Imperial College London

Dr Susan Burnett

Faculty of MedicineDepartment of Surgery & Cancer

Honorary Research Fellow
 
 
 
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Contact

 

+44 (0)20 7594 3427s.burnett Website

 
 
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Location

 

506Medical SchoolSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

68 results found

Jones L, Pomeroy L, Robert G, Burnett S, Anderson JE, Morris S, Capelas Barbosa E, Fulop NJet al., 2018, Explaining organisational responses to a board-level quality improvement intervention: findings from an evaluation in six providers in the English National Health Service., BMJ Qual Saf

BACKGROUND: Healthcare systems worldwide are concerned with strengthening board-level governance of quality. We applied Lozeau, Langley and Denis' typology (transformation, customisation, loose coupling and corruption) to describe and explain the organisational response to an improvement intervention in six hospital boards in England. METHODS: We conducted fieldwork over a 30-month period as part of an evaluation in six healthcare provider organisations in England. Our data comprised board member interviews (n=54), board meeting observations (24 hours) and relevant documents. RESULTS: Two organisations transformed their processes in a way that was consistent with the objectives of the intervention, and one customised the intervention with positive effects. In two further organisations, the intervention was only loosely coupled with organisational processes, and participation in the intervention stopped when it competed with other initiatives. In the final case, the intervention was corrupted to reinforce existing organisational processes (a focus on external regulatory requirements). The organisational response was contingent on the availability of 'slack'-expressed by participants as the 'space to think' and 'someone to do the doing'-and the presence of a functioning board. CONCLUSIONS: Underperforming organisations, under pressure to improve, have little time or resources to devote to organisation-wide quality improvement initiatives. Our research highlights the need for policy-makers and regulators to extend their focus beyond the choice of intervention, to consider how the chosen intervention will be implemented in public sector hospitals, how this will vary between contexts and with what effects. We provide useful information on the necessary conditions for a board-level quality improvement intervention to have positive effects.

JOURNAL ARTICLE

Burnett S, 2018, Learning from 38 Never Events occurring in hospitals between April 2016 and March 2017., Learning from 38 Never Events occurring in hospitals between April 2016 and March 2017., Publisher: NHSI

REPORT

Aylin P, Benn J, Bottle A, Burnett S, Vincent C, Esmail A, Cecil E, Charles K, D'Lima Det al., 2018, Evaluation of a national surveillance system for mortality alerts: a mixed-methods study. Health Serv Deliv Res 2018;6(7), Evaluation of a national surveillance system for mortality alerts: a mixed-methods study

BackgroundSince 2007, Imperial College London has generated monthly mortality alerts, based on statistical process control charts and using routinely collected hospital administrative data, for all English acute NHS hospital trusts. The impact of this system has not yet been studied.ObjectivesTo improve understanding of mortality alerts and evaluate their impact as an intervention to reduce mortality.DesignMixed methods.SettingEnglish NHS acute hospital trusts.ParticipantsEleven trusts were included in the case study. The survey involved 78 alerting trusts.Main outcome measuresRelative risk of mortality and perceived efficacy of the alerting system.Data sourcesHospital Episodes Statistics, published indicators on quality and safety, Care Quality Commission (CQC) reports, interviews and documentary evidence from case studies, and a national evaluative survey.MethodsDescriptive analysis of alerts; association with other measures of quality; associated change in mortality using an interrupted time series approach; in-depth qualitative case studies of institutional response to alerts; and a national cross-sectional evaluative survey administered to describe the organisational structure for mortality governance and perceptions of efficacy of alerts.ResultsA total of 690 mortality alerts generated between April 2007 and December 2014. CQC pursued 75% (154/206) of alerts sent between 2011 and 2013. Patient care was cited as a factor in 70% of all investigations and in 89% of sepsis alerts. Alerts were associated with indicators on bed occupancy, hospital mortality, staffing, financial status, and patient and trainee satisfaction. On average, the risk of death fell by 58% during the 9-month lag following an alert, levelling afterwards and reaching an expected risk within 18 months of the alert. Acute myocardial infarction (AMI) and sepsis alerts instigated institutional responses across all the case study sites, although most sites were undertaking some parallel activities

REPORT

Jones L, Pomeroy L, Robert G, Burnett S, Anderson JE, Fulop NJet al., 2017, How do hospital boards govern for quality improvement? A mixed methods study of 15 organisations in England, BMJ QUALITY & SAFETY, Vol: 26, Pages: 978-986, ISSN: 2044-5415

JOURNAL ARTICLE

Burnett SJ, 2016, Organisational and systems factors impacting on patient safety in acute care organisations: lessons from four multi-site research studies

Background Patient safety is concerned with preventable harm in healthcare, a subject that became a focus for study in the UK in the late 1990s. How to improve patient safety, presented both a practical and a research challenge in the early 2000s, leading to the eleven publications presented in this thesis. Research question The overarching research question was: What are the key organisational and systems factors that impact on patient safety, and how can these best be researched? Methods Research was conducted in over 40 acute care organisations in the UK and Europe between 2006 and 2013. The approaches included surveys, interviews, documentary analysis and non-participant observation. Two studies were longitudinal. Results The findings reveal the nature and extent of poor systems reliability and its effect on patient safety; the factors underpinning cases of patient harm; the cultural issues impacting on safety and quality; and the importance of a common language for quality and safety across an organisation. Across the publications, nine key organisational and systems factors emerged as important for patient safety improvement. These include leadership stability; data infrastructure; measurement capability; standardisation of clinical systems; and creating an open and fair collective culture where poor safety is challenged. Conclusions and contribution to knowledge The research presented in the publications has provided a more complete understanding of the organisation and systems factors underpinning safer healthcare. Lessons are drawn to inform methods for future research, including: how to define success in patient safety improvement studies; how to take into account external influences during longitudinal studies; and how to confirm meaning in multi-language research. Finally, recommendations for future research include assessing the support required to maintain a patient safety focus during periods of major change or austerity; the skills needed by healthca

THESIS DISSERTATION

Burnett S, Mendel P, Nunes F, Wiig S, van den Bovenkamp H, Karltun A, Robert G, Anderson J, Vincent C, Fulop Net al., 2016, Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries, JOURNAL OF HEALTH SERVICES RESEARCH & POLICY, Vol: 21, Pages: 109-117, ISSN: 1355-8196

JOURNAL ARTICLE

Burnett SJ, 2014, How do hospitals respond to competing demands to reduce costs & improve quality of care?, How can change management make management change, Publisher: Swedish Forum for Health Policy

CONFERENCE PAPER

Burnett SJ, 2014, Patient Safety and Human Factors - lecture, Brighton & Sussex Medical School: MSc Leadership and Commissioning

CONFERENCE PAPER

Wiig S, Aase K, von Plessen C, Burnett S, Nunes F, Weggelaar AM, Anderson-Gare B, Calltorp J, Fulop Net al., 2014, Talking about quality: exploring how 'quality' is conceptualized in European hospitals and healthcare systems, BMC HEALTH SERVICES RESEARCH, Vol: 14, ISSN: 1472-6963

JOURNAL ARTICLE

Burnett SJ, Woodcock N, 2014, On That Day I Left My Boyhood Behind, Publisher: Acorn Independent Press, ISBN: 1909121843

BOOK

Vincent C, Burnett S, Carthey J, 2014, Safety measurement and monitoring in healthcare: a framework to guide clinical teams and healthcare organisations in maintaining safety, BMJ QUALITY & SAFETY, Vol: 23, Pages: 670-677, ISSN: 2044-5415

JOURNAL ARTICLE

Burnett SJ, 2014, Never?Human Factors in the Prevention of Surgical Never Events, NHS England: Sepsis and Never Event Learning and Sharing Workshop

CONFERENCE PAPER

Burnett SJ, 2014, Measuring and Monitoring Safety in Healthcare, First Do No Harm in Clinical Radiology

1. A framework for measuring and monitoring patient safety will be presented and discussed2. Measuring patient safety is not just about looking at historical data about what harm has happened in the past month or year, other aspects need to be taken into consideration. These are:a. Past harmb. Reliability c. Sensitivity to operationsd. Anticipation and preparednesse. Learning and improving

CONFERENCE PAPER

Burnett SJ, 2014, The measurement and monitoring of safety in healthcare, Measuring and Monitoring Clinical Quality Conference, Publisher: Health Care Events

One of the recommendations made by Don Berwick in his 2013 review into patient safety was that all NHS organisations should: ‘...routinely collect, analyse and respond to local measures that serve as early warning signals of quality and safety problems such as the voice of the patients and the staff, staffing levels, the reliability of critical processes and other quality metrics. These can be ‘smoke detectors’ as much as mortality rates are, and they can signal problems earlier than mortality rates do.’ A huge volume of data is currently collected on medical error and harm to patients. There have also been many tragic cases of health care failure, as well as a growing number of major reports on the need to make health care safer. However, despite this focus, the answer to the question ‘How safe is our care?’ remains elusive. Why is it so difficult to answer this question? This presentation will analyse and present the different facets of safety, considering how these can be monitored. The presentation will draw from the report ‘The Measurement and Monitoring of Safety in Healthcare’ produced for the Health Foundation by Charles Vincent, Susan Burnett & Jane Carthey.

