2.4 Research Capability Funding projects
Improving medication safety through service user involvement in patient safety interventions
Lead and collaborators:
Professor Carl Thompson; Professor John Baker and the CLAHRC evidence based transformation theme team (in conjunction with Yorkshire and Humber AHSN Improvement Academy and the Patient Safety Collaborative Network)
National attempts at improving medication safety in mental health have failed to maximise the potential that exists by co-producing safety interventions alongside service users (Paton et al. 2008). Interventions to change behaviour have an increased chance of success where they draw on theory and research evidence, but the role of service users in the design of safety interventions in mental healthcare is less well established. We are currently undertaking a preliminary exploration of the issues, potential benefits, challenges, and feasibility of service user involvement in the design of patient safety interventions in mental health – and the reduction of inappropriate polypharmacy prescribing for people with psychosis in particular. Currently CLAHRC RCF funds are supporting i)the production of a scoping review on the methods and potential impact of published research findings and ii) interviews with service users on the barriers and facilitators to involvement in designing interventions to improve prescribing practice and medication safety.
The work is being undertaken in partnership with the emerging and developing network of mental health professionals in the Yorkshire and Humber Patient Safety Collaborative Network and the Improvement Academy.
Behaviour change to prevent Acute Kidney Injury
Lead: Dr Jane O’Hara
Collaborators: Sally Moore, Research Nurse, Bradford Institute for Health Research; CLAHRC evidence based transformation theme
Acute Kidney Injury (AKI) is emerging as a global patient safety issue. Estimates suggest that one in five emergency admissions into hospital are associated with AKI (Wang et al, 2012), with approximately 100,000 deaths in secondary care associated with acute kidney injury, many of which may be preventable. Over the past 9 months we have begun the development of an intervention using an approach previously found to be successful in implementing patient safety alerts (Taylor et al., 2013;2014) We have i) mapped the current process for identifying and managing AKI within LTHT; and, ii) identified the target behaviour. We have done this in combination with key stakeholders from across the trust, and have identified members for the implementation team to take this work forward.
This current project will facilitate the next key stage in this work, the identification of the barriers to, and levers for, the identified target behaviour(s). This will be undertaken using an adapted version of the Influences on Patient Safety Behaviours Questionnaire (Taylor et al, 2013). A purposive sample of representative staff from across LTHT will be asked to complete the survey. From this the barriers and facilitators for the target behaviours will be identified and we will use this and a consensus process to develop our intervention. It is then our intention to apply for funding to evaluate an intervention to support the management of AKI, based on the data generated from this study.
Patient involvement in diagnosing cancer in primary care
Lead: Dr Jane Heyhoe / Professor Rebecca Lawton
Collaborators: Professor Ian Watt (University of York)
Diagnostic delay can have a serious impact on treatment options and outcomes for patients with cancer. Researchers and policy makers suggest that patients could play an important role in helping to achieve a quicker cancer diagnosis by assisting with the follow-up and review of symptoms. Recent National Institute for Health and Care Excellence (NICE) guidelines for recognition and referral of suspected cancer also advocates that patients should be involved in safety netting when symptoms may potentially be due to cancer. While there is increasing interest in the role that patients may have in reducing diagnostic delay, there is currently very little research on this topic.
We are currently undertaking a small project to examine whether interventions that involve patients in cancer diagnosis in primary care are acceptable to all stakeholders and to assess and identify the types of interventions that have the potential to become a sustainable component of standard care and improve the diagnosis of cancer in a primary care setting. In order to do this, we will interview patients who have received a cancer diagnosis, GPs and Nurse Practitioners and hold focus groups with stakeholders.