Browse through all publications from the Institute of Global Health Innovation, which our Patient Safety Research Collaboration is part of. This feed includes reports and research papers from our Centre. 

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  • Journal article
    Davids J, Manivannan S, Darzi A, Giannarou S, Ashrafian H, Marcus HJet al., 2020,

    Simulation for skills training in neurosurgery: a systematic review, meta-analysis, and analysis of progressive scholarly acceptance.

    , Neurosurgical Review, Vol: 44, Pages: 1853-1867, ISSN: 0344-5607

    At a time of significant global unrest and uncertainty surrounding how the delivery of clinical training will unfold over the coming years, we offer a systematic review, meta-analysis, and bibliometric analysis of global studies showing the crucial role simulation will play in training. Our aim was to determine the types of simulators in use, their effectiveness in improving clinical skills, and whether we have reached a point of global acceptance. A PRISMA-guided global systematic review of the neurosurgical simulators available, a meta-analysis of their effectiveness, and an extended analysis of their progressive scholarly acceptance on studies meeting our inclusion criteria of simulation in neurosurgical education were performed. Improvement in procedural knowledge and technical skills was evaluated. Of the identified 7405 studies, 56 studies met the inclusion criteria, collectively reporting 50 simulator types ranging from cadaveric, low-fidelity, and part-task to virtual reality (VR) simulators. In all, 32 studies were included in the meta-analysis, including 7 randomised controlled trials. A random effects, ratio of means effects measure quantified statistically significant improvement in procedural knowledge by 50.2% (ES 0.502; CI 0.355; 0.649, p < 0.001), technical skill including accuracy by 32.5% (ES 0.325; CI - 0.482; - 0.167, p < 0.001), and speed by 25% (ES - 0.25, CI - 0.399; - 0.107, p < 0.001). The initial number of VR studies (n = 91) was approximately double the number of refining studies (n = 45) indicating it is yet to reach progressive scholarly acceptance. There is strong evidence for a beneficial impact of adopting simulation in the improvement of procedural knowledge and technical skill. We show a growing trend towards the adoption of neurosurgical simulators, although we have not fully gained progressive scholarly acceptance for VR-based simulation technologies in neurosurgical education.

  • Journal article
    Alwan NA, Attree E, Blair JM, Bogaert D, Bowen M-A, Boyle J, Bradman M, Briggs TA, Burns S, Campion D, Cushing K, Delaney B, Dixon C, Dolman GE, Dynan C, Frayling IM, Freeman-Romilly N, Hammond I, Judge J, Järte L, Lokugamage A, MacDermott N, MacKinnon M, Majithia V, Northridge T, Powell L, Rayner C, Read G, Sahu E, Shand C, Small A, Strachan C, Suett J, Sykes B, Taylor S, Thomas K, Thomson M, Wiltshire A, Woods Vet al., 2020,

    From doctors as patients: a manifesto for tackling persisting symptoms of covid-19.

    , BMJ, Vol: 370
  • Journal article
    Ghafur S, Van Dael J, Leis M, Darzi A, Sheikh Aet al., 2020,

    Public perceptions on data sharing: key insights from the UK and the USA

    , The Lancet Digital Health, Vol: 2, Pages: E444-E446, ISSN: 2589-7500
  • Conference paper
    van Dael J, Gillespie AT, Reader TW, Mayer EKet al., 2020,

    Patient and staff perceptions of safety and risk: triangulating patient complaints and staff incident reports towards a dual perspective on adverse events

    , Society for Social Medicine & Population Health, Publisher: BMJ PUBLISHING GROUP, Pages: A40-A40, ISSN: 0143-005X

    Background Incident reporting systems in healthcare are historically based on staff descriptions of adverse events. An increasing body of literature suggests patients provide critical insights to risk and error, but their potential has not sufficiently been investigated at the incident level. This study aims to examine to what extent patient complaints and staff incident reports discuss identical incidents, and how their perspectives could be integrated for more comprehensive safety analysis.Methods Deterministic data linkage was performed on all complaints (n=5,265) and staff incident reports (‘PSIs’) (n=81,077) between April 2014 and March 2019 at a multisite hospital in London. A total of 402 complaints covered at least one incident also identified in the PSIs, and were included in the study. All incidents reported in complaints and staff incident reports were codified based on problem domain; problem severity; stage of care; staff group implicated; reported harm; and descriptive level (eg, description of human factors and root causes); adapted from the Healthcare Complaints Analysis Tool (HCAT) and the National Reporting and Learning System (NRLS). Aggregated coding outputs informed targeted qualitative analysis of free text incident reports for an in-depth exploration of key overlap and discrepancies in patient and staff descriptions of unsafe care.Results Our preliminary results indicate staff and patients reported similar problem themes for 81.1% of overlapping incidents (of which 66.5% clinical, followed by 27.1% institutional, and 6.4% relational), but commonly differed in their description of contributing factors and root causes (eg, different time points in patient journey). Alongside overlapping incidents, patients reported an average of 1.4 additional incidents in their complaint, of which 23.6% were high severity. Additional patient-reported incidents included blind spot clinical issues (36.7%; eg care continuity; care omissions) or relatio

  • Journal article
    Garfield S, Furniss D, Husson F, Etkind M, Williams M, Norton J, Ogunleye D, Jubraj B, Lakhdari H, Franklin BDet al., 2020,

    How can patient-held lists of medication enhance patient safety? A mixed-methods study with a focus on user experience