CONFERENCE PAPER

Burnett SJ, 2014, Prospects for Comparing Hospital Performance Internationally on the Basis of Quality and Safety: AHRQ commentary, AHRQ: Agency for Healthcare Research and Quality, National Quality Measures Clearinghouse

JOURNAL ARTICLE

Burnett S, 2013, Assessing Patient Safety: Key Issues for the next decade, Quality Watch 2013

CONFERENCE PAPER

Burnett S, Fulop N, Aase K, Anderson J, Robert G, Gäre BA, Calltorp J, Bal R, Nunes F, QUASER teamet al., 2013, Hospitals without borders., Health Serv J, Vol: 123, Pages: 26-27, ISSN: 0952-2271

JOURNAL ARTICLE

Wiig S, Storm M, Aase K, Gjestsen MT, Solheim M, Harthug S, Robert G, Fulop Net al., 2013, Investigating the use of patient involvement and patient experience in quality improvement in Norway: rhetoric or reality?, BMC HEALTH SERVICES RESEARCH, Vol: 13, ISSN: 1472-6963

JOURNAL ARTICLE

Burnett S, 2013, Measuring and Monitoring Safety in Healthcare, NHS Confederation Conference 2013

CONFERENCE PAPER

Burnett S, Riddel-Bamber J, 2013, Measuring and Monitoring Safety in Healthcare, Patient Safety Congress 2013

CONFERENCE PAPER

Carthey J, Burnett S, Vincent C, 2013, The Measurement and Monitoring of Safety.Drawing together academic evidence and practical experience to produce a framework for safety measurement and monitoring, Publisher: The Health Foundation

REPORT

Charles K, Burnett S, Robert G, Anderson J, Poestges H, Fulop N, Bal R, Aase K, Nunes F, Andersson Gare B, the QUASER teamet al., 2013, Quality and Safety in European Union HospitalsA Research-based Guide for Implementing Best Practice and a Framework for Assessing Performance (QUASER), International Forum on Quality and Safety in Healthcare

POSTER

Fulop N, Burnett S, 2013, Quality and Safety in European Union Hospitals: The QUASER Study, BMJ International Forum: Third Annual International Improvement Science Symposium

CONFERENCE PAPER

Burnett S, Renz A, Wiig S, Fernandes A, Weggelaar AM, Calltorp J, Anderson JE, Robert G, Vincent C, Fulop Net al., 2013, Prospects for comparing European hospitals in terms of quality and safety: lessons from a comparative study in five countries, INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, Vol: 25, Pages: 1-7, ISSN: 1353-4505

JOURNAL ARTICLE

Burnett S, Poestges H, Charles K, Anderson J, Robert G, Fulop Net al., 2012, Quality & Safety in Europe by Research (QUASER): a comparative, multi-level study of the system and organisational interactions that shape quality improvement implementation in five European countries, Publisher: OXFORD UNIV PRESS, Pages: 113-113, ISSN: 1101-1262

CONFERENCE PAPER

Burnett S, Norris B, Flin R, 2012, Never Events: The Cultural and Systems Issues that cannot be Addressed by Individual Action Plans, Clinical Risk, Vol: 18, Pages: 213-216, ISSN: 1356-2622

JOURNAL ARTICLE

Burnett SJ, 2012, Patient Safety Policy into Practice: experience in England and lessons from a study across 5 European Countries, Improving Patient Safety

CONFERENCE PAPER

Burnett SJ, 2012, Managing Quality in the Healthcare Sector: a Study in 5 European Countries, Providing High Quality Public Services in Europe Based on the Values of Protocol 26 TFEU

CONFERENCE PAPER

Parand A, Benn J, Burnett S, Pinto A, Vincent Cet al., 2012, Strategies for sustaining a quality improvement collaborative and its patient safety gains, INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, Vol: 24, Pages: 380-390, ISSN: 1353-4505

JOURNAL ARTICLE

Benn J, Burnett S, Parand A, Pinto A, Vincent Cet al., 2012, Factors predicting change in hospital safety climate and capability in a multi-site patient safety collaborative: a longitudinal survey study, BMJ QUALITY & SAFETY, Vol: 21, Pages: 559-568, ISSN: 2044-5415

JOURNAL ARTICLE

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