THIS Institute (The Healthcare Improvement Studies Institute)

The stakes are high during childbirth. Electronic fetal monitoring with cardiotocography (EFM-CTG) tracks, in real time, the baby’s heart rate and the mother’s contractions during labour. It’s used during higher-risk births in the UK and many other countries to help detect signs of fetal distress. But its use in practice isn’t always optimal, and it has been implicated in poor outcomes and negligence claims. While improving individual training in EFM-CTG has been a focus of improvement efforts in the past, there may be many other influences on safety of electronic fetal monitoring. We reviewed the evidence on these other factors. The evidence shows that factors such as staffing levels, inconsistent procedures and communication issues, along with workplace environment and equipment problems, can all play a role. A systems approach will be needed to address these challenges and improve care. Find out more ⤵️ THIS summary: https://ths.im/3P6Y6g9 Full paper: https://ths.im/3PaI0C8

Almost 10 million people have surgery in the UK every year. If you work in any part of the NHS, we need your help to identify the best ways to measure standards of care before, during, and after surgery. We need your expertise to help rank the metrics that are most important to you. Your input will contribute to building essential evidence in perioperative care. Part 1 is open now and part 2 opens in February.  This is an excellent opportunity to get involved in research, contribute to data collection, and shape how important aspects of perioperative care will be measured.  We hugely appreciate your help. We can provide a certificate of participation as evidence of your contributions to research upon completion of the two surveys – great for portfolios. Find out more and take part: https://ths.im/3ZYDexE

Without high-quality, reliable evidence, the puzzle of healthcare improvement will always be incomplete. At THIS Institute, we're working in collaboration with staff, patients, carers and many others to fill the gaps. We ask tough questions: 👉What really matters to patients? 👉 How can patients and staff be involved in understanding the issues? 👉 Which solutions need to be implemented at scale, and which ones should be local? Learn more about our mission ⤵️

In our biggest conference to date, THIS Space 2024 hosted an array of speakers to discuss the leading research and evidence in improving the quality and safety of healthcare. Five research fellows from our fellowship programme delivered insightful lightning talks exploring varied subjects contributing to the advancing the field of healthcare improvement. Topics ranged from using big data for intelligent blood test ordering to co-designing quality improvement strategies in specialist eating disorder units, to addressing the challenges of national clinical audits in the stroke community, plus sharing learning from mixed methods approaches when examining variation in prescribing practices and implementing new service models for perioperative care for older people. Read the full story and watch the lightning talks here https://ths.im/4iBea7f

Healthcare supply chains are critical but often overlooked. They manage everything from medical equipment to linen and food, ensuring supplies reach point-of-care locations efficiently and managing the flow of patients. Good supply chain management (SCM) improves performance and reduces costs without compromising quality. Poor SCM, however, can lead to bottlenecks, fluctuating demand, and inappropriate ad hoc purchasing decisions. Check out the latest in our Elements series for an evidence-based look at some of the core characteristics of effective supply chain management. This one is written by Sharon Williams from Swansea University. It's free to read and download. https://ths.im/49D2RqV

There is so much pressure on urgent emergency care services - and the situation is getting worse. A more proactive approach is needed to manage this increasing pressure and achieve high-quality results, while making sure that the system is sustainable long term. THIS Institute and LCP Health Analytics are carrying out an evaluation of the AI-guided clinical coaching in urgent and emergency care programme, which is being carried out by UCLPartners, North East London Integrated Care System, and Health Navigator. The programme aims to support patients and ease pressure on A&E services. It uses routinely collected local hospital data to create bespoke machine learning algorithms and predict high-intensity users of unplanned care. It then offers support via targeted, phone-based clinical coaching with trained healthcare professionals. We aim to gather evidence that will support broader use of the programme, and guide future policies for better proactive care. Find out more ⤵️

