knowledge exchange: the foundation of health research 3 clark.pdf · knowledge exchange: the...

PROFESSOR CHARLOTTE CLARKE

S C H O O L O F H E A L T H I N S O C I A L S C I E N C E U N I V E R S I T Y O F E D I N B U R G H

Knowledge Exchange: The Foundation of Health

Research

The Ecology of Knowledge

Knowledge

application

generation

communication

use

What role do we each play?

Knowledge

application

generation

communication

use

Our challenge is to find new ways to generate and use knowledge together with those who use

it and need it.

A gift - static & a-contextual

Is knowledge most helpful as -

A gift - static & a-contextual

A provocateur - existing in wicked environments and with multiple, contradictory viewpoints

OR

Is knowledge most helpful as -

It’s important to recognise that…

The source of the value of knowledge is use rather than mere possession

‘Compound’ knowledge is promoted,

increasing and developing over time

• Working

Institutions

• To-

Policy • -Gether

Practice

Researching with organisations

HEFCE SDF Urban Regeneration

Universities of: Northumbria Central Lancashire Manchester Met Salford With Bradford

Themes of: Health & wellbeing Community cohesion Crime Enterprise

Disciplines of: Nursing Management studies Information management Arts & drama Sociology Social policy Criminology Design Many many more...

With thanks to Primate Productions

"What convinced the judges was the sheer scale and diversity of the initiative. This is a vivid story of knowledge transfer and exchange, deeply embedded in challenging communities, demonstrating the tangible benefits that can arise from universities, local authorities and communities opening up their worlds to each other and building the most fascinating web of partnerships."

Ewart Wooldridge, former Chief Executive of the Leadership Foundation for HE

Researching with policy

Healthbridge Evaluating the National

Dementia Strategy for England

Policy Research Programme funding

with Wilkinson, Keyes, Alexjuk & many others

Researching with practice

Risk & Dementia

Finding meaning in caregiving for people with dementia (PhD)

Risk construction and management in dementia care (Health Foundation funded, Wilkinson, Keady)

Continence management in acute dementia care environments (NHS funded, Gardner)

Risk construction by people with dementia living in disadvantaged communities in South Africa (post-doc fellowship, Gibb)

International Collaborative Research Network on risk in ageing populations (British Academy funded)

‘This is novel and truly excellent book, made all the more acceptable by its brevity and clarity. It has certainly impressed me as an essential aid to those who care for people with dementia and it sets-out how risk should be assessed and managed in a clear and reassuring manner. It is an excellent slim book with a really helpful approach in an increasingly important field.’ (BMA 2012)

The KE-Research methodological challenge

Problem solving solving problems that build on assumptions

Problem setting identifying and analysing problems

Key characteristics

Socio-critical methodologies, characterised by the use of learning theories in research.

Emphasis on undertaking research that sets out to challenge assumptions of current practice (and disrupt present understandings of an issue).

The context bound nature of practice is emphasised and embraced, rather than seeking to de-contextualise an issue in order to investigate it.

Research aims to manage change & provide sustainability.

One next step?

Do we use the right model of

care to meet health need?

Nursing in Scottish

Universities

Universities Scotland Health

Committee

SFC & CNO Health &

social care organisations

Public & patients

KNOWLEDGE EXCHANGE IS NOT IN ADDITION TO RESEARCH

IT IS WHY AND HOW

WE DO RESEARCH OF EXCELLENCE

So...

Bereavement and bereavement care research at RGU

Knowledge Exchange Scotland: Policy, Practice,

Impact Conference

5th October 2012 Dr Audrey Stephen

Research to policy and practice

Context and background • Range of contexts in which people die • Impact on well being • Key concern in health and social care • Need to develop evidence based practice for

bereavement care Personal development • Developing researcher

RGU input to knowledge and understanding

The voice of stakeholders

What about the voice of bereaved

people?

