HEAPHY 1 & 2 PLENARY Angela DUXBURY Sat 31 st Aug 2013 Session 1 / Talk 1 08:40 – 09:15 ABSTRACT The need to keep practitioner skills evolving to meet changing context and agendas- name key workforce agendas / Francis report / Every contact Counts / Improvement Science, six C's and User carer initiatives etc. Changes in education commissioning and expectations-mandatory training requirements/service user involvements in admissions, curricular development, teaching etc...HCPC -regulatory body expectations now of service user involvement in training. Meeting service expectations-individual skills development to include management and leadership, strategic thinking, emotional resilience, entrepreneurial and interpreneurial skills (might use some of CoR research evidence on this) impovement science etc. The continued importance of research and knowledge transfer skills, evidence based practice etc. This would then lead into going through how easy it is to submit a paper for publication by a demo of the Editorial manager for the JRP. What makes a good paper , a good reviewer. I thought I would conclude with as a profession we have come a long way over the last 20 years since becoming an all graduate profession and demonstrate this by presenting some outcomes of recent relevant research and its importance to practice-published
ABSTRACT The need to keep practitioner skills evolving to meet changing context and agendas-name key workforce agendas / Francis report / Every contact Counts / Improvement Science, six C's and User carer initiatives etc. - PowerPoint PPT Presentation
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HEAPHY 1 & 2PLENARY
Angela DUXBURY
Sat 31st Aug 2013Session 1 / Talk 1
08:40 – 09:15
ABSTRACTThe need to keep practitioner skills evolving to meet changing context and agendas-name key workforce agendas / Francis report / Every contact Counts / Improvement Science, six C's and User carer initiatives etc.Changes in education commissioning and expectations-mandatory training requirements/service user involvements in admissions, curricular development, teaching etc...HCPC -regulatory body expectations now of service user involvement in training.Meeting service expectations-individual skills development to include management and leadership, strategic thinking, emotional resilience, entrepreneurial and interpreneurial skills (might use some of CoR research evidence on this) impovement science etc.The continued importance of research and knowledge transfer skills, evidence based practice etc. This would then lead into going through how easy it is to submit a paper for publication by a demo of the Editorial manager for the JRP. What makes a good paper , a good reviewer.I thought I would conclude with as a profession we have come a long way over the last 20 years since becoming an all graduate profession and demonstrate this by presenting some outcomes of recent relevant research and its importance to practice-published
Radiation Technologists:What does it take to Practice?
Professor Angela DuxburyDeputy Head of Department: Allied Health
Professions
The Issues to be explored• How do we rise to the challenges, contribute to service
improvement, and employ evidence based practice whilst working smarter, faster, safer, and with the right skills?
• What are the important practitioner attributes?
• What is the importance of innovation, ingenuity and entrepreneurialism?
• Research skills are key to evidence based practice. How do we overcome the barriers to undertaking research in the clinical setting, and share these outcomes?
Some facts
• In both the UK/NZ-massive increase in cancer, obesity and diabetes incidence and chronic disease
• People living longer
UK-a rise in chronic disease
Arthritis up 100% to 17mill by 2030
People with 3+ long-term conditions
up 100% to 2.9 m by 2018
Diabetics up 29% by 2025 to reach 4
million
People living longer with cancer
doubling by 2034 to 4 million
People living with dementia will more than double over
next 30 years to 1.4 mill
Changing world=we have some challenges!
New Zealand/ United Kingdom health care costs
• Funding health systems: mainly from-Vote Health- $14,655 billion in 2013/14
cost per head of population $3,271(£~1807)• NHS mainly tax payers- £111,400 billion in
2013/14 cost per head of population £2,082 (~$3769)
• In UK 10% of patients are harmed during their healthcare experience-900,000 people-impact on spending £1 billion per year (1)
1. Vincent C.Is health care getting safer? BMJ 2008;337;a2426
NZ: The Ministry of Health’s Statement of Intent 2013–2016 identifies three outcomes for the health system.
• New Zealanders are healthier and more independent.
• Health services are delivered better, sooner and more conveniently.
• The future sustainability of the health system is assured
National Health Service (NHS) objectives:
New emphasis: Achieving outcomes depends on the performance of people
• Telling and controlling the reality of the situation-through reports and policy agendas
• Regulation and training of staff• Doing things differently-we cannot afford
the growing demand for service or growing litigation costs-education and its people
It feels like....
NHS greater emphasis on patient voice and patient safety
Mid Staffordshire NHS Foundation Trust Public Enquiry:
The Frances Report
• A story of “appalling suffering of many patients.”
