Impact for healthcare…the additional requirement

We are all familiar with the word impact. However, for those within the academic world this word continues to take on importance as the need to demonstrate relevance and transferability of research outputs grows. No longer do the neat definitions above suffice, now we are provided with comprehensive resources, leading to detailed “Pathways to Impact” to guide us on our way…

I’ve written before on my concerns/disappointment on the apparent gap between my two worlds – academia and healthcare. Exciting academic advances don’t appear to be making it to our “front-line”, on the average ward, on a Tuesday morning at 10.15am. According to literature there are multiple interventions that should be working to improve hand hygiene…behavioural models that can be applied…future work that is recommended….but follow-up is often lacking. Publication dates stretch back over 10, 15 years now. And on a Tuesday morning at 10.15am does that hand hygiene occur..?

The additional requirement…

Be brave!

I find it interesting, then, that in many conversations I have with healthcare professionals (of all grades) the word I hear much more frequently than impact is brave.  The fundamental need to be brave enough to implement something new, something that may ruffle some feathers, something that may affect the “targets”, but ultimately, something that evidence suggests should lead to improvement. This takes bravery. And for long-term change, it takes more than individual bravery, there needs to be a network of clear, effective support from managers brave enough to defend new ideas and processes.

Such bravery feeds impact right where it matters, making differences to staff and patients alike.  It engages staff, and it improves patient safety and experience. A good example of this can be seen through the model of Front Line Ownership, whereby a brave decision to allow staff to be creative problem solvers led to increased engagement, and direct impact on patient safety – barriers to hand hygiene were identified and solutions proposed and implemented.

So, within infection prevention, within healthcare, and within academia, we need to ensure that impact does not become (remain?) a tokenistic term used only for the purpose of securing funding or reputation. We need to constantly question what practical benefit our work can have at the front-line, and a fundamental lever to this appears to be bravery. Will the intended setting, be it the NHS, the private sector, industrial partners or beyond, be brave enough to make the changes your research is suggesting?

#RAIB15 Brings me back to blogging!

I will get back to blogging…in fact, I have a half written blog that is almost ready to go… It’s just that it is sitting on my desk some 5,900 miles away.
In another country.
On another continent.
In another hemisphere…

Indeed. I’m as surprised as you. For someone who has managed to achieve a total academic/industrial/life geographical spread of approximately 25 miles, my current adventure marks quite the landmark!  (Perhaps influenced by location/in-flight entertainment, my mind turns to a certain South American ursine fellow, and I’d like to assure my own “Aunt Lucy” team that I am indeed being very well looked after…)

Identity role model?

So, here I am in Brazil, after day one of our collaborative workshop. Today has given all the participants opportunity to share short presentations outlining backgrounds, institutional key facts, and research highlights, and has been an eye-opening and enthralling introduction to an exciting week. I cannot pretend to do these talks justice in an off the cuff blog, but thoughts milling around my head this evening include:

Passion: all the participants spoke with such passion about their research, institutions and future aims…  How can we fail to produce something meaningful if we harness this?

Diversity yet overlap: apart from the obvious differences from the UK/Brazilian participants, we all also bring wide ranges of experiences; infection prevention, management, clinical skills, educational training, sociology… However, within this diversity there are already emerging themes and points of overlap…and it is only day 1!

Fun: The day has been underpinned by laughter, warmth and blossoming friendships. Surely this is the perfect environment from which to begin discussions about future, meaningful collaborations…?

Looking forward to tomorrow…

(follow our progress on twitter #RAID15)

The two-headed monster at #IP2014

After a busy few weeks of holiday followed by personal quarantine, I thought it was time I put pen to paper and shared some of the thoughts I’ve been having whilst reflecting upon my time at Infection Prevention 2014…(#IP2014).

Being an “academic” in a “real-world” situation is a great privilege, it allows you to get a real sense of the current state – something which can be missed if you only rely on feedback from academic papers and conference discussions.

My new role within a medical setting has changed the way I interpret information. It is not that I am no longer optimistic – far from it, I am, and always will be, an optimist – but now I have a wider appreciation for the reality of infection prevention “as it is”. Day to day. On the front line. And this is not a negative, difficult reality view. Or one filtered through an anti-research, anti-forward thinking environment. On the contrary, as I have the pleasure of working with the 2013 IPS Team of the Year, noted for their continuous focus on engagement activities and involvement with research and development, both with IPS and the RCN.