Impact on practice

• Through Shaping Bereavement Care – Co-ordination at each NHS Board – Local policy and procedure development – Education and training development – Development of staff support

• Guidelines for caring for bereaved older people • Improved knowledge and understanding • Evidence based practice

Impact on personal development • Research Training Fellowship*

– PhD – Training – methods, management, leadership – Networking – Research project 3 years full time, fully funded, provides protected

time Developed to stage where can lead on projects (*Now called Doctoral Fellowship)

Acknowledgements and further information

• Funders: SEHD, Scottish Government, CSO, NHS Education for Scotland, NHS QIS, NHS Grampian Endowment Fund

• Shaping Bereavement Care http://www.sehd.scot.nhs.uk/mels/cel2011_09.pdf

• NHS Education for Scotland: education and training report http://www.nes.scot.nhs.uk/education-and-training/by-discipline/nursing-and-midwifery/resources/publications/nes-bereavement-report-and-executive-summary.aspx

• Scottish Grief and Bereavement Hub http://www.griefhub.org.uk/

• Email [email protected]

http://www.sehd.scot.nhs.uk/mels/cel2011_09.pdf

http://www.nes.scot.nhs.uk/education-and-training/by-discipline/nursing-and-midwifery/resources/publications/nes-bereavement-report-and-executive-summary.aspx



http://www.griefhub.org.uk/

mailto:[email protected]

Knowledge Exchange Projects in Health at RGU

Professor Cherry Wainwright Director Institute for Health & Welfare Research

Institute for Health & Welfare Research

The Institute for Health and Welfare Research is a multi-disciplinary research centre that focuses it's activities on addressing major issues around the diagnosis, prevention, treatment, care and welfare of patients.

The institute draws on the research skills of academic staff in : School of Applied Social Studies School of Health Sciences School of Nursing and Midwifery School of Pharmacy and Life Sciences Centre for Obesity Research & Epidemiology (CORE) Aberdeen Centre for Trauma Research (ACTR)


Knowledge Exchange Projects in Health: Many shapes and sizes

• Health Disciplines: – Physiotherapy – Exercise Science – Nutrition and lifestyle – Occupational Health – Psychology – Pharmacy – Nursing

• Collaborations with: – NHS – Health and welfare organisations – Private Sector

• Nature of relationship – Academically-driven research – Research driven by need of

collaborating organisation • Funding through:

– NHS/NES – Government departments

(SFC/DoH) commissioned research

– Research Grant Funding – Interface Innovation Vouchers – Knowledge Transfer Partnerships


KE Activities influencing Policy/Practice

Government/Public Body Commissioned Projects


Delivering and Managing Psychosocial Services for Victims of Major Incidents:

The Background - Aberdeen Centre for Trauma Research

• ACTR first trauma centre in UK to provide specialist care for trauma victims and their families

• Established (in 1999) following the Piper Alpha oil platform disaster in 1988

– Professor David Alexander – Professor Susan Klein (Current Director)

• Combined clinical practice with research and training

• International recognition as centre of excellence • Advised on more than 13 major disasters

worldwide, including: – Estonia ferry disaster – Ural’s train disaster, Russia – Nairobi terrorist bombing, Kenya – Pakistan Kashmir earthquake – North Sea helicopter crash 2009

• Advised on the setting up of the Humanitarian Assistance Centre in Aberdeen

Aberdeen Centre for Trauma Research


A UK and International Government Initiative

ACTR commissioned by DoH/NATO in 2007

Provide evidence base for post incident emergency response

Produce guidance on: • designing • delivering • Managing provision of psychosocial services to people involved in major incidents



The Outcomes

All 28 member countries of NATO signed up to guidance ACTR currently contributes to range of emergency planning

and response activities: Local

• Grampian Strategic Coordinating Care for People Liaison Group

• Aberdeen City Care for People Liaison Group • Emergency Preparedness Offshore Liaison (EPOL) Group

National • Resilience Advisory Board for Scotland (RABS) • Care for People affected by Emergencies

International • Partner in a FP7 consortium led by Trinity College Dublin

to develop a comprehensive approach to crisis aftermath planning

Actively engaged in research-related endeavours around emergencies, particularly in remote and hostile environments (e.g. medical evacuation)


Development of a Pharmacist Consultation Assessment Tool: Background - Pharmacy Practice Research Group

• Funded by – NHS Education for Scotland (NES) – Scottish Government – Community Pharmacy Scotland (CPS) – Royal Pharmaceutical Society (RPS) – Medicines and Healthcare products Regulatory Agency (MHRA).

