How was it for you? Reflections on involvement

1 Aug

This edition, we meet Andrew Grundy, who is involved in the Safer Transitions project in our Safer Care Systems and Transitions research theme.

Why did you decide to become involved in the Safer Transitions project?

I accepted an invitation to become involved in the Safer Transitions project because I am a mental health service user with lived experience of mental health service transitions myself; community to inpatient, and back again, on a number of occasions.

I also have research interests this area – my interests are in service user’s experiences of mental health services. My PhD is focussed on service users’ experience of risk assessment and management in an acute setting, which (among other things) involved sitting in and observing ward rounds and discharge meetings.

I wanted to use my lived and learned experience to make a difference in this area of hospitalisation discharge. We know that staff can become so focussed on the process that they lose sight of the person, and service users often feel lost in the system. So I feel it is important to constantly remind people that it is service users and carers who we hope will benefit from the research we do.

How do you think the Greater Manchester PSTRC has benefitted from your involvement? What difference do you feel that you made?

My involvement has focussed on assisting with the design and conduct of a study on the development of a Core Outcome Set for mental health hospitalisation discharge interventions – that is, a fundamental set of outcomes that we hope would be used in all future research into mental health discharge. This involved making the online study information sheet and surveys accessible and acceptable to a lay audience.

I have also been involved in co-producing an intervention to improve the service user experience of hospitalisation discharge. I’ve been involved to bring the service user experience and perspective into consideration when coming up with potential ideas in this area, and I’m excited about the next steps (watch this space!).

How do you feel you have benefitted from your involvement?

I’ve definitely picked up more research understanding and skills, particularly around developing a Core Outcome Set and the Delphi method – the process for producing the Core Outcome Set via an online panel completing various surveys, and then a face-to-face consensus meeting to agree the final outcome set.

I’ve also been able to use some of the most difficult experiences of my life (such as inpatient admissions) to make a difference to the research.

Would you recommend becoming involved in research to other patients/carers/health professionals? If so, why?

I would recommend being involved in the design and conduct of research, particularly if you have first-hand experience of a mental health condition (with all that entails) because you have a form of knowledge and expertise that people with only an academic knowledge-base don’t have.

The same is true if you are a friend or family member supporting someone with a mental health condition – that knowledge and experience is invaluable to academic researchers.

If you’re a health professional, your experience of clinical practice is also really helpful.

You may not feel like an ‘expert’ but clinicians, carers and service users have such a wealth of different kinds of knowledge that can make a real difference throughout the research process.

Developing prescribing safety indicators for the prison setting

17 Jul

by Richard Keers

pharmacy store interior with medicine on medical shelves blur background

A project has just begun which aims to develop and test prescribing safety indicators in prison healthcare.

Prescribing safety indicators describe prescribing and drug monitoring practices that may place patients at risk of harm, and which should generally be avoided. Whilst these indicators have been successfully introduced into hospitals and general practices in the UK, they have not been developed specifically for use in prisons, where research tells us the needs of patients and the way in which medicines are used differs from other health care environments.

The project team hopes that this work will lead to the implementation of prescribing safety indicators across prisons to help improve care for prisoners.

The project team will work closely with prison pharmacists to develop, input and test the prescribing safety indicators within prison healthcare records. Testing will take place in cycles to maximise learning and to help ensure that the indicators capture the right information. Following this exercise, the project team aim to run an event with prison staff and researchers to explore the potential for these indicators to be deployed on a national scale.

The project team are aiming to use the findings of this work to plan and submit a funding application to continue building on this research area.

If you would like to learn more about this study please contact Richard Keers.

Improving injectable medicines administration safety in hospitals

16 Jul

by Richard Keers

Row of medical syringes with blue lids

A new project has recently got underway to explore whether a new intervention to reduce injectable medicines administration errors in hospitals would be practical and welcomed by nursing staff. It is hoped that this NIHR Greater Manchester PSTRC work will identify how this intervention will be best designed and introduced into hospitals so it has the highest chance of success.

