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Research into understanding and addressing the gaps between evidence and practice in health care has been conducted and applied at the University of Manchester. Working within the Department of Health funded National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester, research teams have applied an evidence-based approach to knowledge mobilisation to improve the identification and management of two vascular related conditions: impaired glucose tolerance (IGT) and chronic kidney disease (CKD). As a result of the initial pilot projects in Greater Manchester 1863 new CKD patients have been identified with the success leading to a further implementation programme that has spread to other areas of the UK. The IGT pilot project has directly led to the improved health of targeted patients in two areas of Greater Manchester.
Research conducted at the University of Manchester (UoM) has shaped the design of national systems of accreditation for general practice in the UK, Europe and beyond. Accreditation systems set standards that reflect key aspects of the organisational systems and processes in general practice that are needed to ensure delivery of good quality care. Accreditation systems also provide a kite mark of quality assurance and act as a platform for supporting continuous quality improvement. UoM developed indicators of quality in general practice structure and organisation and demonstrated how they could be used effectively to improve quality. Working in partnership with health professional organisations, governmental organisations and other universities, UoM used knowledge from the research to develop systems for general practice accreditation now used in the UK and across Europe.
The University of Aberdeen's Business School has built a strong programme of research focussing on managing strategic change, particularly in the healthcare sector. Using a conceptual framework which explores the complex interplay between organisational context, content and process, the University has completed a number of studies looking into patient safety, quality and service redesign, four of which are described here. Because the work routinely involves health care stakeholders across the research pipeline, from articulation of the research problem, through to recommendations and the delivery of solutions, impact is wide-ranging, including changes in staff behaviours, improvements to safety, and significant financial savings.
Research at the university of ulster into the theory and practice of person-centredness has resulted in:
i. the development of person-centred practices that lead to better outcomes for patients, staff and teams.
ii. the influencing of policy for the development of person-centred services.
International Standards for Nursing Terminology is focused on supporting nursing practice internationally, through the application of theoretical informatics research, demonstrating the following impact:
Bournemouth University (BU) has facilitated improvements to health and social care practice through cultural change in care provision. Researchers developed a practice development framework for implementing and assessing the delivery of evidence-based practice in 82 UK health and social care units during the impact period. Benefits to staff include better communication and team structure. Benefits to patients include higher standards of cleanliness, privacy and dignity, as well as a decrease in length of hospital stays and appointment waiting times. Delivery has extended to cover entire NHS Trusts serving a resident population of over 3.5 million, social services departments and third sector organisations across the south of England and beyond. The research has since been applied to develop a similar system in Australia.
The Healthy Settings Unit at UCLan www.uclan.ac.uk/hsu has contributed to the adoption of the `whole system' settings approach to the promotion of health and wellbeing within a range of sectors nationally and internationally — including higher education and criminal justice. This impact has included: recognition of higher education as a key setting for health improvement by the UK Government, World Health Organization (WHO) and International Union for Health Promotion and Education (IUHPE); implementation of Healthy Universities as a model for promoting student, staff and community wellbeing by an expanding number of higher education institutions (HEIs) within the UK and globally; and investment in and roll-out of a whole system Healthy Prison model across North West England — stimulating extensive national and international engagement and debate.
Empirical evidence generated by UEL research has directly influenced the reform of health financing in two Indian states with total populations of 154 million through changes to provider behaviour, the organisation and use of funds, and treatment verification processes and package rates. The impacts of this work have been commended by the UK Department for International Development (DFID) and the World Bank, and attracted interest from states with similar healthcare schemes. More widely, it has helped policymakers in India and the UK recognise the importance of including high quality comprehensive primary care in India's strategic planning for universal health care, and the benefits to the UK in prioritising primary care collaboration with India.
Advanced practice roles in nursing (APN roles) have been developed widely across a range of healthcare settings and organisational boundaries in response to government policy directives. A programme of research has been undertaken to generate robust evidence of the contribution of APN roles to healthcare. Research outputs include a theoretical framework to evaluate the impact of these roles. This framework has been used to underpin the development of a practical toolkit to assist practitioners to demonstrate their impact on patients, staff and the organisations in which they work. Beneficiaries include policymakers, professional organisations and NHS providers and individual practitioners.
Improving patient experience of health services is a policy priority worldwide. The University of Manchester (UoM) has conducted research on patient experience since 1995, leading to the development of a series of validated measures for assessing patient experience of quality of care in primary care, including access to care and the degree to which services are patient-centred. Our measures have been in routine use in the NHS since 2004, sent to samples of several million patients. The data have been used to provide incentives for the highest quality practices, and to inform policy makers about current care throughout the UK.