Shaping the future of patient safety through research

Prof Gozie Offiah describes some research projects supported by the recently established Medical Protection Society Foundation

At the Medical Protection Society (MPS) we see the many complex issues faced by today’s doctors, along with their medico-legal repercussions. These range from burnout and its impact on patient safety to consent issues and systemic problems that can harm both patients and clinicians.

Given the challenging medical environment, patient safety and the wellbeing of healthcare professionals and teams are more vital today than ever, but research into both areas has been limited. In 2021, MPS set out to change this by establishing the MPS Foundation, of which I am Chair.

The MPS Foundation aims to take a proactive step towards helping healthcare professionals improve their wellbeing, reduce risk, and improve patient safety by funding research, analysis, education, and training in these areas.

Research

This global not-for-profit research initiative is striking a chord with clinicians, with around 150 applications being received each year. It has supported over 30 research projects worldwide to make a difference and apply tangible results in the workplace. Projects awarded funding in Ireland since the MPS Foundation’s launch include a study on the experiences of female physicians in Ireland around fertility and family planning.

We have also funded research by the RCSI aimed at improving clinical handover after surgery. Poor communication contributes significantly to adverse events in healthcare. Despite established strategies to mitigate communication failures, patients can experience significant risk, and preventable harm. Clinical handovers represent a particular area of risk for communication breakdowns.

The MPS Foundation is not just about funding clinicians’ ideas. It also funds two other streams of work. The first is its own commissioned research on priority areas identified from the wealth of experience gained at MPS over many years supporting doctors facing some of the most challenging issues of their careers. The second is a series of competitions aimed at supporting the next generation of doctors who focus on patient safety and risk reduction research, thus building research capability for the future for the benefit of patients and the broader healthcare community.

Recently, I was proud to announce the winners of the MPS Foundation’s first research competition for medical interns in Ireland. The standout winning projects exemplify what doctors can achieve even at the start of their careers.

TED stockings

The national winning project by Dr Leah Lyne in the West /Northwest Intern Training Network evaluated thrombo embolic deterrent (TED) stockings in adults admitted under general surgery in Sligo University Hospital (SUH). According to the HSE Preventing Blood Clots in Hospitals report (2018) approximately 11,000 Irish people may be affected by venous thromboembolism (VTE) every year and 9 per cent of all deaths are VTE-related. Approximately 63 per cent of all VTE cases are hospital-acquired, occurring either during hospitalisation or within 90 days after discharge.

One way to prevent these deaths is to apply tight-fitting stockings, which cause compression in the lower limbs where these blood clots most commonly form and prevent blood stasis. It is the responsibility of doctors and nurses taking care of patients to ensure that those at risk of developing a clot are wearing these stockings.

Dr Lyne collected data from 49 patients admitted under general surgery. She interviewed these patients and reviewed their medication chart where TEDs are prescribed. She found that in 71 per cent of the cases, TED stockings had been prescribed for the patients by doctors, but TEDs were applied in only 47 per cent of cases. In 78 per cent of cases, the patients did not know the importance/function of TED stockings. Dr Lyne presented the findings to the nurses and doctors in the surgical department of SUH. The research will help ensure the correct prescribing and application of TED stockings and, therefore, reduce the risk of venous blood clots from occurring.

Electronic communications

The national runner-up project by Dr Shival Salgaonkar, Dr Karam Hadi, and Dr Ralph Golden, also in the West/Northwest Intern Training Network, sought to develop a more efficient electronic communications system in Galway University Hospital (GUH). Pager devices, which we commonly refer to as bleeps, are widely acknowledged as swift and dependable means of communication between nursing staff and clinicians in hospital settings. However, their frequent use for non-emergency tasks can disrupt patient care and workflow.

This global not-for-profit research initiative is striking a chord with clinicians, with around 150 applications being received each year

This project delved into the impact of frequent paging of interns for non-urgent matters during night shifts and explored the potential of electronic communication tools to alleviate this challenge.

The proposed electronic communication system utilised by both nursing staff and doctors underwent a pilot phase for three weeks. It encompassed a specific bleep covering six wards during the 12-hour night shift at GUH. It should be noted that urgent clinical reviews and emergencies were handled using the pre-existing system, ensuring patient safety was not compromised.

The results revealed a remarkable 34.2 per cent decrease in the number of bleeps received by interns during their night shifts. This reduction is particularly significant, considering that the auditory disturbance not only affects healthcare staff, but also presents a challenge for patients seeking rest and recovery.

Furthermore, it was established through surveys that the electronic communication tool received favourable feedback from both nursing staff and doctors. This positive reception lays the groundwork for the project’s expansion to a hospital-wide scale and eventually to a network-wide implementation.

Both projects have added to the body of knowledge about patient safety, risk mitigation, and healthcare professionals’ wellbeing. The demonstrated outcomes and learnings can also be replicated in other hospitals in Ireland.

Applications

I encourage medical interns in Ireland to consider entering their projects for the next MPS Foundation research competition, which is now open for applications until 14 February 2025. Those involved in interns’ work can also help by encouraging participation. Once again, we welcome project entries focused on patient safety, risk mitigation, and healthcare professionals’ wellbeing.

Each internship network winner will receive €400 and a certificate. The runners-up for each network will receive €200 and a certificate and the commended project will receive a certificate. Network winners will also compete for the national prize, making their total prize money €1,000. Further information is available on the competition portal www.thempsfoundation.org.

I look forward to continuing the fantastic work of the MPS Foundation and highlighting the value of research, which can drive important improvements in clinician wellbeing and patient care.