Collaborative systems for enhancing the analysis of social surveys: the grid enabled specialist data environments

This paper describes a group of online services which are designed to support social survey research and the production of statistical results. The 'Grid Enabled Specialist Data Environment' (GESDE) services constitute three related systems which offer facilities to search for, extract and exploit supplementary data and metadata concerned with the measurement and operationalisation of survey variables. The services also offer users the opportunity to deposit and distribute their own supplementary data resources for the benefit of dissemination and replication of the details of their own analysis. The GESDE services focus upon three application areas: specialist data relating to the measurement of occupations; educational qualifications; and ethnicity (including nationality, language, religion, national identity). They identify information resources related to the operationalisation of variables which seek to measure each of these concepts - examples include coding frames, crosswalk and translation files, and standardisation and harmonisation recommendations. These resources constitute important supplementary data which can be usefully exploited in the analysis of survey data. The GESDE services work by collecting together as much of this supplementary data as possible, and making it searchable and retrievable to others. This paper discusses the current features of the GESDE services (which have been designed as part of a wider programme of ‘e-Science’ research in the UK), and considers ongoing challenges in providing effective support for variable-oriented statistical analysis in the social sciences

Can we enhance transfusion incident reporters’ awareness of human and organisational factors?

The importance of considering human/organisational factors when reporting transfusion incidents has been highlighted recently. The UK haemovigilance scheme, Serious Hazards of Transfusion (SHOT), has established over the past two decades that most incidents are caused by human errors in the transfusion process. In order to enhance reporter’s awareness of human and organisational factors, we implemented two interventions and evaluated the effects. First, we created and incorporated a bespoke human factors investigation tool (HFIT) explicitly asking the level of contribution of individual staff member(s), the local environment or workspace, organisational or management and government or regulation. Second, we created and incorporated a self-learning package with good examples of human and organisational factors reporting within the UK national haemovigilance reporting database. Data from this tool have been analysed to investigate whether increased learning is possible. The main conclusion after one year’s use of the HFIT, was that incident reporters tended to attribute culpability mostly to individuals (62.6%). It is possible this result is due to lack of system awareness amongst incident reportersSix month initial data analysis after the inclusion of the self-learning package shows that if the incident reporter has studied the self-learning package before scoring the level of contribution associated with an incident , there is a slightly lower tendency to attribute most responsibility to individuals

Can we learn about human and organisation factors from past transfusion errors?

Seven human factors models were evaluated using a small number of historical transfusion error reports to explore learning from human and organisation factors and decide the best model for a planned larger retrospective study. Insufficient information given in many reports led to subjectivity in categorisation, but the conclusion was that systems engineering initiative for patient safety 2.0 may be the best single system to use. Analysing the human factors effectively in transfusion incidents could provide some insights into process improvement

Noticing errors in blood transfusion prevents harm to patients

Errors in blood transfusion can lead to serious patient harm, including death or major morbidity, especially as a result of ABO incompatibility. The transfusion process is a complex sociotechnical system and relies on multidisciplinary teams (MDT) of healthcare professionals, hence there are many opportunities for error. Serious Hazards of Transfusion (SHOT) is the United Kingdom (UK) independent, professionally-led haemovigilance scheme, which has collected and analysed anonymised information on adverse events and reactions in blood transfusion since 1996. The emphasis has been to learn from what goes wrong in these incidents, but the recent development of the safety II concept helped to see the importance of learning from what goes right. Investigation of near miss errors (what eventually goes right) can show where resilience/recovery within the transfusion process could be enhanced. Therefore, SHOT near miss incidents in calendar years 2014 and 2015 were analysed for how noticing actions prevented harm to patients, including what was noticed, by whom and what action they took. To do this, the near miss reports were searched for the words notice/noticed/noticing and various synonyms of these words. A total of 778/2410 (32.3%) near miss incident reports showed noticing actions had prevented patent harm. Of these, 552/778 (71.0%) were noticed by clinical staff and 226/778 (29.0%) by laboratory staff. Clinical staff performing the final ‘bedside check’ before administering the transfusion are the largest group to notice errors 327/552 (59.2%), showing the final check is crucial to patient safety. Noticing actions can prevent transfusion-related patient harm and demonstrate the value of situation awareness throughout the complex transfusion process

Effects of a demand-led evidence briefing service on the uptake and use of research evidence by commissioners of health services:A controlled before-and-after study

Background: The Health and Social Care Act 2012 has mandated research use as a core consideration of health service commissioning arrangements. We evaluated whether or not access to a demand-led evidence briefing service improved use of research evidence by commissioners compared with less intensive and less targeted alternatives. Design: Controlled before-and-after study. Setting: Clinical Commissioning Groups (CCGs) in the north of England. Main outcome measures: Change at 12 months from baseline of a CCG’s ability to acquire, assess, adapt and apply research evidence to support decision-making. Secondary outcomes measured individual clinical leads’ and managers’ intentions to use research evidence in decision-making. Methods: Nine CCGs received one of three interventions: (1) access to an evidence briefing service; (2) contact plus an unsolicited push of non-tailored evidence; or (3) an unsolicited push of non-tailored evidence. Data for the primary outcome measure were collected at baseline and 12 months post intervention, using a survey instrument devised to assess an organisation’s ability to acquire, assess, adapt and apply research evidence to support decision-making. In addition, documentary and observational evidence of the use of the outputs of the service was sought and interviews with CCG participants were undertaken. Results: Most of the requests were conceptual; they were not directly linked to discrete decisions or actions but intended to provide knowledge about possible options for future actions. Symbolic use to justify existing decisions and actions were less frequent and included a decision to close a walk-in centre and to lend weight to a major initiative to promote self-care already under way. The opportunity to impact directly on decision-making processes was limited to work to establish disinvestment policies. In terms of impact overall, the evidence briefing service was not associated with increases in CCGs’ capacity to acquire, assess, adapt and apply research evidence to support decision-making, individual intentions to use research findings or perceptions of CCGs’ relationships with researchers. Regardless of the intervention received, at baseline participating CCGs indicated that it felt it was inconsistent in its research-seeking behaviours and its capacity to acquire research remained so at follow-up. The informal nature of decision-making processes meant that there was little or no traceability of the use of evidence. Limitations: Low baseline and follow-up response rates (of 68% and 44%, respectively) and missing data limit the reliability of these findings. Conclusions: Access to a demand-led evidence briefing service did not improve the uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. Commissioners appear to be well intentioned but ad hoc users of research. Future work: Further research is required on the effects of interventions and strategies to build individual and organisational capacity to use research. Resource-intensive approaches to providing evidence may best be employed to support instrumental decision-making. Comparative evaluation of the impact of less intensive but targeted strategies on the uptake and use of research by commissioners is warranted. Funding: National Institute for Health Research Health Services and Delivery Research programme