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Clinical Outcome Modelling Saves Lives

Summary of the impact

  1. Practitioner/professional service impact. Our work on clinical outcome modelling has influenced the Royal College of Physicians' (RCP) new standard for the assessment of the severity of acute illness (known as the "National Early Warning Score" or NEWS). The specific recommendation is for adoption by NHS bodies, but is already being adopted internationally.
  2. Health impact. The chairman of the RCP working party estimated that our work could result in the saving of thousands of lives per year.
  3. Economic impact. Our work is incorporated in the VitalPAC system developed by The Learning Clinic Ltd (TLC), and currently deployed to more than 20 hospitals.

Submitting Institution

University of Portsmouth

Unit of Assessment

Computer Science and Informatics

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Nursing, Public Health and Health Services

Improving the Safety and Quality of Healthcare Delivery Using Routine Data

Summary of the impact

Imperial College researchers have developed methods and indicators for highlighting potential variations in healthcare performance and safety using routinely collected health data. Analytical tools based on our methodological research are used by managers and clinicians in over two thirds of NHS hospital trusts, and hospitals throughout the world. The results of our analyses helped detect problems at Mid Staffordshire NHS Foundation Trust and triggered the initial investigation and subsequent public inquiry with wide ranging recommendations based on the recognition of their value and their use in enhancing the safety of healthcare.

Submitting Institution

Imperial College London

Unit of Assessment

Clinical Medicine

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Influencing national policy to improve service delivery and patient care in gastroenterology

Summary of the impact

Between 1996 and 2013 researchers at Swansea University evaluated service initiatives and changing professional roles associated with the management of patients with debilitating gastrointestinal disorders. This work showed the clinical and cost effectiveness of two main innovations: open access to hospital services for patients with inflammatory bowel disease; and increased responsibility for nurses, particularly as endoscopists. Our evidence has had a broad, significant impact on: national policy through incorporation in NHS strategies, professional service standards and commissioning guides; service delivery through the provision of increasing numbers of nurse endoscopists and the wide introduction of nurse-led open access to follow-up; and patient care, as documented in sequential national audits in 2006, 2008 and 2010.

Submitting Institution

Swansea University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Nursing, Public Health and Health Services

Health related quality of life measurement in clinical trials

Summary of the impact

Ensuring that a new medicine improves or maintains a person's quality of life is important. Abbott's longstanding collaborative relationship with health professionals and service users has enabled the development of two patient-reported, quality of life instruments (CFQoL, LupusQoL). Abbott's expertise has contributed to the development of policy/guidelines concerning quality of life measurement in clinical trials for the European Medicines Agency and European Cystic Fibrosis Society. The instruments have been adopted internationally with the LupusQoL providing a global business opportunity for a US translation company. At the request of pharmaceutical companies, the LupusQoL is translated into the numerous languages required for use in their multi-national clinical trials of new medicines.

Submitting Institution

University of Central Lancashire

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Public Health and Health Services

A clinical management service for stroke prevention

Summary of the impact

Helicon Health is a UCL spin-out company providing a stroke prevention clinical management service (Helicon Heart) developed through UCL health informatics research. In partnership with Whittington Health, a large north London hospital, Helicon Heart provides stroke prevention management to 5 NHS Clinical Commissioning Groups (CCG) across north London and Hertfordshire, covering 2 Hospital Trusts, 30 General Practice delivery sites and 3 Community Pharmacies. The system underpins clinical care for 3,000 at-risk patients, and Helicon Health has secured additional contracts to extend this to 4,500 patients in 2014. Every prevented stroke saves the NHS £16,000 per annum; the estimated saving to each CCG is approximately £500,000 per annum, to which the Helicon Heart service makes a significant contribution.

