The ability to learn from evidence is critical to keeping patients safe. However, these evidences are highly complex, increasingly diverse, and frequently distributed across multiple systems. As a result, whilst healthcare organisations have access to a lot of evidence, this evidence does not always shape what they do. Birmingham Children’s Hospital is committed to manage evidence to ensure that patients are kept safe in a sector leading way. We have therefore established a group of research projects which support them achieve this ambition, and also helps other hospitals learns from them.
Because of the complexity and importance of this work, we are taking a multi-staged approach to investigate different dimensions of evidence management (acquisition, assimilation, transformation and exploitation). We are also researching different levels of this work i.e. evidence management across networks, teams and individuals. The first stage of research seeks to capture insights at the corporate management and governance level of risk evidence. We will conduct non-participatory observations of hospital risk committees and interviews with staff. Our findings will help shape strategic-level practice; they will also help identifying future stages of research.
The second stage of our research will develop insights about how evidence flows around an origination. The specific projects we research will depend on our first stage findings, but this will include researching things like the hospitals performance dashboard. We will look at how middle leave practices affect how these tools are used, for example the perceived tension in using a performance dashboard as management tool for control, and an early warning system for safety. We may also look at how patient experience evidence is captured and exploited across the hospital. The final stage of research focuses on the contextual challenges of learning from evidence at the front line of service provision. This stage of research includes a four-year Ph.D. project focusing on patient safety in day-to-night handover. Other project may including things like safety case methodology to proactively manage safety or the use of electronic prescribing.
Across these three phases, researchers will undertake qualitative research to capture rich contextual details which is often missing in this kind of research. We will interview staff and other stakeholders (e.g. regulators), whose behaviours affect the translation of evidence into clinical practice. We will observe forums through which evidence is processed, such as the various clinical governance committees. We will study documents for insights about Birmingham Children's hospital and also for wider contextual evidence.