Imperial College London

ProfessorBryonyFranklin

Faculty of MedicineDepartment of Infectious Disease

Visiting Professor
 
 
 
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Contact

 

b.deanfranklin

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Publication Type
Year
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245 results found

Garfield S, Begum A, Toh KL, Lawrence-Jones A, Staley K, Franklin BDet al., 2022, Do patients and family carers have different concerns about the use of medicines compared with healthcare professionals? A quantitative secondary analysis of healthcare concerns relating to adults with complex needs, PATIENT EDUCATION AND COUNSELING, Vol: 105, Pages: 447-451, ISSN: 0738-3991

Journal article

Wheeler C, Blencowe A, Jacklin A, Franklin BDet al., 2021, Combining research and design: A mixed methods approach aimed at understanding and optimising inpatient medication storage systems, PLOS ONE, Vol: 16, ISSN: 1932-6203

Journal article

Jani YH, Chumbley GM, Furniss D, Blandford A, Franklin Bet al., 2021, The Potential Role of Smart Infusion Devices in Preventing or Contributing to Medication Administration Errors: A Descriptive Study of 2 Data Sets., J Patient Saf, Vol: 17, Pages: e1894-e1900

OBJECTIVES: Errors in medication administration are common, with many interventions suggested to reduce them. For intravenous infusion-related errors, "smart infusion devices" incorporating dose error reduction software are widely advocated. Our aim was to explore the role of smart infusion devices in preventing or contributing to medication administration errors using retrospective review of 2 complementary data sets that collectively included a wide range of errors with different levels of actual or potential harm. METHODS: We reviewed 216 medication administration errors identified from an observational study in clinical practice and 123 medication incidents involving infusion devices reported to a national reporting system. The impact of smart infusion devices in preventing or contributing to these errors was assessed by the research team and an expert panel. RESULTS: The data suggest that use of any infusion device rather than gravitational administration may have prevented 13% of observed errors and 8% of reported incidents; additional reductions may be possible with standalone smart infusion devices, and further potential reductions with smart infusion devices integrated with electronic prescribing and barcode administration systems. An estimated 52% to 73% of errors that occurred with traditional infusion pumps could be prevented with such integrated smart infusion devices. In the few cases where smart infusion devices were used, these contributed to errors in 2 of 58 observed errors and 7 of 8 reported incidents. CONCLUSIONS: Smart infusion devices not only prevent some medication administration errors but can also contribute to them. Further evaluation of such systems is required to make recommendations for policy and practice.

Journal article

Jani YH, Franklin BD, 2021, Interruptive alerts: only one part of the solution for clinical decision support, BMJ QUALITY & SAFETY, Vol: 30, Pages: 933-936, ISSN: 2044-5415

Journal article

Harkanen M, Vehvilainen-Julkunen K, Franklin BD, Murrells T, Rafferty AMet al., 2021, Factors Related to Medication Administration Incidents in England and Wales Between 2007 and 2016: A Retrospective Trend Analysis, JOURNAL OF PATIENT SAFETY, Vol: 17, Pages: E850-E857, ISSN: 1549-8417

Journal article

Krasuska M, Williams R, Sheikh A, Franklin B, Hinder S, TheNguyen H, Lane W, Mozaffar H, Mason K, Eason S, Potts H, Cresswell Ket al., 2021, Driving digital health transformation in hospitals: a formative qualitative evaluation of the English Global Digital Exemplar programme., BMJ Health Care Inform, Vol: 28

BACKGROUND: There is currently a strong drive internationally towards creating digitally advanced healthcare systems through coordinated efforts at a national level. The English Global Digital Exemplar (GDE) programme is a large-scale national health information technology change programme aiming to promote digitally-enabled transformation in secondary healthcare provider organisations by supporting relatively digitally mature provider organisations to become international centres of excellence. AIM: To qualitatively evaluate the impact of the GDE programme in promoting digital transformation in provider organisations that took part in the programme. METHODS: We conducted a series of in-depth case studies in 12 purposively selected provider organisations and a further 24 wider case studies of the remaining organisations participating in the GDE programme. Data collected included 628 interviews, non-participant observations of 190 meetings and workshops and analysis of 9 documents. We used thematic analysis aided by NVivo software and drew on sociotechnical theory to analyse the data. RESULTS: We found the GDE programme accelerated digital transformation within participating provider organisations. This acceleration was triggered by: (1) dedicated funding and the associated requirement for matched internal funding, which in turn helped to prioritise digital transformation locally; (2) governance requirements put in place by the programme that helped strengthen existing local governance and project management structures and supported the emergence of a cadre of clinical health informatics leaders locally; and (3) reputational benefits associated with being recognised as a centre of digital excellence, which facilitated organisational buy-in for digital transformation and increased negotiating power with vendors. CONCLUSION: The GDE programme has been successful in accelerating digital transformation in participating provider organisations. Large-scale digital transfor

