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Service Improvement and Quality

We have expertise in the area of service improvement and quality, with our work focussed around four main areas of activity:

Society, wellbeing and diversity

This stream considers health and wellbeing in the context of diversity and social inequalities. Our health and wellbeing are shaped by the context of our lives including by our socio-economic position, gender, ethnicity, age and by the availability of services. This research theme considers the relationship between these and public health agendas, health promotion and the configuration of health and social care providers. It considers public policy, the mobilisation of individuals and communities and the ways attitudes are formed and modified.

Situated within the service improvement and quality research theme, work within this stream explores how a quality service has to respond to those factors that create and perpetuate inequalities within society and how a workforce with an embedded understanding of inclusion and diversity is essential in delivering a high quality service for all. However, within the wider context of health, this stream also connects with all research streams in the School supporting an integrated approach to research.

Related Projects

Patient safety

Professor Gerry Armitage vital area of work focussing on error reduction and patient involvement, with a particular focus on medicines safety and care transitions.

This stream may link closely with others, in particular improving the quality of care for people with dementia and the practice innovation stream below including the QIPP agenda.  Patient and clinician involvement in improving the quality and safety of care is a priority here, in common with other streams.

Gerry is concluding his work on an innovative NIHR Programme Grant. This investigates the impact of patient involvement on patient safety, including the co-production of an incident reporting scheme for hospital patients.

Related Projects

(2015) Doctoral Training Centre for Dementia Care and Services Research. Alzheimers Society (£450,000). Downs M, Oyebode J, Blenkinsopp A, Armitage G.

(2011 - 2014) Research for Patient Benefit Programme - Development and Evaluation of an Electronic Quality and Safety Patient-led Reporting Scheme in Renal Services. National Institute for Health Research (£250 000). Armitage G (Principal Investigator)

(2009 - 2014) Patient Involvement in Patient Safety. National Institute For Health Research Programme Grant (£2 million). Armitage G, Watt I (PI), Wright J (co-PI) Thomson R, Lawton R.

(2013) Impact of body morphology on determining degree of thoracic rotation on chest radiographs. Society & College of Radiographers: Nuffield undergraduate student award. (£1260 to support undergraduate student). Hardy M.

(2012-13) Improving Neo-natal Chest Radiography. International Society of Radiographers & Radiological Technologists. (£2500) baseline pilot project. Hardy M, Snaith B.

(2010) 30 Million Stars. Department of Health. Blackburn M, Shah K, Armitage G, Marshall K, Adams J.

(2010-2011) Development and Evaluation of Medicines Management Toolkit. Department of Health/Children’s Hospices UK (CHUK). (£30, 000). Armitage G, Blackburn M, Marshall K.

(2009-2011) Evaluation of a shared approach to diabetes care planning. Yorkshire and Humber Strategic Health Authority. (£92,000). Armitage G, Wright J, Rhodes P, Giles S.

(2009-2010) Development and Evaluation of a Training Programme for Patient Safety for Junior Doctors and Healthcare Teams. MEDEL and Yorkshire and Humber Strategic Health Authority. (£375, 000). Armitage G, Lawton R, Wright J.

Improving healthcare quality through practice innovation

This stream encompasses a number of activities focussed around the evaluation of service innovations and operation, including:

  • 4 tier structure
  • QIPP
  • advanced practice
  • service redesign
  • nurse led interventions
  • blurred boundary working
  • movement of services to primary care setting from secondary or tertiary settings

These activities are based on the priority of the regional LETB around advanced and innovative practice; the redesign of NIHR health services and delivery research group to specifically focus on evaluating models of service organisation which have the potential to improve service effectiveness, efficiency and productivity as well as patient outcomes,

Notably, work in this stream includes the the evaluation of practice development and impact of education on practice (potentially using HEE EOF framework), and supports the work of those who are interested education research and the effect this has on professional behaviours and activities.

Measuring and monitoring healthcare quality

Over the next decade, the economics of healthcare will be increasingly scrutinised as the pressure to reduce health spend as a proportion of GDP increases.  Measures of successful interventions and service effectiveness will be increasingly demanded as part of research outcomes.

There has been criticism in some fields that existing health outcome measures are flawed and fail to appropriately capture the impact of interventions beyond organisational economic or medical outcomes. In addition, the target driven approach to healthcare and league tables has been identified as a significant factor in oversights in patient safety and service quality.

The breadth of this stream is wide and may interlink with all other streams. Work will range from organisation to individual level and will involve defining new measures or questioning existing measures and exploring methodological issues. Links to social policy are also possible.

Within these themes are a number of projects with a growing number of UK/EU and international doctoral students from diverse professional backgrounds working across these. We also work with international, national and regional partners to enhance the quality and relevance of our work.  Projects include: