Embedding Research in Practice

Judy Lawrence RD PhDJ.lawrence@bda.uk.com

Aim

To outline ways in which AHP’s, can embed research in their work

– Audit/Practice evaluation

– Research projects

– Getting help

What is research?

Definition• Aims to derive new knowledge which is

potentially generalisable or transferable.

Barriers to dietetic research

• Time and money• Lack of research knowledge and skills• No support and advice• No research culture in our dept• No personal interest

• Howard et al, J Hum Nutr Diet. 2013; 26 S1:180-7.

No time

Audit and service evaluation involve lots of research skills, and should be part of your roleAudit “Clinical audit should be compulsory for all healthcare professionals providing clinical care and the requirement to participate in it should be included as part of the contract of employment.” 'Principles for Best Practice in Clinical Audit' (2002, NICE/CHI)

Lack of knowledge & skills

Audit• Does not involve a completely new treatment

or practice• Addresses a clearly defined audit question• Uses robust methodology• Measures against an established standard• Generates evidence to demonstrate a level of

compliance with agreed standards

How to get involved

Should be part of your job description• Get management support• Start by repeating an audit as part of the cycleCan the original audit be improved?– Was the method robust?– Could the data collection be expanded?– Get help from clinical audit department

How to get involved

• Initiate a new audit• What standards exist in your area?• What are neighbouring trusts auditing?• Develop a student project• Share the outcome - publish

Audit as CPD

What did you learn?• Clear aim• Robust methodology• People skills • Data collection • Analysis• Writing up• Presentation skills

No research culture in the dept.

Service evaluation• Aims to judge a services’

effectiveness/efficiency through assessment of its aims activities outcomes and cost. May also be called benchmarking or organisational audit.

http://www.institute.nhs.uk/research_and_evaluation/general/research_and_evaluation_home.html

Get involved

Usually designed to answer the question “What standard does this service achieve?”• Monitor how well the service meets its aim

and how it can be improved– What is the aim of your service?– What outcomes do you expect to see?– Do you routinely collect data?

Process

How can you evaluate your serviceWhat data do you routinely collect?• How robustly is it collected?Does it relate to your aim?• Do you need to collect different data or better data?• Quantitative/qualitative/both• How will you analyse it?

Outcomes

Data collection– Interviews, focus groups, questionnaires• What questions are you trying to answer?• Are there validated questionnaires available?• Who will do the interviews?• Are there conflicts of interest?

Ethical approval may not be needed but the work should still be ethical

Data analysis

Consider this before you collect the data• Do you have the skills necessary• How can you acquire them?• How will the analysed data allow you to show

that the service met its aim?How will you share the work you have done?CPD - What have you learnt?

Research Projects

Derives generalisable new knowledgeYou already have lots of the skills neededQuestion your practice• What is the evidence base for what you do?• Would another treatment option be better?May compare interventions or evaluate an

experienceDon’t be put off by ethics

A clear aim

The success of the project depends on the clarity of the aim

Time/Money

Students!Grants• Companies • Nutricia, DANONE

• Charities• http://www.amrc.org.uk/our-members_member-profiles

• What do they want done?• Can you do it? You may need to use your own time

NIHRNational Institute of Health Research• http://www.nihr.ac.uk/Pages/default.aspx• Commission and fund NHS, social care and public

health research• Funding based on quality and relevance• Research design service• Publications – briefing documents• Calls for proposals• Research training

Clinical Academic Training Nurses, midwives and AHP • Brilliant scheme• (internships)• Masters in Research, Masters in Clinical

Research• Clinical Doctoral Research Fellowships• Clinical Lectureship• Senior Clinical Lectureshiphttp://www.nihrtcc.nhs.uk/cat/

Internship

New schemeAllows clinicians to try research About £10,000Administered by Local Education & Training Boards

(LETBs)

http://em.hee.nhs.uk/2013/10/09/health-education-east-midlands-launch-the-new-clinical-academic-careers-internship/

Masters in Research University of Birmingham• http://

www.birmingham.ac.uk/postgraduate/courses/combined/med/health-research.aspx

• To link theory and method with practical skills• Funding to cover salary and fees• Minimum of 1 year experience as AHP

Clinical Doctoral Research Fellowship

• 1 years clinical experience since graduating• Sufficient research training or experience• Wish to obtain a PhD by research whilst

developing their clinical skills• Salary cost + tuition fees + research costs

• http://www.nihrtcc.nhs.uk/cat/cdrf

Research Design Service

Part of NIHR• Give priority to grant applications • Regional centres, hub in Birmingham– Workshops– Seminars– Newsletter– Resource packs

http://www.rds-wm.nihr.ac.uk/web/guest/home/

Help

Centre for Reviews and Disseminationhttp://

www.york.ac.uk/inst/crd/finding_studies_systematic_reviews.htm

Cochranehttp://training.cochrane.org/AHP Research Networkhttp://

www.csp.org.uk/professional-union/research/networking/allied-health-professions-research-network