Congratulations to THIS fellow Mahmood Bhutta who received the Royal College’s 2024 President’s Medal from the Royal College of Physicians and Surgeons of Glasgow for his contribution to global health and improving sustainability and ethical trade in healthcare. Awarded annually, this accolade recognises outstanding work in the community, either locally, nationally, or internationally. Mahmood is a leading consultant ear, nose, and throat (ENT) surgeon and campaigner and clinical green lead for University Hospitals Sussex. His fellowship project looks at creating a circular economy to tackle the use of single-use products in healthcare settings. In an article published by the Royal College of Physicians and Surgeons of Glasgow about the honours, Mahmood said: “I am truly honoured and humbled to receive this award, and the recognition given to the issues of protecting our planet and protecting workers in our medical supply chains.” Learn more about Mahmood’s project: https://ths.im/3Vz7E7j Read more about the Royal College honours: https://ths.im/3ZOjiNW

Effective healthcare supply chains are crucial for safe, effective patient care, but managing these supply chains is complex with challenges like underuse, overuse, and misuse of resources. In the latest release from our Cambridge University Press & Assessment Elements series, Sharon Williams from Swansea University provides a practical insight into the design and operation of healthcare supply chains. Read and download it for free: https://ths.im/4g56VD1

AI may have considerable potential in healthcare, potentially transforming many aspects of patient care or streamlining administrative processes. Some possible benefits include detecting diseases earlier, making patient care safer, better predicting resource needs, and supporting personalised medicine. But how do healthcare professionals feel about using AI tools in their clinical practice? Our research identified seven areas of concern around the adoption of AI in clinical settings: • Understanding how AI is used. • The amount of trust and confidence people have in AI tools. • Judging the added value of AI. • The availability of data and the limitations of AI. • Balancing time and other priorities. • Concerns about AI governance. • Working together to support the use of AI tools. Healthcare professionals were concerned that they didn’t fully understand how to use AI tools, how the algorithms work, how results are generated, or the reasoning behind the results. This lack of transparency creates barriers to trust, particularly when AI recommendations can differ from clinical judgment. Professionals are reluctant to rely solely on AI, as the responsibility for patient care ultimately rests with them. Other concerns include potential biases in AI worsening health disparities, a lack of guidance, and concerns about governance; there were uncertainties on legal responsibilities for misdiagnosis stemming from AI recommendations. We looked at the available research to discover healthcare professionals’ experiences of AI, and how any challenges could be mitigated. THIS summary: https://ths.im/3ZFv90A Full paper: https://ths.im/4f95QbL

All sessions from #THISspace2024 are available to watch now. You can catch up on sessions you missed, watch sessions again, and share with colleagues. Enjoy! https://lnkd.in/eSiyxzd9 Got ten minutes?⌚ Watch lightning talks by fellows and researcher from THIS Institute. 🔹 Strategies for implementing new service models: learning from POPS | Justin Waring https://ths.im/4inVqIr 🔹Mixed methods in healthcare research | Matt Gittus https://ths.im/3ZD95nF 🔹 Personalised uncertainty estimates for intelligent blood test ordering | Jonathan Gillham https://ths.im/4iyIcJ1 🔹What are the challenges of national clinical audit in the community? | Lal Russell https://ths.im/3B24bHn 🔹Exploring the impact of reducing NGT (nasogastric tube) feeding under restraint and co-designing meal support in a specialist eating disorder unit | Helen West https://ths.im/4idm32F 🔹THIS Institute Core Learning Systems | Kristina Wanyonyi Kay https://ths.im/4igh6WF Got 40 minutes? 🕑 🔹 Over-test and over-diagnosis https://ths.im/4ih5KSr 🔹Improving maternity care: The importance of exploring the system and co-designing solutions https://ths.im/41kdpte 🔹 What’s the problem with access to general practice? https://ths.im/4ilCYQv 🔹Today’s challenges in responsible data science and healthcare innovation https://ths.im/41dvyJ2