As part of our engagement with the public Dr Linda Pomeroy presented the CLAHRC’s iQUASER study at a recent Bart’s Health research evening.
The event gave us a chance to showcase the project which is evaluating the impact of implementing QUASER – a Board-level intervention NHS Trust leaders can use to diagnoses the strengths and weaknesses in their approach to delivering quality improvement.
Linda discussed the importance of NHS Boards setting the direction for Trusts and leading on efforts to improve quality and safety, and how this impacts patient care at ward level.
Our thanks to Bart’s Health for giving us the chance to present our work.
Vari has a PhD in Health Psychology and is experienced in applying psychological methods to the study of behaviour relevant to health, illness and health care. Her particular interest lies in psychological factors associated with treatment non-adherence and acceptance in long-term conditions and has specific knowledge of developing psychological theory-based interventions and in conducting and evaluating psychological intervention randomised controlled trials. Joining UCL, Vari supports the Optimising Behaviour and Engagement with Care theme: Improving adherence to essential medication for asthma: feasibility study and development of the ‘Perceptions and Practicalities Approach’ Intervention. She also is working on the Tandem project with QMUL, a tailored, psychological intervention for mild to moderate anxiety or depression in people with chronic obstructive pulmonary disease(COPD).
Samantha completed an undergraduate Masters of Nursing Science (MNurSci) degree at the University of Nottingham before working as qualified Intensive Care nurse at the East Midlands Major Trauma Centre in Nottingham. She later completed a MSc at The London School of Economics and Political Science in International Health Policy before joining UCL for her PhD. Her research interests include patient safety, specifically avoidable harm, quality improvement and the role of external and internal governance systems- having previously worked with the Care Quality Commission as an Inspector of NHS Trusts in the UK.
This PhD aims to carry out observational research on wards to ascertain the attitudes and cultures of safety in regards to medicines safety. The methods will be ethnographic in nature, involving spending an extended period of time in each clinical setting to acquire a detailed understanding of the tacit conventions and social relations practiced within and between different professional communities that constitute different ‘safety cultures’. In each setting, non-participant observations and formal and informal interviews will be used to study the everyday practice of medication safety and develop ideas for the intervention in consultation with healthcare professionals. Different settings within the hospital will be studied (for example surgery, admissions areas and intensive care) to ascertain the importance of ward culture upon safety cultures and medicines safety.
The Innovations to improve pathway for people with COPD project is evaluating what works to better manage this respiratory condition. The team are measuring whether a variety of interventions will make GPs’ management of patients with the condition more effective and efficient in the long-term.
As part of our engagement with patients the project’s Senior Research Associate and Research Associate visited Havering Breathe Easy Group. The Breathe Easy network provides support and information for people living with a lung condition, and those looking after them.
As well as getting insight on living with COPD and variations in service patients’ can experience, researchers wanted to get a feel for what aspects of GP care were most important to patients’ health and quality of life.
We asked patients to identify what they thought were the most important interventions general practices provided to support COPD sufferers.
Our choices were based on a list of activities that the National Institute for Health and Care Excellence (NICE) – the independent organisation which decides which drugs and treatments are available on the NHS in England and Wales – has recommended should be delivered as part of COPD care from general practice.
What GP service patients valued most
What GP services patients valued least
Annual reviews with their GP
Smoking cessation advice
Pulmonary rehab (exercise and education and to manage their condition)
Spirometry Testing/Diagnosis (to diagnose a condition and monitor lung function)
Rescue Packs (of emergency medicines)
Self-management of care
How this will help our research
If we need to decide what weight we give to different outcomes, patients’ views of their relative importance could be one factor we consider.
Whether the measures we are using in our research are the ones patients consider most important
Patients’ views will provide useful pointers and questions for interviews with general practice staff that are part of our research
Dr Natalia Lewis is a Research Fellow at the Centre for Primary Care and Public Health, QMUL. She was trained as a physician and completed her PhD at the North-Western State Medical University, Russian Federation, investigating prevalence and associations of domestic violence and abuse among women patients attending Russian general practice. Her post-doc projects included longitudinal analysis of HPA axis functioning in abused women (CEASE study), evaluation of a training intervention for general practice on domestic violence and child safeguarding (RESPONDS study) and review of grey literature on interventions for children exposed to domestic violence and abuse (IMPROVE study). She is a member of the IRIS/ CLAHRC research team working on post-implementation evaluation of IRIS intervention in five northeast London boroughs (https://www.clahrc-norththames.nihr.ac.uk/iris/).
NIHR CLAHRC North Thames conducts ground-breaking research that directly impacts the health of patients with long term conditions and the health of the public.