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Fiona Dobbie, Research Fellow in the Institute of Social Marketing has blogged in the Times Higher Education:
“I turned 40 this year, and rather than indulge in the clichéd symptoms of a mid-life crisis (getting a tattoo, having an affair, Botox) I am in my second year of a part-time PhD.
“It’s not that my life isn’t fulfilling or challenging enough. I am typical of my age: happily married with an energetic 6-year-old, fortunate to have friends and family and a full-time job as a university research fellow. So why am I doing a part-time PhD?”
Click here for the full article, published 12 March 2017.
Carrie Milligan graduated from the University of Stirling in November 2016 with a Masters in Advanced Practice. Her dissertation was a Quality Improvement Project and focused within her work place.
She was awarded a Research-Based Learning Prize for her dissertation titled: Maintaining the functional ability and quality of life of patients leaving hospital: improving information sharing with care home staff on discharge from an organic assessment ward.
We found out about Carrie and her work:
Tell us about your project:
I am a Specialist Occupational Therapist working in older peoples’ mental health. The project was focused in the organic assessment ward that I work within. It looked at the communication process from the inpatient setting to the care home. Our patient group is complex, and admission lengths at the commencement of the project were, on average, 98 days. There is some evidence that patients’ quality of life and functional ability decreases on discharge from hospital. I wondered if improved information sharing could also lead to improved outcomes for patients.
The discharge communication process is reliant on one nurse disseminating the assessments, interventions and treatments of the multi-disciplinary team on discharge. This means that important information from other clinical disciplines, such as occupational therapy, were not being shared with care homes when patients were discharged from hospital. Consistent and timely information sharing between the multidisciplinary teams hospital and care home staff sounds simple, but is not as straightforward as it seems.
What was the aim of your project?
I aimed to develop and implement a new information care procedure to make sure care homes were receiving all appropriate information about a patient when they were discharged. We were interested to find out if this process would also lead to improvements in patients’ quality of life, functional ability and Body Mass Index (BMI) on transfer.
How did you carry it out?
I used various methods recommended by the Improvement Science approach. A new discharge form was created through consultation with members of the multi-disciplinary team and community staff, including social work. Staff engagement was vital. Continuous education about the new project was required to inform and engage with new ward staff.
The impact of the project was measured using questionnaires with staff in the ward, care homes, and the liaison mental health team. Patient outcomes were measured using quality of life and functional ability scales, and body mass index (BMI) before and four weeks after discharge. Audits of the new discharge form measured how regularly and correctly staff were using the form.
What was the impact of your project?
Twenty patients were discharged from the ward over 6 months using the new discharge form: 13 were discharged to a care home and 7 returned to their own home. The 13 patients’ discharged to care home were evaluated pre-discharge and post-discharge at 4 weeks by telephone to the care home. One patient died during this time.
Over the six months of the project 98% of professions engaged in the form’s completion. The 12 patients demonstrated an increase in their BMI, 42% improved or maintained their functional ability and 75% improved or maintained their quality of life. All care homes reported a benefit to the increased information to their care of the patient.
This impact of improved sharing of information from hospital to care home appeared to improve patients’ quality of life, function and BMI on their transfer to a care home setting.
What were your conclusions?
The use of the new multi-disciplinary discharge form increased the level and consistency of information disseminated to a care home on discharge. The information aided care homes to shape their care for the patient.
There appears to be a positive impact of improving communication between the ward and care homes on patient outcomes as demonstrated through their BMI, Quality of Life and Functional Ability on discharge. However, this improvement was only measured over a short time frame with a limited number of patients, and without any control group.
What next for the project?
This project has shown that improved information sharing systems can increase the range of important clinical information that is shared and may benefit patient outcomes. I hope to continue to improve the discharge information sharing processes on the ward.
27 January 2017
“When you hear the word “cancer” probably the last thing that you think of is physical activity. In fact, most of us think of cancer as a death sentence. Treatments for cancer make many people feel lousy and the side effects of treatment include fatigue, anxiety, nausea, vomiting and pain. So it is hardly surprising that people who are diagnosed with cancer are not reaching for their running shoes or gym kit.”
Read Dr Gill Hubbard’s full article Cancer and exercise do mix in The Conversation.
19 October 2016
Shared decisions, shared goals: Trauma amputees’ clinical experiences and communication with their prosthetists
During the Iraq and Afghanistan conflicts there was a rise in the number of trauma related military amputees with complex prosthetic needs. The level of prosthetic provision from the Ministry of Defence at that time was anecdotally high and the expectation was that the responsibility for this level of provision would be passed to the NHS when military amputees were discharged from the Armed Services. This brought about fears from NHS prosthetic providers and veteran charities around how this transition of care would be funded in the best interest of veteran amputees.
As a trained prosthetist I was also curious about how the switch of care from the Ministry of Defence to the NHS would be managed in a practical sense as well as how the NHS would manage the provision of high end prosthetic limbs within restricted prosthetic budgets. It was this interest that led me to undertake my PhD at the University of Stirling.
My project aimed to explore the decision making of prosthetists working within the NHS in Scotland with experience of treating amputee veterans. I also wanted to explore military and civilian trauma amputees’ experiences of involvement in their prosthetic care. This was achieved through analysis of a series of interviews with members of four clinical and managerial groups involved in the delivery of prosthetic care in the NHS and interviews with civilian and trauma amputees. Due to the exploratory nature of this project qualitative semi structured interviews were used to collect data which was then analysed using thematic analysis. Staff and amputee data was analysed separately.
The stories of the amputees included in my thesis show that the circumstances which led to their amputation can have a lasting effect on their rehabilitation journey. Those who have lost a limb through trauma, whether in a civilian or military setting, have experienced a unique set of experiences. This can greatly impact the way they view their amputation as well as the way they interact the clinicians who are involved in their prosthetic rehabilitation. The effect of this suggests that prosthetists and other clinicians involved in the care of trauma amputees should be conscious of the circumstances which led to their amputation and take that into account in the rehabilitation process.
My thesis Exploring decision making and patient involvement in prosthetic prescription highlighted the importance of the evolving relationship between trauma amputees and their prosthetists and the benefits that were seen by both groups from developing a good relationship and the impact that this could have on the prosthetic prescription process. Through these developing relationships combined with communication between prosthetists and patients, these groups can work together to create optimal prosthetic prescriptions. Clinical experience and communication are key in enabling prosthetists to prescribe limbs which allow patients to achieve their goals and aspirations in their post amputation lives.
Dr Karen Semple,
Researcher, Faculty of Health Sciences and Sport, University of Stirling
11 July 2016
Prosthetic photo copyright Belahoche on 123RF
Graduation photo copyright University of Stirling
“Crucible – A situation of severe trial, or in which different elements interact, leading to the creation of something new.”
Walking into a room with other research academics (either known to each other or complete strangers), one can never be sure if it’ll be a “severe trial” or a motivating and exciting experience “leading to the creation of something new”. In many situations it’s more a case of ‘and’ rather than ‘or’, with the typical academic social awkwardness (faces buried in phones) being mixed with work pressures (faces buried in phones) that make many of us go into our shells at the start of such events. When we are given time and support though, we can usually generate some exciting ideas.
So in April 2016, the Stirling Crucible kicked off with 19 research academics consisting of a mix of postdoctoral researchers, lecturers and senior lecturers. The key idea was for the Crucible to be a space for researchers from across the University to come together to talk, learn and share ideas.
What made this event different to most was the time investment required, with three two-day ‘labs’ spread over 3 months and it being residential, with people staying overnight at the venue and indulging in some organised evening entertainment [insert poor health behaviours here]. Each lab focused on a different topic hosted by three excellent facilitators: Saskia Walcott on impact; Sara Shinton on collaboration; and John Willshire on innovation and leadership.
While the details of what happens during the Crucible need to remain a closely guarded secret (what happens at the Crucible, stays at the Crucible – but check #StirlingCrucible for a few sneak peeks), I can reveal that it was a success, bringing together people from contrasting disciplines to begin thinking about how to collaborate and some people starting to initiate research ideas.
Research collaborations cannot be forced and it does not always work throwing people together in the hope that something sticks. However, the Crucible succeeded in setting up a safe, unhindered and honest environment for sharing ideas and letting people take the time and space to simply make friends first, before expecting anything concrete in terms of collaborations and the future research outputs and impact.
The pressures faced by many academics mean that having this kind of protected time to think and engage with other people, especially those from different disciplines, with no forced expectations, is severely limited and often not given the respect and support it deserves. This process has also been supported by a small research seed fund available to attendees of the Crucible to apply for money to support interdisciplinary pilot projects that can lead to further collaborations and more substantial grant applications. A little cash incentive always helps!
Since finishing the formal Crucible events, I have teamed up with colleagues in the Faculty of Health Sciences and Sport and Education Studies within the Faculty of Social Sciences to apply for funding to support a small research project. This project would use focus groups to look at the barriers and facilitators to career development and progression for women studying part-time for a research doctorate within the Faculty of Health Sciences & Sport. The money provided by the Crucible would help generate positive policy change within the University (largely through the Athena SWAN initiative), but then also lead to further funding applications to explore this topic across disciplines, as well as across institutional and national boundaries.
Amongst the 2016 Crucibilists, there are sure to be plenty of exciting projects to emerge that are hopefully just the start of several years of successful partnership. There may be some severe trials that the Crucibilists face in their careers going forward, but hopefully we’ll continue to be able to face these as colleagues and friends who support each other through these challenges.
© Tony Robertson, 1 July 2016
Tony Robertson is a Lecturer in Public Health in the Faculty of Health Sciences & Sport at the University of Stirling
Email: email@example.com and on Twitter @tonyrobertson82