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The impact of educational research from the Rothschild Centre for Clinical Simulation and Education Research (RCSER) at Imperial College London has progressed from the development and validation of simulators and skill assessment, through to shaping guidelines for training curricula and continued professional development in the NHS and beyond. This body of multidisciplinary research brings together Imperial's contributions in simulation science, skills assessment, performance-shaping factors, educational theory and surgical practice to contribute to national and international healthcare education and policy. The work impacts upon clinical practice at regional, national and international levels, with far-reaching implications for the quality and safety of patient care.
The MRC Conventional versus Laparoscopic-Assisted Surgery In Colorectal Cancer trial (CLASICC) is the largest and most successful UK trial of a technology applied to general surgery. It addressed an area of huge clinical uncertainty, providing a rigorous evaluation of a new technology and enabling its safe and widespread implementation. The impact of CLASICC has been global, confirming the advantages for patients (quicker recovery) and healthcare providers (cost-effectiveness) and so influencing national and international policy in favour of the laparoscopic technique. It informed NICE guidance and led to a major DH initiative that has seen the UK become one of the largest providers in the world of laparoscopic colorectal cancer surgery. CLASICC is regarded as a benchmark surgical trial, combining high quality trial design with rigorous quality assurance, which has informed the design of many subsequent colorectal cancer studies.
We have developed resources that have been widely used, nationally and internationally, to support the education of healthcare professionals and nurses. Our aim is to enhance the safe care of patients.
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.
Research on the theoretical and experimental assessment of the stability of damaged ships in the Department of Naval Architecture and Marine Engineering from the mid-1990s to the present day has been pivotal in the development, adoption and implementation of the latest amendment of the International Convention on Safety of Life At Sea (SOLAS 2009) by the International Maritime Organization (IMO), the UN body regulating maritime safety. The impact of these regulations has been a significant reduction in the risk to human life at sea by enabling ship design and operation with higher standards of damage stability. SOLAS 2009 represents a step change from deterministic to probabilistic rules and from rule compliance to goal-based standards; it has improved design and operation of all commercial ships built worldwide from 2009, and has thus resulted in far-reaching and long-lasting impact on maritime safety.
Developed from Loughborough University research into the employee impact of safety management, the Loughborough Safety Climate Assessment Toolkit (LSCAT) has helped change attitudes and raise awareness across a variety of industry sectors. Freely available in the public domain, it has facilitated the assessment of safety climate as part of a process of culture change and wider management system enhancement. Beneficiaries during the impact period have included the Royal College of Nursing and the NHS, which have used the tool as a "fundamental" means of benchmarking best practice, and logistics giant DHL Supply Chain, which has used it to identify specific areas for improvement in its safety management systems.
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.
Maternity staff from hospitals in the UK and around the world have benefited from training to improve their communication and team-working skills in emergency situations. This has been achieved through input into a standard training manual now in wide use, and through the development of course content used in `train-the-trainer' sessions for consultant obstetricians, consultant anaesthetists and senior midwives who have in turn been able to train their colleagues. Research findings at UWE, Bristol, contributed to showing that clinically better results correlate with specific linguistic behaviours. The findings of the work made a direct contribution to this training content.
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.
(1) Enhancing the awareness of (i) women of childbearing age suffering from epilepsy and prescribed new and/or older generation AEDs, and (ii) their healthcare professionals. Empowering both to make informed decisions through evidence-based practice that will reduce/prevent the risk of harm to unborn children potentially exposed to AEDs in early pregnancy.
(2) A change in the process by which GlaxoSmithKline (GSK) practices post-marketing epidemiological surveillance of the new generation AED `lamotrigine' in pregnancy.
(3) Benefit to the methodological practice of other researchers in Europe involved with AEDs and epidemiological surveillance
(4) Contribution to building European system for reproductive safety evaluation