However, it is certainly a different position to be in.  And it made my experience of #IP2014 very different from my previous ones.  Let me explain…

In 2012 and 2013 I experienced the IPS conference through the eyes of a “pure” researcher, eager to know what was “out there” in terms of new data, new approaches and concepts, and potential new technologies to appraise.  I felt optimistic because infection prevention seemed to be moving at such a pace, swept along by incredible passion, determination and enthusiasm.  The wealth of information produced, through conference papers, journal articles, webinars and seminars was mind-blowing, yet incredibly welcome to a researcher “new” to the field.  Now, having completed my thesis and with more experience under my belt, I am much more concerned about what impact all this information could have on the way we work within healthcare. As I see it, from paper to practice.

image from http://www.coloringcrew.com

So I felt very much like a two-headed monster through most of the conference sessions I attended – one brain very excited about recent findings, theoretical discussions and endless potential, whilst my “other” brain was much more pragmatic, continually asking the questions “how would this impact healthcare professionals on any given Tuesday?”, “is this feasible”, and sometimes just a rather pointed “Really?!”.

Team inf_con at #IP2014 (image from @allisoncbradley)

 

The saving grace (that prevented one or both of my heads exploding) was the delightful new experience of attending the IPS conference as part of a team. Each session we attended, together or individually, was followed by the opportunity to discuss implications for our Trust, our staff and our patients. This directly addressed my “paper to practice” dilemma, and kept the two headed monster calm.

Darren sharing one of our posters

As a team we were very excited to be presenting three posters (.pdf here: 1, 2, 3) outlining a diverse selection of our current activities, and also providing an oral presentation on how we won the inaugural IPS Team of the Year award (abstracts available here).  I could not have been more proud of the enthusiasm, excitement and energy displayed by my colleagues; something which I am sure did not go unnoticed by the rest of the #IP2014 community. 

A key aim of my role within the team is to ensure that research is conducted which not only involves healthcare professionals, but which is driven by them. Therefore I was particularly proud to be involved in delivering our posters which outlined research instigated, and conducted, by current active healthcare professionals. It’s exciting to know that this is just the start…

Wonderful memories of #IP2014 (image from @darrenwheldon)

An open admission…

So here it is.

As we know, I have now safely navigated through the PhD journey, and can officially say I have qualified as a Doctor of Engineering. My thesis, which examines future systems of hand hygiene measurement in healthcare, will soon be available for anyone to read.  Amazing.

Image from: http://manpreetdhuffar.files.wordpress.com/2013/04/photo1.jpg

Even more exciting (not sure I ever thought anything would top that…which shows you how much a PhD can change you!), we also know that I have now started working for the NHS – with the phenomenal IPCT at UHCW. 

Now two weeks into my role as IPC Research Practitioner and I have been blown away by how much I am enjoying myself, how diverse the workload and challenges that face the team are, and crucially how overwhelmingly welcoming the team have been.  I never doubted that for a second, but they have surpassed even my high expectations. I have LOVED every moment I have been there, and am so excited about the plans we have been making.  One thing I know for sure…we’re going to be BUSY!

And my admission?

I am SMUG.

I cannot help it. I have tried to battle it, but to no avail.  I just cannot help randomly smiling whenever I think about how much I am enjoying my new post-doc freedom, the ability to offer an “expert” opinion on real world, patient safety matters, and to be given the opportunity to develop research ideas that could make a difference to the way we think in the IP community.  It’s fantastic, and the picture below sums it up beautifully.

Whilst I enjoyed my PhD journey immensely, there is an element of being “caged” – when all is said and done, the main purpose is to develop as a researcher, and ensure you display skills required to earn the qualification.  Once this has been achieved, the freedom is granted to really focus on the research area…and this feels immense!

Image from: http://www.wayofcats.com/blog/wp-content/uploads/2011/04/Smug.jpg

Double Headline Week #UHCW #IP2014

Having returned from a lovely holiday, it’s been such an exciting week so far – two major headlines:

1. I officially started my new role as Infection Prevention and Control Research Practitioner with the wonderful IPCT at UHCW. I had an amazing couple of days, sitting in on meetings, watching team members prepare to spread the love (#IPSWales) planning our summer of research activities, and taking part in my very first team schimee.  Cannot believe I get to do this every week now!
2. We had our abstract accepted for #IP2014 – we’ll be there sharing our work on how ATP screening may help increase engagement with environmental cleaning… Look for the #TeamGreen poster.  The team have also been successful with other abstracts, but I’ll leave it to them to share that news over on their twitter feed….

