A5089183901- Emergency and Acute Care Studies
- Healthcare Quality and Management
- Hospital Admissions and Outcomes
- Patient Safety and Medication Errors
- Healthcare Policy and Management
- Patient Satisfaction in Healthcare
- COVID-19 and Mental Health
- Health Policy Implementation Science
- Occupational Health and Safety Research
- Disaster Response and Management
- Medical Malpractice and Liability Issues
- Maternal and Perinatal Health Interventions
- Family and Patient Care in Intensive Care Units
- Pelvic floor disorders treatments
- Optimism, Hope, and Well-being
- Telemedicine and Telehealth Implementation
- Healthcare cost, quality, practices
- Artificial Intelligence in Healthcare
- Ethics in medical practice
- Interprofessional Education and Collaboration
- Healthcare professionals’ stress and burnout
- Innovations in Medical Education
- Trauma and Emergency Care Studies
- Migration, Health and Trauma
- Patient-Provider Communication in Healthcare
University of Leicester
2014-2025
University of Cambridge
2023
Department of Medical Sciences
2020-2021
National Health Service
2018
National Institute for Health Research
2018
Johns Hopkins University
2018
Downtown Women's Health Care
2014
University of East Anglia
2010
Surgery for pelvic organ prolapse is a common surgical procedure. There little research studying post-operative pain, contrasting with extensive literature on pain after childbirth trauma which shows that suture method has significant effect pain. We designed protocol trial comparing techniques and conducted pre-protocol pilot to inform our design.Routine data, scores (from 10 cm Visual Analogue Scales, VAS) analgesic requirements were obtained from the notes of cohort women undergoing...
Abstract Background The Covid-19 pandemic has imposed extraordinary strains on healthcare workers. But, in contrast with acute settings, relatively little attention been given to those who work mental health settings. We aimed characterise the experiences of working English NHS secondary services during first wave pandemic. Methods design was a qualitative interview-based study. conducted semi-structured, remote (telephone or online) interviews 35 members staff from (inpatient and community)...
Objectives To explore the experiences of service users, carers and staff seeking or providing secondary mental health services during COVID-19 pandemic. Design Qualitative interview study, codesigned with users carers. Methods We conducted semistructured, telephone online interviews a purposively constructed sample; lived experience researcher analysed users. Analysis was based on constant comparison method. Setting National Health Service (NHS) in England between June August 2020....
Maternity care continues to be associated with avoidable harm that can result in serious disability and profound anguish for women, their children, families, high costs healthcare systems. As other areas of healthcare, improvement efforts have typically focused either on implementing evaluating specific interventions, or identifying the contextual features may generative safety (e.g. structures, processes, behaviour, practices, values), but dialogue between these two approaches has remained...
Candidacy, a construct describing how people's eligibility for care is negotiated between themselves and services, has received limited attention in the context of mental health care. In addition, candidacy research only rarely studied views carers professionals. this article, we use concepts relating to enable theoretically informed examination experiences access secondary services during first wave COVID-19 pandemic England. We report qualitative study service users, carers, healthcare...
Objectives: We explored the perceptions, views and experiences of diabetes education in people with type 2 who were participating a UK randomized controlled trial methods education. The intervention arm was based on DESMOND, structured programme group sessions aimed at enabling self-management diabetes, while standard usual care from general practices. Methods: Individual semi-structured interviews conducted 36 adult patients, whom 19 had attended DESMOND 17 been to receive care. Data...
Background Reducing avoidable harm in maternity services is a priority globally. As well as learning from mistakes, it important to produce rigorous descriptions of ‘what good looks like’. Objective We aimed characterise features safety units and generate plain language framework that could be used guide improvement. Methods conducted multisite ethnography involving 401 hours non-participant observations 33 semistructured interviews with staff across six units, stakeholder consultation 65...
We aimed to explore the experiences and perspectives of pregnant women, antenatal healthcare professionals, system leaders understand impact implementation remote provision care during COVID-19 pandemic beyond.We conducted a qualitative study involving semi-structured interviews with 93 participants, including 45 individuals who had been period, 34 health 14 managers system-level stakeholders. Analysis was based on constant comparative method used theoretical framework candidacy.We found...
Clinical tools for use in practice-such as medicine reconciliation charts, diagnosis support and track-and-trigger charts-are endemic healthcare, but relatively little attention is given to how optimise their design. User-centred design approaches co-design principles offer potential improving usability acceptability of clinical tools, limited practical guidance currently available. We propose a framework (FRamework co-dESign practice tOols or 'FRESCO') offering based on user-centred methods...
