Research Projects Completed in 2016

Epoch Trial
National Institute for Health, 1 November 2013 - 30 April 2016

Overall mortality for patients receiving inpatient, non-cardiac surgery in the NHS in England is between 1.6% and 3.6%, but for some kinds of operation and some kinds of patient it is much higher. Patients undergoing ‘emergency laparotomy’—major surgery to treat an acute life threatening problem within the abdomen—have an overall mortality rate of 17% within 30 days of surgery, due to the age of the patients, their comorbidities, the nature of the condition, and the high-risk nature of the surgery, and this figure rises to over 22% of patients in the worst 10% of hospitals.

Because of these poor outcomes, and the variation between hospitals, a working group led by the Royal College of Surgeons has developed an ‘integrated care pathway’, which includes a number of evidence-based standards for the treatment of emergency laparotomy patients before, during and after surgery, which may significantly improve quality of care for this patient group. However, a systematic approach to implementing the care pathway as a whole has not yet been made. The EPOCH study, led by Barts Health NHS Trust, is a stepped wedge cluster randomised trial of implementation of the care pathway using a set of quality improvement methodologies, to evaluate the impact on mortality for these patients. As part of the study, SAPPHIRE will be leading an ethnographic evaluation of the work to implement the care pathway across a range of hospitals, providing knowledge about what works best, how far different hospitals are receptive to the change, which parts of the care pathway are most readily implemented, and how this relates to any improvements in patient outcomes and quality of care.

For more information, please visit epcohtrial.org or contact Graham Martin

Evaluation of Safer Clinical Systems Phase 2
The Health Foundation, November 2011 - March 2016

An independent evaluation of the Safer Clinical Systems approach for improving safe and reliable health care based on principles adapted from high-reliability organisations, established risk management techniques from hazardous industries, and quality improvement methods.

For more information, please contact Liz Shaw

Improving patient safety through international partnerships: An ethnographic study

International partnerships are a strategy for promoting patient safety globally, which characteristically context involve hospitals in low- and high-income countries pairing up to work together, to improve safety. This ethnographic study comprised longitudinal ethnographic case studies of two international patient safety partnerships in action. It aimed to strengthen the evidence-base for effective patient safety interventions in low-income countries and for optimising partnership-based approaches to intervention, including optimising the potential for reciprocal learning and mutual benefit between partners.

For more information, please contact Emmilie Aveling

Share this page: