The first of this year’s series of CaHRU/LIH (Community and Health Research Unit/Lincoln Institute for Health) improvement science and research methods seminars was given by Prof Siriwardena on mixed methods on 16 February 2016. Improvement and implementation science benefits from the use of mixed research designs which combine quantitative and qualitative methods to show not only what happened but also why and how this might have occurred. Mixed methods approaches are a subset of multiple methods which involve more than one type of qualitative or quantitative method.
The seminar covered principles such as definitions, theoretical approaches (such as pragmatism and transformation), basic and advanced (including case study) designs and approaches to data integration and transformation. This was then applied to examples of mixed methods designs used by CaHRU in a previous programme of research: the Ambulance Services Cardiovascular Quality Initiative (ASCQI). ASCQI was a national project, led by CaHRU and East Midlands Ambulance Service NHS Trust, designed to improve care for people presenting to ambulance services with heart attack or stroke using a large-scale quality improvement collaborative (QIC), evaluated using a multiple case-study design.
ASCQI involved gathering quantitative and qualitative data to describe what effect the QIC had, and how improvements, if they did occur, were brought about. Integration of data was carried out using techniques such annotated control charts showing time series data together with what was implemented, pattern matching comparing what services did and whether improvements occurred (doi: 10.1186/1748-5908-9-17), and comparison of quantitative and qualitative data from an online questionnaire (doi: 10.1111/jep.12438). Attendees were finally asked to consider a mixed methods question and think about research designs which they might use to answer it.
Thank you to all those staff and students who attended. Details of future seminars will be posted on the CaHRU and the LIH sites shortly.
[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2016/02/Mixed-methods_Siriwardena.pdf” responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]
Dr Stephanie Armstrong joined CaHRU this month to work on the Wellcome Trust funded ‘Network exploring Ethics in Ambulance Trials (NEAT)’ project. She says, “I come to Community and Health Research Unit from a rather diverse background having begun my academic life in the field of Zoology. I completed a PhD in Zoology from Trinity College, Dublin in 2006, where my work focussed on the nutrition and behaviour of large captive herbivores and in particular zebra.
In 2004 I joined Sparsholt College, Hampshire as a lecturer in the Equine Studies section and worked my way up to Head of Department for Animal Management Higher Education. This career path however, took me away from hands on research and, after working for Sparsholt College for 7 years, I realised that I needed a change of direction. With that in mind I undertook an MSc in Forensic Anthropology at the University of Lincoln, reigniting my passion for research. I also hold degrees in Equine Studies and Herbal Medicine.
As a result I have extensive experience in a wide range of research both quantitative and qualitative ranging from novel animal behaviour studies to in-depth systematic reviews. My research interests lie within the areas of ethics and human rights.” The NEAT project is CaHRU’s first Wellcome Trust grant, led by Prof Siriwardena in collaboration with Dr Adele Langlois from the School of Social and Political Sciences.
Professor Niro Siriwardena recently presented on ‘Developing new ways of measuring the quality of emergency medical services’ on 21 January 2016 at the Larrey Society’s inaugural conference on the Future of EMS in London. The Larrey Society, the brainchild of its founder David Davis, is an international organisation of paramedics and NHS, independent and voluntary ambulance services with leaders from health and academic communities, formed a year ago. The society is named after Dominque Jean Larrey, an army surgeon in Napoloen’s army who developed field medicine and ambulances.
The meeting was chaired by Sue Noyes, chief executive of East Midlands Ambulance Services NHS Trust and included keynote lectures from Prof Andy Newton, president of the society, Prof Jonathan Benger, professor of emergency medicine at the University of West of England, Prof Siriwardena, director of CAHRU, and Prof Kevin Mackway-Jones, professor of emergency medicine. Prof Newton talked about the current state of ambulance services and the urgent need to innovate to improve care quality. Prof Benger described an innovative method of ambulance dispatch currently being introduced and evaluated in the South West. Prof Mackway-Jones discussed the causes of and potential solutions to emergency department blocking.
Prof Siriwardena described work done by ambulance services in England over the past eight years developing new quality measures of ambulance service care and improving care for conditions such as heart attack, stroke, diabetes and asthma using methods such as largescale quality improvement collaboratives. He went onto describe the new indicators being developed through research programmes such as Prehospital Outcomes for Evidence Based Evaluation using method such systematic literature reviews, interviews of ambulance staff and patients, consensus methods and data linkage to derive risk adjustment measures, which provide potential for better measurement and improvement of ambulance service care.
The latest edition of the CaHRU Newsletter (Autumn2015) was published in November. 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 [su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2016/01/CaHRU-Newsletter-Autumn-2015.pdf” responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]produced by Sue Bowler, CaHRU administrator.
The Community and Health Research Unit were awarded the University of Lincoln team award for Achievement in Research at the awards ceremony in November 2015. Members of the team were Professor Niro Siriwardena (director), Dr Zahid Asghar, Dr Zowie Davy, Dr Jo Middlemass, Dr Coral Sirdifield, Ana Godoy Caballero, Fiona Togher, Viet-Hai Phung, Despina Laparidou, Rebecca Porter, Rachel Hawley and Sue Bowler. Ana Godoy has left the team to begin a new post in Spain and Rebecca Porter has started her medical studies at Durham.
Over the past year CaHRU achieved research centre status. The centre focussed its efforts on ‘making an impact on healthcare through international and world class research’ by: conducting research which is likely to make a difference to people’s health and well-being; promoting high quality care which enhances the experience, safety, effectiveness, efficiency and equity of healthcare by investigating how to transform the performance and function of health and social care practice, organisation and delivery; positively engaging with health care organisations regionally and nationally; strengthening its academic and health service collaborations regionally, nationally and internationally; supporting its researchers to achieve their potential through a research environment that encourages cooperation, collaboration and mutual support; and engaging with service users, carers, practitioners, health service managers, commissioners and policymakers in research activities to maximise the impact of its research by responding to service priorities, working with service users and care organisations to embed research into practice and disseminate findings.
The team’s efforts have led to an increase in the number and quality of successful research bids including funding from the National Institute for Health Research, Wellcome Trust and Falck Foundation, greater numbers of research outputs in high quality peer-reviewed journals, and continuing research impact extending regionally, nationally and internationally. Team members use a wide range of research designs and methods, but the centre is now undertaking more clinical trials which provide greater potential for future research impact.