1 May 2020

Researchers will carry out a qualitative study at St George's NHS Foundation Trust to develop a greater understanding of how service innovation and rapid transformation were achieved and how these improvements might be sustained to support future service improvements,

Intensive care unit

The project aims to investigate:

  • How has knowledge been mobilised to support service innovation and rapid service transformation?
  • What improvement and implementation approaches have been used to support service innovation?
  • What effects have rapid innovation had on the service, and to what extent?

How will the research will be carried out

We have an opportunity to capture in real time some of the impacts of the implementation and improvement interventions that are underway in the Intensive care unit (ICU) at St George's NHS Trust.  We will do this in a dynamic and flexible way to ensure that patient care is not compromised by research activities.  The goal would be to continue tracking the process of implementation and improvement throughout the current crisis and into the period of recovery (estimate 9 months-1 year).

Methods: Weekly interviews (via Zoom) will be held between the clinician-researchers and the wider research team. These will be recorded and transcribed. Additional short, focused ethnographic interviews conducted by the three NHS clinician-researchers with a range of healthcare professionals (e.g. doctors, nurses, physiotherapists) and NHS managers. Fieldnotes in the form of written notes or photos (not featuring patients or staff) or voice messages will be taken by the three NHS staff members in the form of either a WhatsApp messaging group (written or an audio recording) or short e-mail updates to the research team and will include insights from meetings that specifically focus on implementation and/ or improvement. We will also collect documents (such as e-mails, communications to staff, clinical guidance/protocols) relevant to the study.

Data analysis will be conducted by the research team as a whole.  Given the pressures on the current service context, data will not be analysed until the end of project staff and two researchers in the Faculty of Health, Social Care and Education and Kingston University and St George’s University of London.  A small virtual advisory group will be set up (Professor Fiona Jones and Dr Deborah Harding from St George's University of London/ Kingston University) and Sally Brearley (Patient Representative) will support the study.

This project will provide an opportunity to learn from the experience of service innovation and rapid service transformation to improve current and future patient care in south London.

Annette Boaz

Prof Annette Boaz

About the research team

The research team consists of of an ICU physician, anaethesiologist and nurse practice educator at St George's Hospital, an innovation specialist from the Health Innovation Network, and health service researchers with backgrounds in social science from Kingston University and St George's, University of London. 

The study was adopted by ARC South London in June 2020. It will be completed by April 2021.