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.
Members of the Community and Health Research Unit (CaHRU) recently attended the Trent Regional SAPC Spring Conference (13 March 2018) organised by the University of Sheffield. The conference included delegates mainly from the Universities of Lincoln, Nottingham, Leicester and Sheffield, as well as professionals from all over our region interested in primary care research and education.
After a very warm welcome from Professor Chris Burton, Dr Austin O’Carroll gave a very inspiring and thought-provoking keynote speech on his work with marginalised groups (especially homeless people) and their challenges with accessing healthcare. Delegates then had the opportunity to attend oral presentations of posters and a variety of longer 15′ oral presentations. Dr Zahid Asghar of CaHRU also gave a very well-received oral presentation on his study, entitled “Exploring factors increasing Paramedics’ likelihood of administering Analgesia in pre-hospital pain”. After a much-needed lunch, delegates were split into three smaller workshop groups looking into three distinct subjects: “Resources for grant-writing” (Paul Leighton), “Introducing community/voluntary sector placements to Undergraduate Medical Education” (Joanne Thompson), and “Patient and Public Involvement at the Deep End Yorkshire and Humber: How should we involve patients with our research” (Liz Walton). The day came to an end with a great key note speech by Professor Robbie Foy on a ‘real world’ trial of a strategy to promote evidence-based primary care.
Delegates, while waving goodbye to the wonderful St Mary’s Conference Centre – an old church converted into a conference centre- promised to meet again this July in London for the Annual Conference of the Society for Academic Primary Care.
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]
Dr Pradeep Ratnasekare joined CaHRU this January 2018 as our third international visiting fellow from the University of Colombo’s Postgraduate Institute of Medicine. Pradeep graduated as a bachelor of Medicine and bachelor of Surgery in 1996 from the faculty of Medicine, University of Ruhuna and then completed postgraduate studies at the University of Colombo, Sri Lanka, in the fields of respiratory medicine and then in medical administration where he gained his master’s in 2011 and MD in 2016.
He has worked for over four years as a primary care medical officer, and six years as a medical officer in respiratory medicine, health system manager and health care researcher. As a health system manager he developed experience in various fields of hospital and public health programme management. He has worked as a hospital director in many secondary and tertiary care hospitals in Sri Lanka and worked as deputy director of the Medical Research Institute, the premier national level reference and referral medical laboratory and medical research centre for public and private sectors in Sri Lanka for last 18 months. His main interests are in health technology assessment and management, modern hospital planning and architecture, health system research and quality improvement in health care. Pradeep has several publications into his credit in the Journal of Medical Administrators Sri Lanka and Sri-Lanka journal of Health Policy and Management mainly on interventions carried out to improve health systems. He is a member of several academic associations in Sri Lanka including the College of Medical Administrators of Sri Lanka and Sri Lanka Medical Association. He is a member of research evaluation committee of the Medical Research Institute.
While at CaHRU he plans to: study the prehospital care system in the UK with a view to adapting it to develop a suitable model for Sri Lanka; to study the primary health care system in the UK National Health Service (NHS) of United Kingdom with respect to quality improvement and clinical governance; to study the systems and methods in place for Health Technology Assessment (HTA) and Health Technology planning in the United Kingdom; to learn about hospital design and planning; and to actively contribute to CaHRU’s research programme in primary and prehospital care. Listening to classical music, singing and playing cricket are his favourite hobbies.