• 400-1200 deaths attributed to poor care
• First inquiry held in 2009
• First report in 2010 from Sir Robert Francis QC focused on Trust failings and patient / carer accounts of care – “patients not numbers”
• Second report published 5 February 2013 focused on system failures and need for system and cultural change – no heads have rolled!
• In total the report is 1776 pages long with 290 recommendations
Agendas
• The NHS constitution: access to service- right place right time
• Patient safety and patient voice• Values, ethics, compassion, adaptability of staff• Service improvement science agenda• Leadership-importance of taking responsibility• Reflective, resilient, innovative and entrepreneurial
The Health Professions Order 2001Health and Care Professions Council (UK)
• Public Protection • Registration• Standards of Education• Standards of Conduct,
Performance and Ethics • Standards of
Proficiency• Tribunals
• health and safety of the public• high standard of treatment• requires update and improve
their skills• properly trained and qualified
before they can be registered• independent registering
authorities to register and monitor health practitioners
• independent Health Practitioners Disciplinary Tribunal
Frances report findings:
Spotlight on Education and Training greater emphasis on:
• Employability and Career Development• Graduate attributes• Resilience and Wistleblowing• Curricular design provides opportunity for
Entrepreneurship and Social Enterprise• Personal and Professional Development
Planning/Life Long Learning• Evidence based practice - Research
NHS Values and constitution-the brand
Excellent Education: Treatment Simulation
Competent & Capable Staff
NHS Constitution
Adaptive & Flexible Workforce: Responsive to Innovation and knowledge dissemination of new technologies, Best Practice, and Research and Innovation in order to Reduce Variability and Poor Practice.
values and behaviors to provide Person-Centered Care and improved patient experience by positive engagement with Continuing Professional Development.
• Widening Participation: Talent and Leadership flourishes free from discrimination and individuals and groups are able to progress to fulfill their potential in best possible patient outcomes
(not serious!)
• Patient-centred care-useful reminder of what we need to do for anyone prone to lapses of concentration
• Joined-up thinking-something we aspire to when you’ve mastered joined –up writing and joined up shoelaces
• Going forward-adds a sense of purpose to the idea of getting around to something at some point
Glossary of NHS Speak-Some of my favourites!
Must do things differently.....
• Emphasis on staff• Importance of people attributes
Skills and attributes
Importance of Culture? Personality, Attributes?
Different skills
Entreprenurial/ Intraprenurial• Internal entrepreneurs are independent
thinkers. They are willing to try new things. They don’t let past experience get in their way or cloud their judgement.
• They see possibilities where others don’t.
Entreprenurial/ Intraprenurial• They don’t sit back and wait for things to
become clear. They control uncertainty by acting. • Internal entrepreneurs are totally engaged
and energized by a challenge. They take on the toughest jobs.
Entreprenurial/ Intraprenurial Internal entrepreneurs are good at driving change. They are willing to take on risks to change their comfort zone. They make change happen.
Internal entrepreneurs are highly effective leaders. They are able to break down barriers and create new systems to support them. They lead through complexity.
Entreprenurial/ Intraprenurial
Internal entrepreneurs are good at execution. They have the discipline to stay focused and bring things to closure. They close the gap between strategyand execution. (2)
(2) Amo B, Kolvereid L. Organisational strategy, individual personality and innovation behaviour, Journal of Enterprising Culture 2005;13(1): 7-19
The skills and capabilities that were needed in the past are not the skills needed moving forward. The reality is that we all need to be entrepreneurs now and we need leaders who havethe entrepreneurial talent toshake things up and get things moving.
through pedagogy, increases innovation, retention and employability.
Dr Heidi Probst. Sheffield Hallam University Reader and Principal Lecturer
Some quotes from the 2INSPIRE project
• In response to a question about people starting out on the path to intrapreneurship:
• “ this is not going to be an easy road. If your not prepared to take that level of challenge…then it’s get out of the kitchen now”
• “to be an expert practitioner…in order to be confident in what you do you need to know that your underpinning theory is absolutely sound so that there is a commitment to learn about your subject…its about knowing you know”
Some quotes from the 2INSPIRE project
“ knowing your stuff is really important, expect to be challenged, and be prepared , but also it’s important to trust your institution and yourself….. and know that I am right”
Qu. What drives you to innovate, what are the motivators?