The intervention involves changing the way staff perform ‘second checks’ on injectable doses, which research tells us can be a task that is vulnerable to mistakes leading to medication errors. It is also known that errors involving injectable medicines pose a risk to patient safety and that it is therefore important to support the staff responsible for the complex process of preparing and administering them.

This project involves carrying out workshops with nursing staff across hospitals within one NHS trust to find out what they think about the intervention, how they think it might be introduced and work day-to-day in the hospital, and what factors might influence how successful it is.

The work will also explore how the staff members think the intervention should be tested to see if it is successful in improving medicines safety and being adopted into everyday clinical practice.

The project team are aiming to use the findings of this work to plan and submit a funding application to continue exploring the potential of this intervention.

If you would like to learn more about this study please contact Richard Keers.

Artificial Intelligence and decision making – experts discuss results of Citizens’ Juries to inform national guidance

1 Jul

Banner _Citizens Juries workshop image

Is it necessary to give reasons for decisions made using artificial intelligence (AI) software even if the results may not be as accurate? Leading academics and experts believe, with the development of AI advancing, guidance on how it can be used in decision making is needed.

The National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre (NIHR Greater Manchester PSTRC) and the Information Commissioners Office (ICO) commissioned two citizens’ juries* to investigate AI and decision making. In healthcare, the juries prioritised accuracy over explanation, but in other scenarios** they reached different conclusions; clearly, context matters.

The results were presented and discussed recently at a workshop attended by NHS National Data Guardian, Dame Fiona Caldicott, and chaired by Professor Stephen Campbell, Director of the Greater Manchester PSTRC. More than 50 people from across the country participated, including members of the two juries, NHS executives, academics and researchers working in range of specialisms such as philosophy, computer science and the arts.

Professor Niels Peek, Theme Lead for Safety Informatics at the Greater Manchester PSTRC, said: “Before there is widespread adoption of AI across the NHS it is important to develop guidelines to make sure patient safety is assured. We were keen to work with the ICO on this to help inform the guidance it is writing. We chose to commission two citizens’ juries to find out what the public think about this complex issue.

“It was valuable to reflect on the findings of the juries with a large group of experts during the workshop. We presented the research and invited questions before taking part in table discussions about AI and decision making which helped to give extra weight to our existing findings.”

Kayshani Gibbon, from The Royal College of Art (RSA), also spoke about research it’s due to publish on the ethical use of AI, giving the attendees additional background information.

Dame Fiona Caldicott, NHS National Data Guardian, said: “I welcome this project and the way it has involved a cross-section of the public in these important considerations on AI that will have a major impact on our lives. We have also used the citizens’ jury approach, and have found it’s a valuable way to learn in more depth what members of the public think.”

Ben Bridgewater, CEO at Health Innovation Manchester, attended the event and expressed how important he felt it was to be establishing a position on AI and decision making in the NHS. Ben said: “In Manchester we’re at the forefront of innovation in healthcare so being involved in this research and having the opportunity to comment on the results has been valuable.”

Simon McDougall, Executive Director for Technology and Innovation at the ICO spoke about the wider importance of the research as well as its significance: “Better understanding the public’s views on explaining AI decisions is vital for the ICO and The Alan Turing Institute, who are working with us on this, as we are developing guidance for organisations in this area.”

“The citizens’ juries gave us the opportunity for an in-depth exploration and discussion about the issues arising from AI decision-making and equipped us with a unique and informed public opinion on this complex issue.

“Our research findings, informed by the juries, have recently been published in our interim report.”

The citizens’ juries were run by Dr Malcolm Oswald, Director of Citizens Juries c.i.c. He said: “Bringing together experts from across the country and varying specialisms to discuss AI and explainability was a great opportunity to open up the debate.  These questions on AI will become ever more crucial as it increasingly affects our daily lives. It’s a complicated topic, and these citizens’ juries gave us five days to bring expert evidence and the time for people to work together to reach reasoned recommendations that will inform national policy.”

To find out more about the NIHR Greater Manchester PSTRC visit –  http://www.patientsafety.manchester.ac.uk/ and you can learn more about the breadth of projects Citizens Juries c.i.c. are working on at https://citizensjuries.org/