Journal article

Black A, Gage H, Norton C, Franklin BD, Murrells T, Courtenay Met al., 2021, Patient satisfaction with medication consultations and medicines information provided by nurses working autonomously in sexual health services: A questionnaire study, JOURNAL OF ADVANCED NURSING, Vol: 78, Pages: 523-531, ISSN: 0309-2402

Journal article

Subakumar K, Franklin BD, Garfield S, 2021, Analysis of the third WHO Global Safety Challenge 'Medication Without Harm' patient-facing materials: exploratory descriptive study, EUROPEAN JOURNAL OF HOSPITAL PHARMACY, Vol: 28, Pages: E109-E114, ISSN: 2047-9956

Journal article

Jones MD, Clarke J, Feather C, Franklin BD, Sinha R, Maconochie I, Darzi A, Appelbaum Net al., 2021, Use of pediatric injectable medicines guidelines and associated medication administration errors: a human reliability analysis, Annals of Pharmacotherapy, Vol: 55, Pages: 1333-1340, ISSN: 1060-0280

Background:In a recent human reliability analysis (HRA) of simulated pediatric resuscitations, ineffective retrieval of preparation and administration instructions from online injectable medicines guidelines was a key factor contributing to medication administration errors (MAEs).Objective:The aim of the present study was to use a specific HRA to understand where intravenous medicines guidelines are vulnerable to misinterpretation, focusing on deviations from expected practice (discrepancies) that contributed to large-magnitude and/or clinically significant MAEs.Methods:Video recordings from the original study were reanalyzed to identify discrepancies in the steps required to find and extract information from the NHS Injectable Medicines Guide (IMG) website. These data were combined with MAE data from the same original study.Results:In total, 44 discrepancies during use of the IMG were observed across 180 medication administrations. Of these discrepancies, 21 (48%) were associated with an MAE, 16 of which (36% of 44 discrepancies) made a major contribution to that error. There were more discrepancies (31 in total, 70%) during the steps required to access the correct drug webpage than there were in the steps required to read this information (13 in total, 30%). Discrepancies when using injectable medicines guidelines made a major contribution to 6 (27%) of 22 clinically significant and 4 (15%) of 27 large-magnitude MAEs.Conclusion and Relevance:Discrepancies during the use of an online injectable medicines guideline were often associated with subsequent MAEs, including those with potentially significant consequences. This highlights the need to test the usability of guidelines before clinical use.

Journal article

Black A, Courtenay M, Norton C, Franklin BD, Murrells T, Gage Het al., 2021, Independent nurse medication provision: A mixed method study assessing impact on patients' experience, processes, and costs in sexual health clinics, JOURNAL OF ADVANCED NURSING, Vol: 78, Pages: 239-251, ISSN: 0309-2402

Journal article

Cresswell K, Sheikh A, Franklin BD, Krasuska M, Nguyen HT, Hinder S, Lane W, Mozaffar H, Mason K, Eason S, Potts H, Williams Ret al., 2021, Interorganizational Knowledge Sharing to Establish Digital Health Learning Ecosystems: Qualitative Evaluation of a National Digital Health Transformation Program in England, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 23, ISSN: 1438-8871

Journal article

Garfield S, Wheeler C, Boucher C, Etkind M, Lloyd J, Norton J, Ogunleye D, Taylor A, Williams M, Grimes T, Kelly D, Franklin BDet al., 2021, Medicines management at home during the COVID-19 pandemic: a qualitative study exploring the UK patient/carer perspective, INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Vol: 29, Pages: 458-464, ISSN: 0961-7671

Journal article

Charani E, McKee M, Ahmad R, Balasegaram M, Bonaconsa C, Merrett GB, Busse R, Carter V, Castro-Sanchez E, Franklin BD, Georgiou P, Hill-Cawthorne K, Hope W, Imanaka Y, Kambugu A, Leather AJM, Mbamalu O, McLeod M, Mendelson M, Mpundu M, Rawson TM, Ricciardi W, Rodriguez-Manzano J, Singh S, Tsioutis C, Uchea C, Zhu N, Holmes AHet al., 2021, Optimising antimicrobial use in humans-review of current evidence and an interdisciplinary consensus on key priorities for research, The Lancet Regional Health - Europe, Vol: 7, Pages: 1-10, ISSN: 2666-7762

