21 results found
Sivananthan A, Machin M, Zijlstra G, et al., 2021, A grassroots junior doctor communication network in response to the COVID-19 pandemic: a service evaluation, BMJ Open Quality, Vol: 10, ISSN: 2399-6641
BackgroundCOVID-19 was declared a worldwide pandemic on 11th March 2020. Imperial NHS Trust provides 1412 inpatient beds staffed by 1200 junior doctors and faced a large burden of COVID-19 admissions.Local problemA survey of doctors revealed only 20% felt confident that they would know to whom they could raise concerns and that most were getting information from a combination of informal work discussions, trust emails, social media and medical literature. MethodsThis quality improvement project was undertaken aligning with SQUIRE 2.0© guidelines. Through an iterative process, a digital network; ICON (Imperial Covid cOmmunications Network) using existing smartphone technologies was developed. Concerns were collated from the junior body (Google Form®) and convey them to the leadership team (vertical - bottom up) and improve communication from leadership to the junior body (vertical - top down using WhatsApp and Zoom®). Quantitative analysis on engagement with the network (members of the group and number of issues raised) and qualitative assessment (thematic analysis on issues) was undertaken.ResultsMembership of the ICON WhatsApp group peaked at 780 on 17th May 2020. 197 concerns were recorded via the Google Form® system between 20th March and 14th June 2020. There were five overarching themes; organisational and logistics; clinical strategy concerns; staff safety and wellbeing; clinical (COVID-19) and patient care; and facilities. 94.4% of members agreed ICON was helpful in receiving updates and 88.9% agreed ICON improved collaboration. ConclusionsThis work demonstrates that a coordinated network, utilising existing smartphone technologies and a novel communications structure, can improve collaboration between senior leadership and junior doctors. Such a network could play an important role during times of pressure in a healthcare system.
Harris A, Butterworth J, Boshier PR, et al., 2020, Development of a Reliable Surgical Quality Assurance System for 2-stage Esophagectomy in Randomized Controlled Trials., Ann Surg
OBJECTIVE: The aim was to develop a reliable surgical quality assurance system for 2-stage esophagectomy. This development was conducted during the pilot phase of the multicenter ROMIO trial, collaborating with international experts. SUMMARY OF BACKGROUND DATA: There is evidence that the quality of surgical performance in randomized controlled trials influences clinical outcomes, quality of lymphadenectomy and loco-regional recurrence. METHODS: Standardization of 2-stage esophagectomy was based on structured observations, semi-structured interviews, hierarchical task analysis, and a Delphi consensus process. This standardization provided the structure for the operation manual and video and photographic assessment tools. Reliability was examined using generalizability theory. RESULTS: Hierarchical task analysis for 2-stage esophagectomy comprised fifty-four steps. Consensus (75%) agreement was reached on thirty-nine steps, whereas fifteen steps had a majority decision. An operation manual and record were created. A thirty five-item video assessment tool was developed that assessed the process (safety and efficiency) and quality of the end product (anatomy exposed and lymphadenectomy performed) of the operation. The quality of the end product section was used as a twenty seven-item photographic assessment tool. Thirty-one videos and fifty-three photographic series were submitted from the ROMIO pilot phase for assessment. The overall G-coefficient for the video assessment tool was 0.744, and for the photographic assessment tool was 0.700. CONCLUSIONS: A reliable surgical quality assurance system for 2-stage esophagectomy has been developed for surgical oncology randomized controlled trials. ETHICAL APPROVAL: 11/NW/0895 and confirmed locally as appropriate, 12/SW/0161, 16/SW/0098. TRIAL REGISTRATION NUMBER: ISRCTN59036820, ISRCTN10386621.
