PhD student Laura Simmons attended the Doctoral Training Alliance Biosciences for Health summer school hosted by the University of Huddersfield on the 24th-26th July. During the 3-day event students took part in a variety of workshops that focused on how individuals can make an impact with their research.
The main focus of the summer school was the Impact Challenge where students had to present a pitch to a group of judges on a particular research topic. We were encouraged to choose a goal, define the outcomes, outputs and funding requirements. This provided a great opportunity for students to consider how much funding would be required and what resources would be needed to carry out the project. We were also encouraged to consider our connections to external charities and organisations that could help us in achieving the project goals.
There were a variety of projects that were presented during the summer school including: a uterus massage to reduce haemorrhaging and maternal mortality (Laura Simmons); a diabetes mobile app to reduce mortality from non-communicable diseases and promote health (Sophie Mohamed); and implementing an online training course to empower healthcare workforces in developing countries (Ksenia Trischel).
Laura and her team were one of three groups who were awarded ‘funding’ from the judging panel (awarded in chocolate coins) for their work on developing an educational programme to reduce haemorrhaging during childbirth to reduce maternal mortality.
Overall the Impact Challenge was a useful exercise that mirrored the real life expectations of working with colleagues to produce a funding application. It challenged us to think outside the box and consider the impact that the project may have from other perspectives such as the economy.
For more information about the Doctoral Training Alliance visit their website https://unialliance.ac.uk/dta/programmes/dta-applied-biosciences-for-health
CaHRU was represented by Prof Niro Siriwardena together with colleagues from East Midlands Ambulance Service NHS Trust at the recent EMS2018 conference which took place at Copenhagen’s Tivoli Congress Hall, 16-18 April 2018. The theme of the conference was “It Takes a System to Save a Life – Next is Now”, emphasising the importance of systems in emergency and out-of-hospital care.
Another highlight of the conference was the European EMS Championship competition where teams from all over the world were assessed in various emergency situations – the competition winners from a strong field including Denmark, Scotland, and Australia, were the team from East Midlands! The social programme included a walk through Copenhagen with the city’s ‘Heart Runners’, a programme to train the population in basic life support for cardiac arrest and a dinner at the Circus Building in the town centre. Overall the conference provided an excellent opportunity to present CaHRU’s work and to hear about developments in prehospital care in the beautiful setting of Copenhagen.
This year’s annual EMS 999 Research Forum, ‘Research for impact in 999 Emergency Care’ was held in the University of Stirling’s picturesque campus from 26-27 March 2018 and was attended by members of CaHRU, Viet-Hai Phung, Laura Simmons, Greg Whitley and Professor Niro Siriwardena. The preconference sessions included two workshops: Professor Rowena Murray from the University of the West of Scotland led a session on how to write a peer reviewed paper; the other session involved CaHRU’s Professor Niro Siriwardena, with Professor Helen Snooks from the University of Swansea and Roy Norris from Service Users for Primary and Emergency Care Research (SUPER), leading a session on designing and planning research projects and getting them funded.
Shona Robison, the Cabinet Minister for Health and Sport in the Scottish Government introduced the start of the second day. This started with presentations on research that makes a difference and the links between prehospital research and Out-of-Hospital Cardiac Arrest (OHCA). There then followed a series of four oral presentations, which included a sensitive one from Kelly Hird and Fiona Bell from Yorkshire Ambulance Service about suicide among ambulance staff, and Belinda Flanagan, from the University of the Sunshine Coast in Australia, who presented her work on unplanned births in paramedic care.
There was a CaHRU representation in the post-lunch poster session with Viet-Hai Phung presenting on the ‘Perceptions and experiences of community first responders on their role and relationships: qualitative interview study’, Rob Spaight from East Midlands Ambulance Service NHS Trust presenting work led by Dr Murray Smith on ‘Modelling of patient outcomes after emergency treatment for out-of-hospital cardiac arrest by paramedics and community first responders’ and Prof Niro Siriwardena presenting an interview study led by Dr Stephanie Armstrong of paramedics’ perceptions of the ethics of ambulance-based trials. Last year’s prize winner, Dr Edward Duncan, from Stirling University, subsequently recounted his experience of presenting at the Paramedic Australasia International Conference.
The final substantive session of the conference was a lively and thought-provoking panel discussion which included Janette Turner from the University of Sheffield and Professor Niro Siriwardena, on future priorities for prehospital research. The conference closed with a prize giving session for some excellent presentations and posters that were given throughout the conference.
The latest in the CaHRU and Lincoln Institute for Health Improvement Science and Research Methods seminar series was given by Professor Siriwardena on ‘Quality Improvement Collaboratives (QICs): theory design and effects on 28 February 2018. The CaHRU team have led three large scale collaboratives over the past 12 years, including Resources for Effective Sleep Treatment (REST), the Ambulance Services Cardiovascular Quality Initiative (ASCQI) and most recently Scaling up PINCER (a pharmacist and information technology intervention to reduce potential clinically important prescribing errors in general practice.
QICs are an organised, multifaceted approach to quality improvement involving five essential features: a specified topic; clinical experts and experts in quality improvement provide ideas and support for improvement; multi-professional teams from multiple sites participate; using a model for improvement (measurement, change, feedback); and a collaborative process involves series of structured activities. The talk described how QICs have been used to implement healthcare interventions at scale and referred to a recent systematic review suggesting that over 4 out of 5 reported improvement in one or more outcomes although the quality of studies was variably poor.
QICs were described in terms of their common features: a logic model and theory of change; the complex (pragmatic) contexts of the intervention, setting and participants; and the variation in effects and changes that the intervention can or will undergo during the process of the collaborative. It was proposed that there were different types of collaborative based on their purpose which could be for intervention development, increasing reliability of evidence based processes, or scaling up evidence based complex interventions. It was argued that reviews of QICs should consider these different purposes when describing the outcomes and effects of QICs.
By Professor Niro Siriwardena[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/03/QICs_Siriwardena.pdf” width=”660″ responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]
Prof Niro Siriwardena of CaHRU attended the North American Emergency Medical Services Physicians (NAEMSP) annual conference in San Diego, California from 10-12 January 2018 to deliver an invited lecture on ambulance quality measures and improvement.
The conference opened with a keynote address, ‘The patient as a mission with a very critical outcome, how to get that right – the first time and every time’ given by Dr Story Musgrave, child labourer, mechanic, farmer, scientist, doctor, pilot, astronaut, artist and university professor. This was followed by Dr Dave Williams of the Institute for Health Improvement in the US who spoke on ‘Improvement science and safety in EMS’ including an example from CaHRU of development of prehospital indicators and their use for quality improvement.
The following day included session on the Canadian Prehospital Evidence-Based Practice Project, National Model EMS Clinical Guidelines and Ethical Challenges in EMS, simulation, cognitive bias and medical error. The afternoon sessions focussed in quality included ‘Mission: Quality – Can Mission Lifeline Help Your Performance Improvement Program?’ presented by Dr Jeremy Cushman MD. He described how a the programme Mission: Lifeline is designed to transform care for patients with myocardial infarction, stroke, and cardiac arrest using national performance benchmarks, and sharing best practices to enhance provider feedback through hospital outcome information.
Prof Siriwardena then spoke on how new quality measures for ambulance services have been developed and implemented over the past decade in England in his lecture entitled ‘Developing Ambulance Quality & Performance Measures that Make a Difference to Patients’. This was based on research conducted by Prof Siriwardena with UK ambulance services and academic institutions as part of the Ambulance Services Cardiovascular Quality Initiative (ASCQI) and the Prehospital Outcomes for Evidence Based Evaluation (PhOEBE) program. There was discussion of the successes as well as the barriers to development of new quality measures, and the underpinning research and quality improvement initiatives that have been vital to progress in this field.
[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/01/NAEMSP2018_Siriwardenav3.pdf” width=”640″ responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]