Addressing the silent pandemic of antimicrobial resistance (AMR) is a focus of the 2021 G7 meeting. A major driver of AMR and poor clinical outcomes is suboptimal antimicrobial use. Current research in AMR is inequitably focused on new drug development. To achieve antimicrobial security we need to balance AMR research efforts between development of new agents and strategies to preserve the efficacy and maximise effectiveness of existing agents.Combining a review of current evidence and multistage engagement with diverse international stakeholders (including those in healthcare, public health, research, patient advocacy and policy) we identified research priorities for optimising antimicrobial use in humans across four broad themes: policy and strategic planning; medicines management and prescribing systems; technology to optimise prescribing; and context, culture and behaviours. Sustainable progress depends on: developing economic and contextually appropriate interventions; facilitating better use of data and prescribing systems across healthcare settings; supporting appropriate and scalable technological innovation. Implementing this strategy for AMR research on the optimisation of antimicrobial use in humans could contribute to equitable global health security.

Journal article

Williams R, Sheikh A, Franklin BD, Krasuska M, Nguyen HT, Hinder S, Lane W, Mozaffar H, Mason K, Eason S, Potts HWW, Cresswell Ket al., 2021, Using Blueprints to promote interorganizational knowledge transfer in digital health initiatives-a qualitative exploration of a national change program in English hospitals., J Am Med Inform Assoc, Vol: 28, Pages: 1431-1439

OBJECTIVE: The Global Digital Exemplar (GDE) Program is a national attempt to accelerate digital maturity in healthcare providers through promoting knowledge transfer across the English National Health Service (NHS). "Blueprints"-documents capturing implementation experience-were intended to facilitate this knowledge transfer. Here we explore how Blueprints have been conceptualized, produced, and used to promote interorganizational knowledge transfer across the NHS. MATERIALS AND METHODS: We undertook an independent national qualitative evaluation of the GDE Program. This involved collecting data using semistructured interviews with implementation staff and clinical leaders in provider organizations, nonparticipant observation of meetings, and key documents. We also attended a range of national meetings and conferences, interviewed national program managers, and analyzed a range of policy documents. Our analysis drew on sociotechnical principles, combining deductive and inductive methods. RESULTS: Data comprised 508 interviews, 163 observed meetings, and analysis of 325 documents. We found little evidence of Blueprints being adopted in the manner originally conceived by national program managers. However, they proved effective in different ways to those planned. As well as providing a helpful initial guide to a topic, we found that Blueprints served as a method of identifying relevant expertise that paved the way for subsequent discussions and richer knowledge transfers amongst provider organizations. The primary value of Blueprinting, therefore, seemed to be its role as a networking tool. Members of different organizations came together in developing, applying, and sustaining Blueprints through bilateral conversations-in some circumstances also fostering informal communities of practice. CONCLUSIONS: Blueprints may be effective in facilitating knowledge transfer among healthcare organizations, but need to be accompanied by other evolving methods, such as

Journal article

Sheikh A, Anderson M, Albala S, Casadei B, Franklin BD, Richards M, Taylor D, Tibble H, Mossialos Eet al., 2021, Health information technology and digital innovation for national learning health and care systems, LANCET DIGITAL HEALTH, Vol: 3, Pages: E383-E396

Journal article

Anderson M, Pitchforth E, Asaria M, Brayne C, Casadei B, Charlesworth A, Coulter A, Franklin BD, Donaldson C, Drummond M, Dunnell K, Foster M, Hussey R, Johnson P, Johnston-Webber C, Knapp M, Lavery G, Longley M, Clark JM, Majeed A, McKee M, Newton JN, O'Neill C, Raine R, Richards M, Sheikh A, Smith P, Street A, Taylor D, Watt RG, Whyte M, Woods M, McGuire A, Mossialos Eet al., 2021, LSE-Lancet Commission on the future of the NHS: re-laying the foundations for an equitable and efficient health and care service after COVID-19, The Lancet, Vol: 397, Pages: 1915-1978, ISSN: 0140-6736

Journal article

Lichtner V, Prgomet M, Gates P, Franklin BDet al., 2021, Automatic dispensing cabinets and governance of controlled drugs: an exploratory study in an intensive care unit, EUROPEAN JOURNAL OF HOSPITAL PHARMACY, ISSN: 2047-9956

Journal article

Ocloo J, Garfield S, Franklin BD, Dawson Set al., 2021, Exploring the theory, barriers and enablers for patient and public involvement across health, social care and patient safety: a systematic review of reviews, HEALTH RESEARCH POLICY AND SYSTEMS, Vol: 19, ISSN: 1478-4505

Journal article

Hinder S, Cresswell K, Sheikh A, Franklin BD, Krasuska M, The Nguyen H, Lane W, Mozaffar H, Mason K, Eason S, Potts HWW, Williams Ret al., 2021, Promoting inter-organisational knowledge sharing: A qualitative evaluation of England's Global Digital Exemplar and Fast Follower Programme, PLOS ONE, Vol: 16, ISSN: 1932-6203