• National & International research collaborations involve: – Patients – Primary and secondary care pharmacists – Nurse prescribers – General practitioners – Scottish general public.

• Research Outcomes have influenced strategy, policy and practice by contributing to evidence base around:

– Pharmacy practice – Pharmacist prescribing (including training) – Consultation skills training and assessment – Pharmacovigilance,


ENHANCE PATIENT CARE

QUICKER & SAFER ACCESS TO MEDICINES

BETTER USE OF SKILLS & EXPERTISE IN

PHARMACOTHERAPY

REDUCE WORKLOAD OF MEDICAL PRESCRIBERS

Development of a Pharmacist Consultation Assessment Tool:

A Collaborative Venture between Academic institutions and Funders


Collaborative Partners Funding Organisations

?

RCGP Consultation Observation Tool (COT)

Pharmacist Consultation Assessment Tool (PharmaCAT) for evaluation and feedback on the consultation skills of pharmacist prescribers

Development of a Pharmacist Consultation Assessment Tool: The Outcomes


NHS Education

for Scotland

Prescribing Research

Group

GP Assessors Patients &

Pharmacists

How will feedback inform practice and training?

Further research and development planned with NES training programme involvement http://www.nes.scot.nhs.uk/pharmacy/consultation

Adopt into consultation

skills training

Extend to all non-medical prescribers

Adapt for use as a

summative tool


Profession/Researcher Driven Projects


Initial Assessments in Musculoskeletal Outpatient Physiotherapy:

Background

• Qualified physiotherapist and Early Career Researcher • Held various staff grade, senior II then senior I positions in

Aberdeen & Aberdeenshire, specialising in musculoskeletal outpatients.

• Completed PhD (2007) through Scottish Funding Council-funded NMAHP training scheme

– Physiotherapy management & outcome measurement of chronic low back pain.

• Research Fellow and now Lecturer in Physiotherapy. Research interests include:

– back pain, – self-management of chronic conditions, – exercise and physical activity in Physiotherapy, and – Movement analysis to aid diagnosis & outcome measurement in

Physiotherapy.

• Co-facilitator of North of Scotland hub of National Physiotherapy Research Network.


• Project developed through discussions with Physiotherapy and AHP leads as to

– What different models of initial assessments exist following referral

– which were most effective/efficient for patients and the service

• Aim of project is investigating the optimal duration of initial assessments from patients' and physiotherapists' perspectives

• Funded by NHS Grampian Endowment Fund – joint application between RGU & NHS

• Involves engagement with: – Physiotherapy lead, – Senior Musculoskeletal Physiotherapist – Patient Representative,

via project steering group meetings (approx quarterly) and e-mails Institute for Health & Welfare Research

Initial Assessments in Musculoskeletal Outpatient Physiotherapy:

A joint NHS/RGU Project

Initial Assessments in Musculoskeletal Outpatient Physiotherapy: Outcomes

• Project itself still in data processing & analysis phase.

• Successful to date in terms of raising the issue.

• National project about to start looking at a number of musculoskeletal service delivery issues, including duration of appointments

• Dialogue with national project leads identifies scope for findings to feed in to Scotland-wide recommendations



Private and Charity Sector Driven Projects


Profiling Offshore Worker’s Size - A Knowledge Transfer Partnership:

Background – Centre for Obesity Research & Epidemiology

• CORE collaborates with internationally recognised experts in obesity and its research portfolio encompasses:

– Clinical management research – Anthropometry & body composition – Molecular aspects of obesity-related diseases – Psychosocial aspects of obesity, – Physiology and behaviour, – Education in the healthcare system, – Nutrition drugs and drug development.

• Obesity presents a health risk not only from disease, but also from an occupational health perspective

• The Oil & Gas Industry face safety issues around overweight/obese offshore workers in emergency situations


Profiling Offshore Worker’s Size: An Academia-Initiated Knowledge Transfer Partnership:

• 2 year KTP project

Project: • Validation of a novel portable scanning system for body shape. • Sample ~ 600 offshore workers across 9 weight categories to assess size and space requirements for: • Different clothing

assemblages/survival suits.

