East Kent Hospitals NHS Trust
Name of Contact: VICKI MAY
Phone: 01227 766877 ex 73695
E-mail: vicki.may@ekht.nhs.uk
Description of Trust
East Kent Hospitals provide acute hospital services at 3 main hospitals but has approximately 1634 beds over 5 hospital sites (William Harvey Hospital Ashford, Queen Elizabeth Queen Mother Hospital Margate, Kent & Canterbury Hospital Canterbury, Royal Victoria Hospital Folkestone and Buckland Hospital Dover). The geographical area covers approx 50 miles, representing both rural and town communities.
The Trust serves a population of 600,000 and employs approximately 8, 000 employees of which 3, 500 are nursing.
There are approximately 150 clinical areas which are currently in 15 directorates (although re structuring is imminent)
We have a 1 star rating.
Infrastructure to support R&D
In July 2002 under the umbrella of “Shared Governance”, the Nursing & Quality Directorate set up its first Nursing & Midwifery Research & Development Forum. Approximately 15-20 members come from a wide range of clinical areas and represent a mixture of nursing and midwifery grades, as well as having members from supporting areas such as the local university, the library services, audit and the Trust R&D department. The forum exists to promote nursing and midwifery research activity and change clinical practice. The forum does this by:
- Informing people about research appraisal workshops and accessing clinical research databases.
- Providing support and supervision to those undertaking a research project.
- Helping people write high quality research proposals in line with national and local priorities.
- Peer review research proposals
- Putting people in touch with possible funding sources
- Facilitating the pathway through the Trust R&D department and Ethics Committee processes.
- Helping and promoting the dissemination of research findings via presentations at national conferences and journal publications.
Managerial support for attending these meetings has been secured by all members.
In addition to the forum, the Trust has a small R&D Department (1 manager, 1 secretary and a part time clinical director). They oversee all Governance issues and have a national perspective on all NHS research. They support multi professional research, however medical research still predominates.
All Trust employees have access to the intranet, e-mail and the internet. However, clinical staff rarely have time to access this. Additionally, all staff can gain access to excellent library resources.
Within the Trust there is also a small central Nursing Practice Development Team, consisting of 5 WTE. They support all nursing staff in a variety of ways, leading on Trust wide initiatives such as ‘Essence of Care’ Benchmarking, which have strong links to the development aspects of R&D and changing practice. The Trust also supports several practice development nurses working within some directorates/specialties and a few joint appointments with the local university in the way of lecturer/practitioner posts.
Examples of clinically based research and development projects / activity that have made a difference to patients experience / outcomes
The forum has only been in existence for 1 year but its achievement levels are high, at this stage not necessarily resulting in differences to patient experiences but in producing foundation blocks to build upon, as no central coordination of nursing research existed previously.
Work initially started with establishing a strategy and action plan.
We then had to let people know that the forum existed. This was achieved as part of the wider launch of Shared Governance and additionally, we produced an information leaflet.
We then had to look at simplifying the research process as too many people were confused and did not know how to access the right help at the right time. We produced a flow chart (attached) and this is sent out when a nurse enquires to the Trust R&D department and by all members if approached for help. Additionally this is available on the forums web page on the intranet.
We have set about increasing the number of nurses available to peer review research projects that come though the Trust R&D Department and have gone from 3 to 9, and this course will be offered bi-yearly. This course has also formally established criteria for both what peer reviewers need in terms of qualifications/experience and what is looked for by them in a project. This reviewing criterion has also been made available to those writing projects so they can set about achieving the criteria in a fair and open manner.
We are establishing a database of all research and development activity. This has however been very difficult over such a large area, battling with a culture of not to share information and people not recognizing that what they are doing is research or development. It is anticipated that this will get easier as the forums presence becomes more established.
Additional achievements have been to facilitate/mediate 2 separate projects at the ethics stage. Confusion occurred with one regarding whether it was advice or an application and what was required to enable things to proceed, based on whether or not the project was research or audit. The second example related to the overlap between permission to proceed forms from R&D and when the process for application at ethics can commence and proceed. Again it was just knowing what was required in both circumstances that helped with negotiations and prevented the projects being abandoned due to frustrations.
The forums final achievement is being part of organizing a nursing and midwifery conference for the Trust. The philosophies of dissemination are being shared through 40 poster presentations and 16 verbal presentations of development initiatives and changing practice that occurred over the past 2 years. Many of the presenters are first timers and the conference is free to 250 nurses and midwives of all grades from A-H+. This will be an excellent example of sharing practice and will hopefully show some people that changing practice is achievable in challenging times and that dissemination has to be part of any research and development process to prevent the wheel form being reinvented
Any internet links
All our information is available on the Trust intranet. I have just found out that this is not available out side the Trust so if people contact me I will be more than happy to pass information on electronically and we as a forum will need to address this in the future.