’ exploring the difficulties of randomising patients and gaining consent in this setting. Prof Siriwardena then spoke about the use of GTN (also known as nitroglycerine, a component of dynamite) for stroke in the RIGHT2 trial and Greg Whitley, paramedic on the AIRWAYS2 trial explained the different airways device being tested in the study.
The seminar continued with a hands-on exercise involving cardio-pulmonary resuscitation, looking at airway devices and listening to heart sounds with a stethoscope. There was also plenty of audience participation with questions, answers and prizes! Prof Siriwardena and Dr Stephanie Armstrong gave an interview to Melvyn Prior at BBC Radio Lincolnshire as part of the event.
The latest edition of the CaHRU Newsletter (Summer 2017) was published in September 2017. 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 written by members of the CaHRU team and produced by Sue Bowler, CaHRU administrator.
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Two key articles on development and prioritization of new ambulance performance measures were published this autumn 2017 in Health Expectations. The studies come from, Prehospital Outcomes for Evidence Based Evaluation (PhOEBE), funded by a five year National Institute for Health Research Programme Grant for Applied Health Research led by Professor Niro Siriwardena from CaHRU and Janette Turner of the Centre for Urgent and Emergency care research (CURE).
The first article, ‘Prioritizing novel and existing ambulance performance measures through expert and lay consensus: a three-stage multimethod consensus study‘ involved a multistakeholder consensus event, modified Delphi study, and patient and public consensus workshop, which together identified a shortlist of ambulance outcome and performance measures important to ambulance clinicians and service providers, service users, commissioners and academics.
The final set of measures included change in pain score, accuracy of call identification, average response time, proportion of patients with a serious condition who survived to 7 days post-admission, death (within 3 days) from a low risk condition, proportion of patients transported to the Emergency Department who were discharged without treatment or investigation, and the proportion of those with specific conditions treated according to current guidelines.
The public consensus workshop, ‘A coproduced patient and public event: An approach to developing and prioritizing ambulance performance measures‘, was effective for obtaining public feedback on which ambulance performance measures were most highly favoured by lay participants. These measures have been developed to be used in future by ambulance services or commissioners to benchmark care quality between services or regions or to measure performance over time.
By Prof Niro Siriwardena
CaHRU are pleased to announce the first publication from the Wellcome Trust funded project, NEAT: Network exploring Ethics in Ambulance Trials. The article, entitled ‘Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review‘, sought to understand the main ethical considerations when conducting clinical trials involving ambulance services.
The review found issues with consent were the most significant ethical issue for ambulance trials. The type of consent gained differed depending on the condition or intervention being studied, but the country in which the research took place had less influence on the type of consent. The terminology used to describe consent varied widely with multiple terms used to describe the same processes. This, coupled with the the wide range of consent types used led to the conclusion that standardisation of consent models and terminology used to describe them was warranted.
The systematic review was published in BMC Medical Research Methodology and is available open access at the following link: http://rdcu.be/vUxW
By Stephanie Armstrong.