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  • Journal article
    Geeson C, Wei L, Franklin BD, 2020,

    Analysis of pharmacist-identified medication-related problems at two United Kingdom hospitals: a prospective observational study

    , INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Vol: 28, Pages: 643-651, ISSN: 0961-7671
  • Report
    Ghafur S, Fontana G, Halligan J, O'Shaughnessy J, Darzi Aet al., 2020,

    NHS data: Maximising its impact on the health and wealth of the United Kingdom

  • Journal article
    Vos J, Franklin BD, Chumbley G, Galal-Edeen GH, Furniss D, Blandford Aet al., 2020,

    Nurses as a source of system-level resilience: Secondary analysis of qualitative data from a study of intravenous infusion safety in English hospitals

  • Journal article
    Runciman M, Avery J, Zhao M, Darzi A, Mylonas GPet al., 2020,

    Deployable, variable stiffness, cable driven robot for minimally invasive surgery

    , Frontiers in Robotics and AI, Vol: 6, Pages: 1-16, ISSN: 2296-9144

    Minimally Invasive Surgery (MIS) imposes a trade-off between non-invasive access and surgical capability. Treatment of early gastric cancers over 20 mm in diameter can be achieved by performing Endoscopic Submucosal Dissection (ESD) with a flexible endoscope; however, this procedure is technically challenging, suffers from extended operation times and requires extensive training. To facilitate the ESD procedure, we have created a deployable cable driven robot that increases the surgical capabilities of the flexible endoscope while attempting to minimize the impact on the access that they offer. Using a low-profile inflatable support structure in the shape of a hollow hexagonal prism, our robot can fold around the flexible endoscope and, when the target site has been reached, achieve a 73.16% increase in volume and increase its radial stiffness. A sheath around the variable stiffness structure delivers a series of force transmission cables that connect to two independent tubular end-effectors through which standard flexible endoscopic instruments can pass and be anchored. Using a simple control scheme based on the length of each cable, the pose of the two instruments can be controlled by haptic controllers in each hand of the user. The forces exerted by a single instrument were measured, and a maximum magnitude of 8.29 N observed along a single axis. The working channels and tip control of the flexible endoscope remain in use in conjunction with our robot and were used during a procedure imitating the demands of ESD was successfully carried out by a novice user. Not only does this robot facilitate difficult surgical techniques, but it can be easily customized and rapidly produced at low cost due to a programmatic design approach.

  • Conference paper
    Zhao M, Oude Vrielink J, Kogkas A, Runciman M, Elson D, Mylonas Get al., 2020,

    LaryngoTORS: A Novel Cable-Driven Parallel Robot for Transoral Laser Surgery

    , International Conference on Robotics and Automation (ICRA)
  • Conference paper
    Zhao M, Zhang H, Mylonas GP, Elson DSet al., 2020,

    Cable-driven parallel robot assisted confocal imaging of the larynx

    LaryngoTORS, a transoral laryngeal surgery robot, can manipulate instruments accurately. Confocal imaging has potentials in laryngeal cancer diagnosis but suffer from high scanning requirement. This work studies using LaryngoTORS to assist confocal imaging of larynx.

  • Conference paper
    Leiloglou M, Gkouzionis I, Avila-Rencoret FB, Chalau V, Kedrzycki M, Darzi A, Leff DR, Elson DSet al., 2020,

    Snapshot hyperspectral system for breast conserving surgery guidance

    There is an unmet need for accurate tumour localization in vivo during breast conserving surgery. Herein a novel snapshot hyperspectral system is presented for accurately detecting the intrinsic fluorescence signal in real-time fluorescence guided surgery.

  • Journal article
    Fontana G, Ghafur S, Torne L, Goodman J, Darzi Aet al., 2020,

    Ensuring that the NHS realises fair financial value from its data

    , The Lancet Digital Health, Vol: 2, Pages: e10-e12, ISSN: 2589-7500
  • Journal article
    Markiewicz O, Lavelle M, Lorencatto F, Judah G, Ashrafian H, Darzi Aet al., 2020,

    Threats to safe transitions from hospital to home: a consensus study in North West London primary care

    , British Journal of General Practice, Vol: 70, Pages: e9-e19, ISSN: 0960-1643

    Background Transitions between healthcare settings are vulnerable points for patients.Aim To identify key threats to safe patient transitions from hospital to primary care settings.Design and setting Three-round web-based Delphi consensus process among clinical and non-clinical staff from 39 primary care practices in North West London, England.Method Round 1 was a free-text idea-generating round. Rounds 2 and 3 were consensus-obtaining rating rounds. Practices were encouraged to complete the questionnaires at team meetings. Aggregate ratings of perceived level of importance for each threat were calculated (1–3: ‘not important’, 4–6: ‘somewhat important’, 7–9: ‘very important’). Percentage of votes cast for each patient or medication group were recorded; consensus was defined as ≥75%.Results A total of 39 practices completed round 1, 36/39 (92%) completed round 2, and 30/36 (83%) completed round 3. Round 1 identified nine threats encompassing problems involving communication, service organisation, medication provision, and patients who were most at risk. ‘Poor quality of handover instructions from secondary to primary care teams’ achieved the highest rating (mean rating at round 3 = 8.43) and a 100% consensus that it was a ‘very important’ threat. Older individuals (97%) and patients with complex medical problems taking >5 medications (80%) were voted the most vulnerable. Anticoagulants (77%) were considered to pose the greatest risk to patients.Conclusion This study identified specific threats to safe patient transitions from hospital to primary care, providing policymakers and healthcare providers with targets for quality improvement strategies. Further work would need to identify factors underpinning these threats so that interventions can be tailored to the relevant behavioural and environmental contexts in which these threats arise.

  • Journal article
    Thibaut B, Dewa L, Ramtale S, D'Lima D, Adam S, Ashrafian H, Darzi A, Archer Set al., 2019,

    Patient safety in inpatient mental health settings: a systematic review

    , BMJ Open, Vol: 9, Pages: 1-19, ISSN: 2044-6055

    Objectives: Patients in inpatient mental health settings face similar risks to those in other areas of health care (e.g. medication errors). In addition, some unsafe behaviours associated with serious mental health problems (e.g. self-harm), and the measures taken to address these (e.g. restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology. Design: Systematic review and meta-synthesis. Embase, CINAHL, HMIC, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to “mental health”, “patient safety”, “inpatient setting” and “research”. Study quality was assessed using the Hawker checklist. Data was extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random effects model.Results: Of the 57,637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150,000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control. Conclusions: Patient safety in inpatient mental health settings is under researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety which require investment in research, policy development, and translation into clinical practice.

This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.

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