    , BMJ Quality & Safety, Vol: 29, Pages: 764-773, ISSN: 2044-5415

    Background Patients often carry medication lists to mitigate information loss across healthcare settings. We aimed to identify mechanisms by which these lists could be used to support safety, key supporting features, and barriers and facilitators to their use.Methods We used a mixed-methods design comprising two focus groups with patients and carers, 16 semistructured interviews with healthcare professionals, 60 semistructured interviews with people carrying medication lists, a quantitative features analysis of tools available for patients to record their medicines and usability testing of four tools. Findings were triangulated using thematic analysis. Distributed cognition for teamwork models were used as sensitising concepts.Results We identified a wide range of mechanisms through which carrying medication lists can improve medication safety. These included improving the accuracy of medicines reconciliation, allowing identification of potential drug interactions, facilitating communication about medicines, acting as an aide-mémoire to patients during appointments, allowing patients to check their medicines for errors and reminding patients to take and reorder their medicines. Different tools for recording medicines met different needs. Of 103 tools examined, none met the core needs of all users. A key barrier to use was lack of awareness by patients and carers that healthcare information systems can be fragmented, a key facilitator was encouragement from healthcare professionals.Conclusion Our findings suggest that patients and healthcare professionals perceive patient-held medication lists to have a wide variety of benefits. Interventions are needed to raise awareness of the potential role of these lists in enhancing patient safety. Such interventions should empower patients and carers to identify a method that suits them best from a range of options and avoid a ‘one size fits all’ approach.

  • Journal article
    Barakat S, Franklin BD, 2020,

    An Evaluation of the Impact of Barcode Patient and Medication Scanning on Nursing Workflow at a UK Teaching Hospital

    , PHARMACY, Vol: 8
  • Journal article
    Cursi F, Mylonas GP, Kormushev P, 2020,

    Adaptive kinematic modelling for multiobjective control of a redundant surgical robotic tool

    , Robotics, Vol: 9, Pages: 68-68, ISSN: 2218-6581

    Accurate kinematic models are essential for effective control of surgical robots. For tendon driven robots, which are common for minimally invasive surgery, the high nonlinearities in the transmission make modelling complex. Machine learning techniques are a preferred approach to tackle this problem. However, surgical environments are rarely structured, due to organs being very soft and deformable, and unpredictable, for instance, because of fluids in the system, wear and break of the tendons that lead to changes of the system’s behaviour. Therefore, the model needs to quickly adapt. In this work, we propose a method to learn the kinematic model of a redundant surgical robot and control it to perform surgical tasks both autonomously and in teleoperation. The approach employs Feedforward Artificial Neural Networks (ANN) for building the kinematic model of the robot offline, and an online adaptive strategy in order to allow the system to conform to the changing environment. To prove the capabilities of the method, a comparison with a simple feedback controller for autonomous tracking is carried out. Simulation results show that the proposed method is capable of achieving very small tracking errors, even when unpredicted changes in the system occur, such as broken joints. The method proved effective also in guaranteeing accurate tracking in teleoperation.

  • Journal article
    Krasuska M, Williams R, Sheikh A, Franklin BD, Heeney C, Lane W, Mozaffar H, Mason K, Eason S, Hinder S, Dunscombe R, Potts HWW, Cresswell Ket al., 2020,

    Technological Capabilities to Assess Digital Excellence in Hospitals in High Performing Health Care Systems: International eDelphi Exercise

  • Journal article
    Lichtner V, Franklin BD, Dalla-Pozza L, Westbrook Jet al., 2020,

    Electronic ordering and the management of treatment interdependencies: a qualitative study of paediatric chemotherapy

  • Journal article
    Atchison C, Pristerà P, Cooper E, Papageorgiou V, Redd R, Piggin M, Flower B, Fontana G, Satkunarajah S, Ashrafian H, Lawrence-Jones A, Naar L, Chigwende J, Gibbard S, Riley S, Darzi A, Elliott P, Ashby D, Barclay W, Cooke GS, Ward Het al., 2020,

    Usability and acceptability of home-based self-testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) antibodies for population surveillance

    , Clinical Infectious Diseases, Vol: 2020, Pages: 1-10, ISSN: 1058-4838

    BACKGROUND: This study assesses acceptability and usability of home-based self-testing for SARS-CoV-2 antibodies using lateral flow immunoassays (LFIA). METHODS: We carried out public involvement and pilot testing in 315 volunteers to improve usability. Feedback was obtained through online discussions, questionnaires, observations and interviews of people who tried the test at home. This informed the design of a nationally representative survey of adults in England using two LFIAs (LFIA1 and LFIA2) which were sent to 10,600 and 3,800 participants, respectively, who provided further feedback. RESULTS: Public involvement and pilot testing showed high levels of acceptability, but limitations with the usability of kits. Most people reported completing the test; however, they identified difficulties with practical aspects of the kit, particularly the lancet and pipette, a need for clearer instructions and more guidance on interpretation of results. In the national study, 99.3% (8,693/8,754) of LFIA1 and 98.4% (2,911/2,957) of LFIA2 respondents attempted the test and 97.5% and 97.8% of respondents completed it, respectively. Most found the instructions easy to understand, but some reported difficulties using the pipette (LFIA1: 17.7%) and applying the blood drop to the cassette (LFIA2: 31.3%). Most respondents obtained a valid result (LFIA1: 91.5%; LFIA2: 94.4%). Overall there was substantial concordance between participant and clinician interpreted results (kappa: LFIA1 0.72; LFIA2 0.89). CONCLUSION: Impactful public involvement is feasible in a rapid response setting. Home self-testing with LFIAs can be used with a high degree of acceptability and usability by adults, making them a good option for use in seroprevalence surveys.

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