 

 

Not sure what next week will bring, but tomorrow I have my final Warwick Women In Science (WIS) meeting before we announce our WIS A Day With…2014 plans, so I am sure there will be plenty more excitement to come…

Reflections on @BCUHealth #SaferCare14

Now I have had a few days to reflect on the BCU Safer Care Conference (#SaferCare14) I thought I’d jot down a brief overview, and then provide an update on what happened after my workshop…a session which involved a lot of talking, sharing of experiences, and post-it-notes…

The day started strongly with three high flying expert speakers addressing the diverse range of delegates.

 

photo @quality_safety1

Prof Laura Serrant-Green explored a history of nursing, highlighting that it was through the collection of evidence (relating to the health of those living in abject poverty in slums) that public health was driven to improve.  This theme has continued with each major change that humanity has faced, be it global warming, industrial incidents, or the increasing threat of antimicrobial resistance. Healthcare has to respond to change.

Key to her talk was that nursing, and healthcare in general, can be viewed as a combination of science and art.  It is a science to create new evidence, but it is an art to be able to translate this evidence and make it understandable for all…

 

photo @quality_safety1

Professor Mark Radford presented a compelling case for why research is relevant to everyone, encouraging the delegates to “be brave” and not to look at “dead end questions”.  A fun quiz regarding “real” research definitely won over the audience.  Much interest was also generated by his presentation of the UHCW CARE Model, a collaborative research approach rolled out at UHCW to widen participation and scope of research, to the benefit of all.

 

photo @quality_safety1

Ann Casey gave a wonderfully engaging talk beginning with a personal story about her experience with a patient named “Ted”. This experience was the trigger point for her to begin her research journey, and provided necessary motivation in the face of common barriers – including self-doubt, lack of time and lack of skills.  Despite always knowing that something needed to change, it wasn’t until Ted came along that Ann was able to find the courage to break the cycle and trigger the change herself.  It wasn’t easy, but she soon found that help was there if sought, and by taking a research approach change has occurred…

 

After these inspiring talks the delegates, refreshed from lunch, were able to develop their research skills through a series of tailored workshops.   I ran one looking at common barriers to research, which allowed delegates to explore their experiences and perceptions of what prevented them being involved in research, and together we generated ideas of how these barriers could be overcome.

This involved lots of discussion, and the use of post-it-notes, which I have now been organising into common themes.  We used a framework based on the work Roxburgh (2006), who highlighted factors limiting nurses’ participation in research, and the workshop output appears to extend and develop this.  I’m quite excited with the data we’ve produced, and look forward to sharing it with the delegates and beyond shortly…

Until then, I’m just happy that I’ve managed to keep the post-it-notes in order…they did seem to get everywhere!!

What’s on the spinning plates?

Image: J Gagnepain (Flickr)

 

I am delighted to be sitting here writing this blog, surrounded by scribbled notes, open books and half written Word documents… Some people would find this a nightmare, but to me it indicates that once again, many plates are up and spinning!

After my viva I experienced a bit of a low, as I had quite a wait before I received my modifications, and I wasn’t yet able to start working on a number of projects a little further down the pipeline. I found this hard to deal with, as my viva had left me so motivated about my research, and inspired me to really pursue my aspirations to make changes within infection prevention. To then find myself “stationary” was frustrating, confusing and unexpected.  Therefore, now I am past that, my corrections complete and my new projects underway, I am even more excited than I was back in April. I’m not sure how I’ll cope in a month or so when the next wave of “new starts” occurs*…!!

So, what’s new?

• I’ve been working hard in my role as Chair of Warwick Women in Science (WIS), alongside my amazing Vice-Chair, and we’re close to finalising the details of our annual symposium, WIS A Day With…2014. We’ve also expanded the vision for WIS, and are generating funding to allow us to run additional events and outreach activities throughout the year. By September we should have our own webpage up and running to complement our existing twitter feed.

