Care award for excellence in the development of care for older people
Clinical Excellence award for work that demonstrates an improved clinical outcome for patients
Communication award for effective communication between healthcare professionals and patients
Epidemiology award for excellence in the long-term study of a chronic disease
Health at Work award for excellence in occupational medicine
Patient Safety award
Research award for the best emerging medical researcher in the UK
Mr Tariq Muhammad, Pharmacy Plus Ltd
Aim
This project set out to improve the standard of medicines management in care homes across the UK. Research showed errors in prescribing, monitoring, dispensing and administration processes. Mistakes within these operations can seriously compromise patient safety and result in hospital admissions.
Findings
The team behind the project previously designed, developed and implemented an innovative dispensing management system to help 300 care homes prevent and capture drug errors. A new system, the 'Proactive Care System' has now been developed and trialled in 13 care homes to manage the entire process from the point of ordering prescriptions through to delivery. A unique barcode validation system in a handheld device ensures that the process is safe and accountable at the point of drug administration. These new measures were evaluated in a data analysis survey and a user questionnaire. The results showed that the new system is able to successfully identify and alert staff to potential medicine errors as well as freeing up valuable nurse time and have measurable cost savings.
Patient benefit
Alerting staff to potential errors at the point of administration will assist in preventing adverse events owing to drug errors in care homes. The system may also have potential application for dispensing in other settings in the future.
Mrs Jill Richards, Solent Healthcare
Aim
The team established three health clubs in supported housing in their area, with the aim of improving access and choice to residents and providing proactive rather than reactive care, resulting in a better quality of life. They offered treatment and advice to residents in a non-clinical, friendly environment for any health related problem. Patients could also be monitored more effectively and be given advice about medication, lifestyle and prevention of falls.
Findings
After informal meetings to explain the purpose of the club and seek the views of service users, ethically approved quality of life questionnaires were sent out. These were repeated after one year. As the clubs progressed, it was found useful to divide the lounge into three areas for routine care, complex care and refreshments/social interaction. This facilitated the most effective and broad use of the skills of the nursing team. The health care assistant or staff nurse could manage more routine care, freeing the community specialist nurse to provide specific disease management and to develop a more autonomous role, which would include nurse prescribing and risk management. Improvements were shown in conditions such as chronic leg ulcers and hypertension. In 2010 the health club was responsible for a 50.7% reduction (numbering 37) in GP visits and 8.4% (numbering 15) reduction in hospital admissions compared with normal case management. On average10 district nurse visits were saved per week.
Patient benefit
As well as the immediate health benefits seen, social interaction at the health club has also been beneficial, reducing isolation in residents and introducing some people to a new and enjoyable volunteering role, assisting with the sessions. This is likely to have health benefits in the longer term.
Ms Tracy Moon, Evelina Children's Hospital St Thomas' Hospital London
Aim
The aim of this project was to improve the information given to children and families of young patients having magnetic resonance imaging (MRI) scans to better prepare them for it and decrease the stress of their procedure. This would then help to increase the scan success rate and reduce the need for a general anaesthetic.
Findings
Quality information about the MRI scan was developed in different formats aimed at a child's level of understanding. A play preparation session was set up with a specialist before the child's real scan so the child could practice lying still and listen to the noises made by the scanner. The creation of a photo story book aimed at difference ages was sent with the MRI appointment and a DVD of 'Jack's MRI' was played on wards and on the trust website. The audited play session was shown to help children go into the scanner, decreased movement artefact on images by 48% and improved the scan success rate by 12%. A total of 200 children have now been scanned awake since June 2010, including children who would otherwise have been given a general anaesthetic.
Patient benefit
Looking at MRI scanning from the point of view of a child and making the whole experience into a game, or journey, has had the effect of making the child patients more accepting of their investigation. This has reduced the need for a general anaesthetic and has increased the quality of the images obtained for the clinicians.
Dr Shaheen Shah, The London School of Hygiene and Tropical Medicine
Aim
The aim was to explore the global variation in cataract surgery to find out what characteristics of both hospital and country are associated with these operations being done for people who can really benefit from them. To do this, Dr Shah had to set up an international network of ophthalmologists (doctors who specialise in eye health, including eye surgery) from high, middle and low income countries. A total of 154 ophthalmologists from 50 different countries were recruited into the International Eye Research Network (IERN) to take part in the study. These members used web-based surveys to contribute hospital and patient data from just over 11,000 people undergoing cataract surgery.