Tribe H, Harris S, Kneebone RL, 2018, Life on a knife edge: Using simulation to engage young people in issues surrounding knife crime, Advances in Simulation, Vol: 3, ISSN: 2059-0628
BackgroundKnife-related behaviour among young people is an increasing social concern with a total of 35 teenagers killed by knife attacks in England in 2017. Distributed simulation has been shown to be a valid method of portable simulation for medical professionals; however, its role in delivering a socially educational message to members of the public has not been previously studied. This paper explores how the novel use of simulation could be used to address a serious social issue amongst young people at risk of criminal knife behaviour.MethodsA qualitative approach was used to study a two-part workshop attended by two groups of young people vulnerable to knife crime. Based on the concepts of sequential simulation and distributed simulation previously developed at the Imperial College Centre for Engagement and Simulation Science, the first part of the workshop showed the patient journey of a young man stabbed in the abdomen, attended by policemen and paramedics, followed by the participants witnessing a simulated emergency abdominal operation on a silicone model and concluded with a dialogue between the surgeon, the victim (who required an intestinal stoma as a result of the knife injury) and his mother. The second part of the workshop involved further discussion with the participants regarding the role of knives from the personal and community perspective. Visual data was recorded during the workshops and qualitative data obtained from group and individual interviews were thematically analysed.ResultsA total of sixty teenagers aged 13–19 took part in the two workshops. The participant feedback suggested that the workshops provided a safe environment where young people could learn about and explore the consequences surrounding knife crime. Furthermore, participant recollection of key points was assessed between 4 and 6 weeks after the second workshop and the data suggested that the workshop could promote learning and a change in the participants’ knife
Blencowe NS, Boddy AP, Harris A, et al., 2015, Systematic review of intervention design and delivery in pragmatic and explanatory surgical randomized clinical trials, BRITISH JOURNAL OF SURGERY, Vol: 102, Pages: 1037-1047, ISSN: 0007-1323
Harris A, Bello F, Kneebone R, 2015, Simulation and training in minimal access surgery, Training in Minimal Access Surgery, Pages: 35-47, ISBN: 9781447164937
This chapter summarises the increasingly important role that simulation has to play in the training of surgeons in minimal access surgery. This chapter defines commonly encountered terms from the simulation literature, describes the relevance of simulation to modern surgical practice, examines the evidence for and against the different types of simulators currently used in surgical simulation training, and considers the practicalities of adopting such an approach. The chapter concludes with an exploration of potential future directions in a rapidly evolving field.
Blencowe N, Boddy A, Harris A, et al., 2015, Descriptions of Surgical Interventions in RCTs: is There Room for Improvement?, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 287-287, ISSN: 0007-1323
Harris A, Kassab E, Tun JK, et al., 2013, Distributed Simulation in surgical training: An off-site feasibility study, MEDICAL TEACHER, Vol: 35, Pages: E1078-E1081, ISSN: 0142-159X
Harris A, Tang J, Maroothynaden J, et al., 2012, The more things change, the more they stay the same, LANCET, Vol: 380, Pages: 1058-1058, ISSN: 0140-6736
Harris A, Tang J, Maroothynaden J, 2012, Can you cut it as a surgeon? Live Science at the Science Museum London, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 33-33, ISSN: 0007-1323
Harris A, Rhodes M, McAvoy P, et al., 2012, Use of contextualised surgical simulation in the assessment of a consultant's clinical practice, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 180-180, ISSN: 0007-1323
Harris A, Mavroveli S, Yeh A, 2012, A systematic review of the literature on Surgical Expertise, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 150-150, ISSN: 0007-1323
Harris A, Tang J, 2012, Patients' and doctors' views of Surgical Expertise, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 177-178, ISSN: 0007-1323
Harris A, Matar N, 2012, The experts' views on Surgical Expertise - a historical perspective, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 149-150, ISSN: 0007-1323
Harris A, Tang J, Kneebone RL, 2011, Oral: Distributed Simulation and soft-preserve cadavers in surgical simulation., Society in Europe for Simulation Applied to Medicine.
Harris A, Kassab E, Kyaw Tun J, et al., 2011, Poster: Distributed Simulation in Surgical Training: An off-site feasibility study., IMSH
Harris A, 2011, Poster: An audit of the hand anatomy knowledge of A&E staff, ASGBI
Cubitt J, Harris A, Ramus J, et al., 2010, Retro Fashion in Surgery: The White Coat, Annals of the Royal College of Surgeons of England, Vol: 92, Pages: 242-243
Harris A, Tsang C, Lieske B, 2009, E-poster of distinction & oral presentation: Dressing Down - Patients' and doctors' perspective on doctors' uniform, ASGBI
Harris A, Buchanan G, 2009, Melanosis Coli is reversible, Colorectal Disease, Vol: 11, Pages: 788-789
Harris A, Buchanan G, 2007, Minerva: Melanosis Coli, British Medical Journal, Vol: 334
Chapple L, Harris A, Phelan L, et al., 2006, Reassessment of a simple chemical method using DCIP for screening for haemoglobin E, JOURNAL OF CLINICAL PATHOLOGY, Vol: 59, Pages: 74-76, ISSN: 0021-9746
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