Blogs

This blog comes from Jen Yates, Clinical Theme Fellow for our Stroke Rehabilitation Programme.

Stroke is the leading cause of adult disability in the UK, with the greatest impact occurring when stroke survivors leave hospital. In parts of the East Midlands, stroke specialist teams have been commissioned to provide therapy for stroke survivors in their own homes to help them achieve recovery through specialist rehabilitation.

Community stroke teams are multidisciplinary teams that consist of individuals from different professions, such as occupational therapists, physiotherapists, speech and language therapists, nurses, rehabilitation assistants and administrators, who work collaboratively to address the needs of the patient holistically.

This blog post comes from; Andrew Wragg, Patient and Public Involvement & Engagement Facilitator, Research & Innovation Nottingham University Hospitals, NIHR Nottingham Digestive Diseases BR, Nottingham University Hospitals NHS Trust and the University of Nottingham.

Liver disease is a growing health burden and is currently the third leading cause of premature death in the UK with the death rate continuing to rise. This is despite the fact that the majority of liver disease results from lifestyle related risk factors including excess alcohol use, obesity (and related type 2 diabetes) and intravenous drug use.

Why are we not identifying liver disease earlier?
In primary care, we rely upon liver function tests (LFTs) to detect patients requiring further investigation for possible liver disease. This is an inadequate approach; LFTs are woeful at detecting liver disease before patients have symptoms. Subsequently in the UK, 50% of patients with cirrhosis are diagnosed for the first time when hospitalised with symptoms of liver failure resulting in a reduced quality of life and an increased risk of death and associated healthcare cost. In contrast, many patients with abnormal LFTs do not have liver disease, resulting in anxiety for patients who require unnecessary invasive investigations.

On Thursday (12 February 2015) we worked in our group and talked about our research proposal in more detail. There was a lot of strategic discussion, and also discussion around the practical issues of our study idea. We discussed how this international collaboration would be worthwhile for both the UK and also locally here in Brazil. We are living on a planet where people are living longer, and our research proposal would examine knowledge transfer activities in relation to catheter-related urinary tract infection (UTI) in our ageing population, not only in the UK but also overseas.  If there is an opportunity to share best practice with our international colleagues - lets take it as we all want better experiences and safer systems / processes for patients!

We're hoping to apply for funding from the Newton Fund. Again....watch this space! :)

Today, Wednesday 11 Feb 2015, we were spilt into groups. Myself and Reena Devi were in the same group with Andreas Xyrichis, a lecturer at Kings College London, with specialist knowledge in Ethnography (the study people and cultures) research, and two of our Brazilian colleagues, Cristina Miriam, and Cristiane Gallasch. We were given the task of brainstorming a potential collaborative research proposal around infection control that could be put forward for funding.

After a morning of brainstorming in our small groups we derived at a proposal of a qualitative study of knowledge transfer activities around catheter associated urinary tract infection. One of the main objectives of this idea is to explore how knowledge is transferred from infection control teams to clinical staff and then eventually to patients (with a particular focus on older patients). We're excited that this is a potential study where we could learn more about knowledge transfer activities between relevant partners. This could lead to a better understanding of what works to ensure best outcomes for patients and efficient use of infection control team resource.

On Thursday we look forward to refining this idea! Watch this space :)

Wow! São Paulo is a complete mixture; homeless people sleeping in cardboard boxes, huge roads, leafy streets with designer shops and beggars on the corner. On our first day here (Sunday 8 Feb) we were unable to get into our hotel so some of us got changed and caught a taxi to a local park where we could walk amongst the rainforest and say hello to the monkeys, the city is vast.  We also watched people doing yoga in this park - it was a 3 mile walk to this point - total dedication!

Yesterday, both the Brazilian and UK researchers did a ten minute presentation on who we are, what our background was and our research interests. Have already made good links with many colleagues in the UK contingent who come from Scotland, Wales and England but we have started to understand some of the challenges facing our Brazilian colleagues and the differences between our health and social care systems.

Myself and my colleague, Reena Devi, are flying out to São Paulo, Brazil for a workshop: "Qualitative study design in healthcare-associated infection research" that is taking place betwween February 9 and 13 2015, coordinated by Maria Clara Padoveze, School of Nursing, University of São Paulo (Brazil), and Stephen Timmons - Centre for Health Innovation, Leadership and Learning, University of Nottingham (UK).

This workshop is fully funded by British Council Research Links and by FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo) and relates to, two of our workstreams: Translating Research into Practice, and our Patient Safety Collaborative. It has provided financial support to gather a group from the United Kingdom and a group of researchers from the partner country, Brazil, whose members are at the beginning of their career.  Why are we there? Well, we're in Brazil because because Reena and I are both early year researchers.

The workshop will provide us with a unique opportunity for sharing research expertise and networking, with a focus on building up links for future collaborations and participants selected on the basis of their research potential and ability to build longer term links.

On Wednesday night I had the pleasure of hosting the East Midlands Academic Health Science Network's inaugural Innovation in Healthcare awards.

We received almost 100 award entries across the six categories, and the shortlist highlights the truly astonishing range of innovations that are improving services and saving lives throughout the East Midlands.

The find out more and see the shortlisted and winning entries, following this link.

Innovation is central to the East Midlands Academic Health Science Network: we were established to identify great ideas and spread them throughout our region and beyond - making sure that if something works well it is made available to everyone, irrespective of where they live in the East Midlands.

I was at the national launch of the 15 Patient Safety Collaboratives on Tuesday 14th - a London hotel ballroom rammed full of people waiting to hear from some experts on patient safety and share their ideas with each other. It started well with a panel of experts by experience and the acknowledgement that speaking out as a patient takes courage and often leads to labelling the patient as "difficult" and even leads to staff avoiding that person. Later on in one of the concurrent sessions I heard some more important messages on whether we really DO place the patient at the centre or is it much more about " .... patient safety until we need the bed " - a fair weather commitment to patient safety?

In a previous blog I mentioned the health and social impacts of alcohol on our region, and highlighted our work to progress early detection of liver disease. This is just one of the programmes EMAHSN will be supporting over the year ahead; other priorities include diabetes, supporting frail older people, stroke rehabilitation, tackling Chronic Obstructive Pulmonary Disease (COPD) and building patient and public engagement in decisions about healthcare services.

I attended the All-Party Parliamentary Health Group meeting recently. The subject – Public Health England: Improving the Nation's Health" featured some great presentations from colleagues from Public Health England, Jane Ellison MP Minister of State for Public Health and Cllr Jonathan McShane Cabinet Member for Health, Social Care and Culture London Borough of Hackney.