Findings
Dr Shah found that people living in lower income countries, and those cared for in less-well equipped hospitals, are more likely to have poor vision or be blind at the time of cataract surgery. The societies in which this is the case are getting good value from what they spend on cataract surgery and are making a real difference to people's lives. However, this becomes less true in better off places where operations are done on people with little capacity to benefit.
Patient benefit
In the developing world, blindness - particularly from cataract - is both a significant cause and consequence of poverty. By building the IERN and feeding back the research results, ophthalmologists around the world can now make a better judgement of the balance between offering surgery to anyone with symptoms of cataract and prioritising those who are severely visually impaired.
The Bupa Foundation Award will allow Dr Shah's team to continue working with the IERN members and conduct the next study on the management of people with glaucoma.
Professor Greg Atkinson, Liverpool John Moores University
Aim
The research aimed to identify and assess the most appropriate timing and composition of meals, as well as activities, which can help to reduce health problems in shift-workers. This is because people who work in such occupations are known to be at an increased risk of developing problems such as chronic fatigue, obesity and high blood pressure. People who work at night are particularly susceptible to developing gastrointestinal disorders as a result of poor eating habits, and have difficulty taking part in leisure-time physical activity.
Findings
During the first phase of the project, questionnaire-based surveys and interviews with shift-workers were undertaken to assess their lifestyle habits. In the second phase, a night-work simulation was set up in a laboratory to measure the effects of meal and physical activity timings on various health aspects. Finally, a three month lifestyle intervention programme specifically designed for shift-workers was piloted. The results from the follow-up were very promising. For example, the intervention group had a significantly lower body mass index (BMI), which is a good indicator of how your weight can affect your health, and better digestive health than the comparator group.
Patient benefit
This research has demonstrated that a semi-remote intervention programme (ie partly dependent on telephone and email contact) can be beneficial to shift-workers' health in both the short and long term.
Professor Gary Smith, Queen Alexander Hospital, Portsmouth
Aim
To develop a PDA-based system to facilitate the collection of patients' vital signs data directly into a database at the point and time of delivery of care, avoiding need for paper. The team wished to improve the vital signs monitoring process; the legibility and usefulness of the charting of vital signs; systems used to detect deterioration; the escalation of care for deteriorating patients, and to audit the "triggering" and "response" processes.
Findings
The team have been successful in producing an electronic vital signs documentation system that has been introduced across the hospital, permitting the removal of paper-based, vital signs charts for adult patients. The system permits staff anywhere in the hospital instantaneous, reliable access to vital signs charts and laboratory data of any patient via the hospital intranet.
Patient benefit
The successful development and implementation of the VitalPAC system has increased patient safety and improved the efficiency of care delivery. By collecting and recording vital signs using a wireless handheld computer system (VitalPAC), using other patient and laboratory data, and applying decision support at the bedside, we have observed an associated 22 percent reduction in hospital standardised mortality ratio (from 106.1 to 84.4).
Dr Rodrigo Floto, University of Cambridge
Aim
Clinicians face an increasing problem of how to treat bacteria which are becoming increasingly resistant to antibiotics. That challenge is nowhere more acute than for tuberculosis (TB) where vaccine development has struggled and new antibiotics are scarce. The aim of this work was to see if a process called autophagy - literally translated as 'eating oneself', could stimulate cells to kill infecting bacteria.
Findings
This work showed that several drugs already licensed for the treatment of non-infectious conditions can enhance autophagy and stimulate cells called macrophages to kill up to 80 percent of mycobacteria infecting them. This strategy works equally well for multi-drug resistant bacteria.
Patient benefit
This research has real potential to have a major impact on patient care since it provides proof of principle that therapeutic enhancement of autophagy may be useful in treating patients with multi-drug resistant bacteria.
The Bupa Foundation Award will help fund research on these drugs in mice infected with resistant TB. If successful, this would be the springboard for a clinical trial in humans.