• Helicopter escape simulation (Timed dry egress through Super Puma windows)

Outputs: Validated digital data set for industry standard • Ongoing survey capability for 48,000 strong offshore workforce

Alternative Academy: A Business-initiated KTP

Transition Extreme • An innovative social enterprise that assists

young people in Aberdeen and Aberdeenshire to make the difficult transition from childhood to adulthood and thereafter maximising their potential in society.

• Increases participation in sport from childhood to adulthood – engaging those not attracted to conventional sports.

• Idea for a training programme for disengaged young people (15-18 years old)

• Approached Sports & Exercise Science experts in School of Health Sciences to work together on the project

• KTP proposal submitted and awarded • Sports Psychologist appointed as KTP

Associate

Outcomes Community:

• Over the last 2 years the programme has provided 90+ young people the opportunity to increase their confidence and motivation, gain qualifications and moving on to positive destinations.

• Development of additional programmes using the Alternative Academy format:

– part time version for those further away from education,

– ‘mobile’ version running in Peterhead using local facilities.


Alternative Academy: A Business-initiated KTP

Benefits to Transition Extreme • Increased ability to provide services and

support for as many young people in Aberdeen City and Shire as possible.

• Improved ability to evaluate programmes and demonstrate their social impact.

• Up-skilling of their work force to provide more effective coaching in their sports.

• Increased revenue through charitable grants and funding bodies to provide social programmes or hire additional resource.

• Spin off projects and relationships developed between Transition Extreme and RGU’s School of Computing, and the School of Education at the University of Aberdeen.

Benefits to TE and RGU • >£150K funding directly attributable to

KTP.

• Programme won the Education category at the Physical Activity and Health Alliance 2012 Awards

• The ‘Alternative Academy’ was chosen to represent the UK at an EU conference on youth mobility in February 2012.

• Research on the programme presented at the ECSS Annual Congress 2012 in Bruges.

• KTP Associate Bryan McCann shortlisted for “Young Achiever of the Year” at the CMI’s National Management and Leadership Awards 2012 (Outcome known 4th October).



Projects Driven by Policy Changes


Helping Independent Pharmacies Negotiate Changes in Pharmaceutical Care of Patients: An Innovation Voucher Project

•NHS Scotland is currently reviewing community pharmacy services to enhance the role of the pharmacist in personalised patient care, the outcome of which will present significant challenges to independent pharmacies to deliver to the required demands •AlbaPharm is a leading pharmacy support group and the voice for independent pharmacy in Scotland, Northern Ireland and Northern England, which provides a comprehensive range of services and support to Community Pharmacists. •RGU Pharmacy Practice Researchers and AlbaPharm have been awarded an Interface Innovation Voucher for a project aimed at:

•Developing a mutual understanding of challenges, impacts, actions and barriers arising from the review

•Identifying criteria for a solution to the key challenges

•Gaining understanding of a focussed solution that addresses the challenges


Helping Independent Pharmacies Negotiate Changes in Pharmaceutical Care of Patients: Expected Outcomes/Key Benefits

• Albapharm : – current understanding and assumptions will be challenged – a clearer and sharper understanding of the key issues will be gained – a proposed solution to address the key challenge(s) will be identified

• RGU :

– Makes significant contribution to strategic vision targets – Enables development and deployment of interdisciplinary expertise to the benefit of local business

community – Helps identify a range of ‘spin off’ initiatives and partners

• Scottish Economy :

– Contribution to the development and implementation of the community pharmacy contract in Scotland

– Resultant potential for enhancement of services to the benefit of the health and wellbeing of the Scottish population

– Potential for enhancement of the safe, rational, effective and economic use of medicines in the Scottish population


The People


Professor Susan Klein Director ACTR Pharmacy Practice Researchers

Dr Scott Cunningham, Prof Derek Stewart (Lead), Katie MacLure

School of Pharmacy & Life Sciences

Dr Arthur Stewart Deputy Director CORE

Dr Kay Cooper Physiotherapy Lecturer School of Health Sciences

Dan Shaw (Sports Science Lead) and Bryan McCann (KTP Associate, now Lecturer) School of Health Sciences

knowledge exchange: the foundation of health research 3 clark.pdf · knowledge exchange: the...

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