Submitting Institution

University College London

Unit of Assessment

Computer Science and Informatics

Summary Impact Type

Health

Research Subject Area(s)

Information and Computing Sciences: Artificial Intelligence and Image Processing, Information Systems
Medical and Health Sciences: Public Health and Health Services

C5 - Improving the safety and quality of healthcare delivery using routine data: improved statistical monitoring techniques

Summary of the impact

Statistical analysis and methodological development carried out by Imperial College London on data from the Bristol Royal Infirmary Inquiry and the Shipman Inquiry have led to new monitoring systems in healthcare. Using routinely collected healthcare information, we have highlighted variations in performance and safety, impacting the NHS through direct interventions and/or policy change. For example: (i) findings and recommendations arising from our research for the Bristol Inquiry were reflected in the final inquiry outputs, which highlighted the importance of routinely collected hospital data to be used to undertake the monitoring of a range of healthcare outcomes, (ii) a range of monitoring recommendations have arisen as a direct result of the research on data from the Shipman Inquiry, (iii) analytical tools based on our methodological research are used by managers and clinicians in over two thirds of NHS hospital trusts, (iv) Imperial's monthly mortality alerts to the Care Quality Commission were major triggers leading to the Healthcare Commission investigation into the Mid Staffordshire NHS Trust.

Submitting Institution

Imperial College London

Unit of Assessment

Mathematical Sciences

Summary Impact Type

Health

Research Subject Area(s)

Mathematical Sciences: Statistics
Medical and Health Sciences: Public Health and Health Services

Influencing Emergency Healthcare Policy and Practice

Summary of the impact

The emergency care team at Warwick Medical School has a strong track record of high-quality health sciences research encompassing evidence synthesis, health-services research and clinical trials. Our trials of a 03b2-agonist (salbutamol) in acute respiratory distress syndrome (ARDS) have influenced therapeutic recommendations in the International Sepsis Guidelines (2013), reducing the use of this potentially detrimental therapy. Our cardiac arrest research informed the 2010 international guidelines on cardiopulmonary resuscitation (CPR) led to the generation of new intellectual property, and prompted industrial collaborations to build new technologies, such as TrueCPRTM (2013). These have led to improved CPR practice and improved patient survival. Furthermore, our research has led to major policy changes and to a redesign of UK emergency healthcare, improving cost efficiency, the patient experience and clinical outcomes (e.g. 95% of patients were treated within 4 hours - up from 65%; and people leaving without been seen reduced to less than 5%).

Submitting Institutions

University of Warwick,Liverpool School of Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Reducing unnecessary attendance at hospital emergency departments by improving care out of hospital

Summary of the impact

Care provided to patients by emergency ambulance services is changing nationally and internationally. For example the proportion of 999 calls in England resulting in conveyance to hospital fell from 68% in 2007-8 to 55% in 2012-3. Professor Snooks of Swansea University and colleagues have collaborated with clinicians, policy makers and academics to identify approaches more cost-effective than routine conveyance to Emergency Departments (EDs) for many patients. International application of Snooks's evidence that telephone advice, decision support and referral pathways are safe and effective has reduced unnecessary attendance at EDs and costs without compromising patient experience, safety or quality of care.

Submitting Institution

Swansea University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Nursing, Public Health and Health Services

International Standards for Nursing Terminology

Summary of the impact

International Standards for Nursing Terminology is focused on supporting nursing practice internationally, through the application of theoretical informatics research, demonstrating the following impact:

  • Bringing together practice-level data from a range of sources and utilising the Web Ontology Language (OWL) within a nursing context, leading to the development of a formal foundation for standardised terminologies for nursing;
  • The only nursing-specific terminology within the World Health Organisation Family, the International Classification for Nursing Practice (ICNP®) has been accepted as a Related Classification within the World Health Organisation Family of International Classifications (WHO-FIC);
  • Translated into 16 languages ICNP is emerging as an international standard for nursing, facilitating more effective nursing care and improved patient outcomes.

Submitting Institution

University of Salford

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Societal

Research Subject Area(s)

Information and Computing Sciences: Information Systems
Medical and Health Sciences: Nursing, Public Health and Health Services

Better clinical outcome monitoring and healthcare quality through the use of graphical methods

Summary of the impact

The Variable Life-Adjusted Display (VLAD) is a graphical tool for monitoring clinical outcomes. It has been widely adopted by UK cardiac surgery centres, and has helped a shift in culture towards more open outcome assessment in adult cardiac surgery, which has been credited with reduced mortality rates. VLAD is also being used for a broad range of other clinical outcomes by regulatory bodies worldwide. For example, Queensland Health uses VLAD as a major part of its Patient Safety and Quality Improvement Service to monitor 34 outcomes across 64 public hospitals, and NHS Blood and Transplant uses VLAD to monitor early outcomes of all UK transplants.

Submitting Institution

University College London

Unit of Assessment

Mathematical Sciences

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

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