Abstract: Improving Patient Safety in Mental Health Services presents a unique set of challenges and there continues to be limited attention paid to it. This seminar will provide an insight into key issues and priorities for future research identified by staff, service users and carers. It will provide an overview of relevant work being conducted by Mental Health Research Group, School of Healthcare, University of Leeds. Examples of current work of the group include reducing restrictive interventions (restraint, seclusion and forced medication), designing safer services through improving transitions and staffing and broadening our understanding of safety incidents in inpatient mental health services.

Biography: John is the Professor of Mental Health Nursing at the University of Leeds. He leads the Mental Health Research Group in the School of Healthcare. His research focuses on the development of safe and effective mental health services and clinical interventions across secondary mental health care. He is a health services researcher who has used a variety of methods from qualitative studies to complex trials and has generated substantial research income via the NIHR including RfPB, HSDR, Programme Grants and charities such as the Health Foundation. The good practice manuals which he developed have been evaluated, cited as examples of good practice, and influenced clinical practice in the UK and abroad. The training package for patients, service users and carers to promote research awareness and understanding has been cited as an exemplar of good practice. He is also a non-executive director at Leeds and York Partnership NHS Foundation Trust.

Abstract: In UK healthcare there has been continuous development in data collection to monitor the quality and safety of care, in the form of both local and national programmes for quality improvement, clinical audit, incident reporting, mortality surveillance and digital technology, amongst others.  In the past, feedback from large-scale monitoring programmes has been limited.  Recently, the promotion of quality improvement methods has given rise to new models for effective use of data and advances across a range of disciplines afford us opportunities to better understand how to make feedback more useful and actionable for clinicians, teams and organisations.  Such approaches promise to translate data into interventions that support professional behaviour change, local quality improvement and robust implementation.  In this research seminar, the challenges and opportunities for enhanced feedback and local use of data will be outlined, drawing upon experience across a range of research projects that have applied human and organisational perspectives to topics in quality improvement and patient safety.  Specific applications include quality in anaesthesia, national mortality alerting and patient safety incident reporting and learning systems.  The relative merits of a model for continuous monitoring and feedback, based upon industrial quality improvement practices, will be discussed.

Biography: Jonathan Benn is Associate Professor in Healthcare Quality and Safety at the School of Psychology at the University of Leeds.  With a background in Psychology and Human Factors, he has 13 years’ experience as a health services researcher using applied theory and methods from the social sciences to address a range of research questions at clinical and policy level.  His previous post was a Lectureship in Quality Improvement at Imperial College London and as Director of the MSc course there in Quality and Safety.  His work has been supported by the Health Foundation, NIHR CLAHRC and NIHR Health Services and Delivery Research programmes.  He is currently an Associate Editor for the Joint Commission Journal on Quality and Patient Safety, which publishes international improvement research and practical case studies to share learning across contexts.

Presentation slides available here

Abstract: Clinical evidence that can improve patient outcomes does not reliably find its way into everyday care. The gap between evidence and practice limits the health, social and economic impacts of clinical research. Dissemination of evidence-based practice via clinical guidelines is necessary but seldom sufficient by itself to ensure implementation. Furthermore, the general practice context presents particular challenges – especially given limited practice organisational capacity, increasing workload and complexity of care, and competing priorities.

This presentation will report the key methods and findings from a major programme of work involving general practices across West Yorkshire.  We aimed to develop and evaluate an implementation package to support the uptake of a range of guideline recommendations and sustainably integrate it within general practice systems and resources.  We made our evaluation as pragmatic as possible to ensure relevance to ‘real world’ primary care.  Seminar participants can judge for themselves to what extent we met our goals.

Biography: Robbie Foy is Professor of Primary Care at the Leeds Institute of Health Sciences and a general practitioner in inner-city Leeds.  His field of work, implementation research, aims to inform policy decisions about how best to use resources to improve the uptake of research findings by evaluating approaches to change professional and organisational behaviour.  His former posts include a clinical senior lectureship at Newcastle University, and an MRC training fellowship in health services research based jointly between the Universities of Edinburgh and Aberdeen.  He is also trained as a public health physician.  He was a 2006-7 Harkness / Health Foundation Fellow in Health Care Policy, based jointly between the Veteran’s Administration and RAND in Los Angeles.  He was formerly Deputy Editor-in-Chief of the open access journal, Implementation Science.

Abstract: The early stages of judgement are the most critical for the final outcome of the diagnostic process. I will present studies that used different methodologies to measure the influence of this early stage on the diagnostic process and outcome. I will also present the design of a computerised diagnostic support system (DSS) prototype for General Practitioners. Designed to support the early stages of the diagnostic process, the DSS prototype was recently evaluated in a study with GPs consulting with standardised patients (actors).

Biography: Olga studied Psychology at the National University of Athens, Greece, and obtained her MSc and PhD in Psychology from Cardiff University. Prior to her current position, she held academic positions at King’s College London, and the University of Birmingham. Her main research interest is the application of psychology theory and methods to the study of medical decisions. She has conducted research on medical judgement in a variety of healthcare settings, using predominantly quantitative experimental methods. She aims to understand the cognitive biases that can lead to diagnostic error and delay, and test ways of reducing bias and supporting judgement. Her research has been funded by Cancer Research UK, the EU and the DoH. She is Associate Editor of the journal Medical Decision Making, has served as elected Trustee on the Board of the Society, and has chaired the Society’s biennial European meeting in London (June 2016). She has given short courses and MSc modules on the psychology of medical decision making to UK and international audiences.

Abstract: The use of medication is one of the most common interventions in today’s healthcare. Medication use takes place in many different settings and involves many different health care professionals as well as patients and their carers – and errors can arise at any stage. This presentation will set the scene by describing some of the problems that can occur, before considering some solutions and challenges, drawing on evidence in this field. Potential solutions include the use of technology (both high tech and low tech), human factors, system design, communication strategies and greater patient involvement. Suitable solutions must also take into account both a ‘medical’ view of safety (the avoidance of harm) and a ‘patient’ view of safety (‘feeling safe’). Challenges include the importance of context (what works in what setting may not work in another), fidelity of implementation, unintended consequences, and the ubiquitous nature of medication use and wide range of stakeholders involved.

Biography: Professor Bryony Dean Franklin is Director of the Centre for Medication Safety and Service Quality (CMSSQ), a joint research unit between Imperial College Healthcare NHS Trust and UCL School of Pharmacy, where Bryony is Professor of Medication Safety. She is a theme lead for both the NIHR Imperial Patient Safety Translational Research Centre and the NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London.

Bryony has been involved with patient safety research for nearly twenty years, and has published widely on medication safety, the evaluation of various technologies designed to reduce errors, and how we can support the public role in patient safety. Her current post combines research, education and training, and clinical practice as a hospital pharmacist. Bryony is an associate editor for the journal BMJ Quality and Safety, and on the editorial board for BMC Safety in Health. She is co-editor of the textbook “Safety in Medication Use” and co-author of “Going into Hospital? A guide for patients, carers and families”, a book aimed at the general public.

Presentation slides available here