“a real passion for wanting to do research, and also wanting to do research that I knew would change the patient experience”
“when doors get slammed in your face...you just keep hammering away”
“ we could be doing this so much better, this was the motivation to make change”
Amanda Bolderston (Canada)Peter Bridge (Brisbane, Australia)Bozidar Casar (Ljubljana, Slovenia)Mary Coffey (Dublin, Eire)Karen Coleman (Wellington, New Zealand)Penelope Engel-Hills (South Africa)Mark Trombetta (Pittsburgh, USA)TS Kehwar (Pittsburgh, USA)Ahmed Salem (Amman, Jordan)Peter White (Kowloon, Hong Kong)Caroline Wright (Melbourne, Australia)
Editorial Manager
• On line platform• All actions undertaken through this
platform-submission through to publication
• www.journals.cambridge.org/jrp
Some statistics
• 62 papers 2012, 57 through peer review process-5 rejected at outset
• Editor and two reviewers review the paper• First decisions made revise or reject• 47 revisions and 10 rejected• 40 revised papers 33 accepted, 7 further
revisions and these accepted.• 7 authors failed to do revisions
Peer Reviewers
• Journal has 130 reviewers from all over the world
• Qualifications-masters degree or higher• Guide for reviewers and annual award for
best reviewer Any volunteers?
Good peer reviewers• Experienced academic or writer• Give constructive and detailed feedback• Use headings to guide review• Access to MEDLINE to view similar papers• Need to understands etiquette of referencing e.g.
when to use et al./accessing web sites protocol-date of access, place of publication often missed out
Publication
• Once accepted-Typeset and checked• First come first served basis so that copy
is a bit of everything rather than one focus• Pagination needs to fit budget• Published online and in paper publication
• And finally.. what you learn by being a reviewer or reading Journals?
Recent research findings.....
Article: Cranberry in radiotherapy: dispelling myths: A literature review. JRP in press 2013
Author: Lynn Gordon• Conclusions: • A lack of high quality data was identified in the literature
reviewed and no firm evidence was found to support the continued recommendation of cranberry as part
of management of radiation induced urinary tract side effects. Well-designed RCT are required before further recommendations regarding the use of cranberry in radiotherapy are made.
Article: Oral candidiasis: Species identification and their antifungal susceptibility pattern in cancer patients receiving
radiation therapy. JRP 2013;12(2) 100-104
Authors: Mane and Pratyusha • Outcome:• The colonisation of candida may lead to development of
infections with drug-resistant strains and patients receiving radiation for head and neck cancers should undergo micro biological study for oral candidiasis
Article: A pain survey to support role development for Radiation Therapist in Ghana JRP 2013;12(2) 105-113
• Authors: Kyei and Engle-Hills• Findings:• RT’s could administer a limited pain questionnaire and use
this for clinical assessment of patients with pain, refer patients who need urgent medical attention to doctors, monitor patients receiving radiotherapy and adjuvant chemotherapy and provide suggestions to multi disciplinary team on pain management
• Role development and improved quality of patent care
Manuka honey mouthwash does not affect oral mucositis in head and neck cancer patients in New Zealand. JRP 2012;11 (4). 249-
256
• Authors: Parsons, Begley and Patries Herst• Findings• In contrast to previous honey trials in Malaysia,
Egypt, Iran and India, diluted manuka honey did not decrease the extent and onset of radiation-induced oral mucositis but did appear to ameliorate radiation-induced weight
loss and increase quality of life in the absence of cisplatin chemotherapy.
“Obstacles are things a person sees when he takes his eyes off his goal.”
“Change is a challenge and an opportunity; not a threat. ”
References1. Vincent C.Is health care getting safer? British Medical Journal 2008;337;a24262 Amo B, Kolvereid L. Organisational strategy, individual personality and innovation
behaviour, Journal of Enterprising Culture 2005;13(1): 7-193. Probst, H.(2013). 2 Inspire: Increasing intrapreneurial skills through pedagogy, increases
innovation, retention and employability. Sheffield Hallam University4. Turner A, D’Alimore L ,Fitch M.Promoting radiation therapy research: understanding
perspectives transforming culture Journal of Radiotherapy in Practice 2013;12(2) 92-995. Williams C. Attitudes to and perception of research for health science lecturers.
Radiography 2013;19 (1) 56-61 6. Gordon L. Cranberry in radiotherapy: dispelling myths: A literature review. JRP in press 7. Kyei, Engle-Hills P. A pain survey to support role development for Radiation Therapist in
Ghana JRP 2013;12(2) 105-113 8. Mane, Pratyusha.Oral candidiasis: Species identification and their antifungal susceptibility
pattern in cancer patients receiving radiation therapy. JRP 2013;12(2) 100-104 9. Parsons, Begley, Herst P. Manuka honey mouthwash does not affect oral mucositis in
head and neck cancer patients in New Zealand. JRP 2012;11(4) 249-256