Journal article

Jones MD, McGrogan A, Raynor DK, Watson MC, Franklin BDet al., 2021, User-testing guidelines to improve the safety of intravenous medicines administration: a randomised in situ simulation study, BMJ QUALITY & SAFETY, Vol: 30, Pages: 17-26, ISSN: 2044-5415

Journal article

Franklin BD, Puaar SJ, 2020, What is the impact of introducing inpatient electronic prescribing on prescribing errors? A naturalistic stepped wedge study in an English teaching hospital, HEALTH INFORMATICS JOURNAL, Vol: 26, Pages: 3152-3162, ISSN: 1460-4582

Journal article

Grimes TC, Garfield S, Kelly D, Cahill J, Cromie S, Wheeler C, Franklin BDet al., 2020, Household medication safety practices during the COVID-19 pandemic: a descriptive qualitative study protocol, BMJ Open, Vol: 10, Pages: 1-6, ISSN: 2044-6055

Introduction Those who are staying at home and reducing contact with other people during the COVID-19 pandemic are likely to be at greater risk of medication-related problems than the general population. This study aims to explore household medication practices by and for this population, identify practices that benefit or jeopardise medication safety and develop best practice guidance about household medication safety practices during a pandemic, grounded in individual experiences.Methods and analysis This is a descriptive qualitative study using semistructured interviews, by telephone or video call. People who have been advised to ‘cocoon’/‘shield’ and/or are aged 70 years or over and using at least one long-term medication, or their caregivers, will be eligible for inclusion. We will recruit 100 patient/carer participants: 50 from the UK and 50 from Ireland. Recruitment will be supported by our patient and public involvement (PPI) partners, personal networks and social media. Individual participant consent will be sought, and interviews audio/video recorded and/or detailed notes made. A constructivist interpretivist approach to data analysis will involve use of the constant comparative method to organise the data, along with inductive analysis. From this, we will iteratively develop best practice guidance about household medication safety practices during a pandemic from the patient’s/carer’s perspective.Ethics and dissemination This study has Trinity College Dublin, University of Limerick and University College London ethics approvals. We plan to disseminate our findings via presentations at relevant patient/public, professional, academic and scientific meetings, and for publication in peer-reviewed journals. We will create a list of helpful strategies that participants have reported and share this with participants, PPI partners and on social media.

Journal article

Franklin BD, Thomas EJ, 2020, Introduction from the new editors-in-chief, BMJ QUALITY & SAFETY, Vol: 29, Pages: 873-874, ISSN: 2044-5415

Journal article

Harkanen M, Franklin BD, Murrells T, Rafferty AM, Vehvilainen-Julkunen Ket al., 2020, Factors contributing to reported medication administration incidents in patients' homes - A text mining analysis, JOURNAL OF ADVANCED NURSING, Vol: 76, Pages: 3573-3583, ISSN: 0309-2402

Journal article

Cresswell K, Sheikh A, Dean Franklin B, Krasuska M, Nguyen H, Hinder S, Lane W, Mozaffar H, Mason K, Eason S, Potts H, Williams Ret al., 2020, Formative independent evaluation of a digital change programme in the English National Health Service: study protocol for a longitudinal qualitative study., BMJ Open, Vol: 10

INTRODUCTION: Many countries are launching large-scale, digitally enabled change programmes as part of efforts to improve the quality, safety and efficiency of care. We have been commissioned to conduct an independent evaluation of a major national change programme, the Global Digital Exemplar (GDE) Programme, which aims to develop exemplary digital health solutions and encourage their wider adoption by creating a learning ecosystem across English National Health Service (NHS) provider organisations. METHODS AND ANALYSIS: This theoretically informed, qualitative, longitudinal formative evaluation comprises five inter-related work packages. We will conduct a combination of 12 in-depth and 24 broader qualitative case studies in GDE sites exploring digital transformation, local learning and mechanisms of spread of knowledge within the Programme and across the wider NHS. Data will be collected through a combination of semistructured interviews with managers, implementation staff (clinical and non-clinical), vendors and policymakers, plus non-participant observations of meetings, site visits, workshops and documentary analysis of strategic local and national plans. Data will be analysed through inductive and deductive methods, beginning with in-depth case study sites and testing the findings against data from the wider sample and national stakeholders. ETHICS AND DISSEMINATION: This work is commissioned as part of a national change programme and is therefore a service evaluation. We have ethical approval from the University of Edinburgh. Results will be disseminated at six monthly intervals to national policymakers, and made available via our publicly accessible website. We will also identify lessons for the management and evaluation of large-scale evolving digital health change programmes that are of international relevance.

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

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