 

• *I’ve been vetted, double-vetted, referenced, photographed and jabbed, which can mean only one thing…I’m joining the NHS! Expect excited news on this around the middle of July…keep your eyes on Twitter…

 

• Previously I’ve mentioned my firm belief that healthcare professionals have a clear place in research – not only participating in research studies, but also instigating new work, designing studies, and disseminating findings to varied audiences. Therefore I eagerly accepted an invitation to run a workshop at the BCU Safer Care Conference (#SaferCare14), addressing the common perceptions healthcare professionals hold regarding “barriers” to research involvement. We had a most enjoyable session, with flurries of post-it-notes and many ideas on how to overcome these barriers. I’m now going to pull together all the ideas and share them with the delegates. Feedback on the day was positive, and it was reassuring to know that there is a definite enthusiasm from healthcare professionals regarding research…we need to ensure this is built upon!

 

• With my lovely, inspiring superstars at UHCW IPCT I submitted an abstract for IP2014. I also helped with the judging of the entries this year (although not mine, obviously…!), and have to say the standard was excitingly impressive. I am so looking forward to seeing the final programme, and hope to attend so I can see the posters. I always find posters at conferences an exceptionally useful source of information, especially as you can go back, back and back again during the event – something not possible with an oral presentation.

 

There have been a few other exciting events going on, but I have to wait to share them. This will include my research on hand hygiene, and also some really exciting discussions I’ve been having with other scientists as part of The New Optimists. Fortunately I’ll be able to blog more going forwards, so expect shorter, more timely updates…

The next blog will provide a whistle-stop overview of the BCU Safer Care Conference…

 

 

 

 

 

 

The “Overdue Update” Blog – Updated!!

WalktheWalk.org Update

As mentioned in the last post, I have been part of a team training for the 2014 London Moonwalk.  I just wanted to thank everyone who sent support and donations, the texts, emails, tweets and personal messages really kept us going.  It was a tough event but we were so proud to take part.

Our debrief blog, including details of what shall always be known as “the lamp post incident“, can be found here….

Thank you, you have made such a difference.

The “Overdue Update” Blog…

SO, here I am back blogging at exploringhandhygiene – it’s wonderful to have the time and opportunity to share my recent activities within the research sphere of infection prevention. Therefore, without further ado, let’s crack on!

• What’s happened to my PhD research?

First, the big news – since my last post I am happy to announce that I successfully defended my thesis in my viva examination!  I had a very enjoyable examination, aided by superb examiners and a moderator who kept the atmosphere friendly, helpful and conducive to meaningful discussion, rather than making it in anyway seem like an interrogation.  My overwhelming thanks must therefore go to Professor Judith Tanner (external examiner), Dr Tina Barnes (internal examiner) and Professor Paul Jennings (viva moderator).

I am now working on my minor modifications, and also working on the feedback from a number of peer reviewed papers stemming from this research.  I’ll update on the progress of these outputs here in due course.

• How I marked May 5th

Whilst I was not able to be online for May 5th – the WHO SAVE LIVES: Clean Your Hands campaign – I did write a guest blog for Deb Group, which you can read here. This explores the origins of the WHO 5 Moments, the role of hand hygiene in helping stop the rise of antimicrobial resistance (AMR), and the importance of producing meaningful data when measuring hand hygiene compliance if we want to change behaviour.

• My latest research plans

Now that I have (almost!) completed my PhD I am working on plans to further key strands of the research in order to improve practice within Patient safety.  The core aspect of my work is Meaningful Data for Behaviour Change, and this involves psychology, human factors and technology.  As I have a strong belief that research should have a practical application I will be looking to maintain close links with day-to-day infection prevention activity, and increase the level of involvement of front-line healthcare professionals in research: exploring issues that they identify as important for Patient safety.

• What I’ve been doing outside the hand hygiene bubble

Finally, because it has been an unusual time, I have been offline quite a bit recently – hence the blog/twitter silence.  This is in part due to a technical hitch (I’m awaiting a new shiny machine, as currently my old faithful laptop is on the way out to pasture), but mainly due to taking some time out on holiday, AND training for the walkthewalk.org London Moonwalk 2014.  You can read all my team, and our motivations here – plus see some rather spectacular training photos…!

 

Coming soon….

Come back here later this week (w/b 5th May) to find out:

• What’s happened to my PhD research…
• How I marked May 5th….
• My latest research plans….
• What I’ve been doing outside the hand hygiene bubble…

Looking forward to returning to blogging!