Abstract Background Operations Management meetings in NHS hospitals provide an opportunity for operational and clinical staff to monitor demand capacity manage patient flow. These play important role the achievement of resilient performance over time. However, little is known about work that takes place within these United Kingdom’s National Health Service. Methods We conducted a qualitative study observing 29 across three English between June October 2023. The observations focused on: who...
Objectives: The aim of this study was to explore, using qualitative methods, the experiences children and their parents living with nut allergy. Methods: Children a confirmed diagnosis peanut allergy were identified from database patients maintained at an clinic large teaching hospital. Interviews 26 families conducted involving 11 children, 25 mothers 12 fathers. Results: signalled critical transition—or biographical disruption—in life family. Parents took on role ‘alert assistant’ sought...
Objectives We aimed to explore the views of strategic level stakeholders on leadership for quality and safety in UK National Health Service. Methods interviewed 107 with close involvement as professionals, managers, policy makers or commentators. Analysis was based constant comparative method. Results Participants identified crucial role ensuring safe, high care. Consistent academic literature, participants distinguished between traditional hierarchical ‘concentrated’ associated particular...
Employee voice plays an important role in organizational intelligence about patient safety hazards and other influences on quality of care. The authors report a case study academic medical center that aimed to understand barriers make improvements identifying responding transgressive or disruptive behaviors.
Measurement of quality and safety has an important role in improving healthcare, but is susceptible to unintended consequences. One frequently made argument that optimising the benefits from measurement requires controlling risks blame, whether it possible do this remains unclear. We examined responses a programme known as NHS Safety Thermometer (NHS-ST). Measuring four common patient harms diverse care settings with goal supporting local improvement, explicitly eschews for blame. The study...
BackgroundMigrants from certain regions are at increased risk of key infectious diseases (including HIV, tuberculosis (TB), hepatitis B and C). Although guidelines increasingly recommend integrated screening for multiple infections to reduce morbidity little is known about what migrants healthcare professionals think this approach.MethodsProspective qualitative study in Leicester, United Kingdom within a novel city-wide programme three iterative phases understand views screening. Phase 1...
Background Although problems that impair task completion — known as operational failures are an important focus of concern in primary care, they have remained little studied. Aim To quantify the time GPs spend on different activities during clinical sessions; to identify number encounter; and characterise nature their impact for GPs. Design setting Mixed-method triangulation study with 61 28 NHS general practices England from December 2018 2019. Method Time–motion methods, ethnographic...
The importance of employee voice—speaking up and out about concerns—is widely recognised as fundamental to patient safety quality care. However, failures voice continue occur, often with disastrous consequences. In this article, we argue that the enduring sociological concepts informal organisation formal offer analytical purchase in understanding causes such problems how they can be addressed. We report a qualitative study involving 165 interviews across three healthcare organisations two...
Background High-quality antenatal care is important for ensuring optimal birth outcomes and reducing risks of maternal fetal mortality morbidity. The COVID-19 pandemic disrupted the usual provision care, with much shifting to remote forms provision. We aimed characterise what quality would look like from perspectives those who use, provide organise it. Methods This UK-wide study involved interviews an online survey inviting free-text responses with: were or had been pregnant since March...
Abstract Background Patient and staff experiences provide important insights into care quality, but health systems have difficulty using these data to improve care. Little attention has been paid understanding how patient experience feedback can act as a prompt reflection in practice the clinical setting. Objective We aimed identify ways which different types of trigger or for engagement acute hospital settings considerations enhancing value reflective learning. Methods conducted an...
Background Organisational change in complex healthcare systems is a multifaceted process. The English National Health Service recently introduced ‘Change Model’ that seeks to offer an evidence-based framework for guiding change. We report findings from formative evaluation of the NHS Change Model and make recommendations those developing its users. Methods involved 28 interviews with managers clinicians making use relation variety projects. Interviews were fully transcribed analysed using...
Problems in intrapartum electronic fetal monitoring with cardiotocography (CTG) remain a major area of preventable harm. Poor understanding the range influences on safety may have hindered improvement. Taking an interdisciplinary perspective, we sought to characterise everyday practice CTG and work systems within which it takes place, goal identifying potential sources risk. Human factors/ergonomics (HF/E) experts social scientists conducted 325 hours observations 23 interviews three...