Yvonne Carter award for Outstanding New Researcher announced

Dr Andrew Carson-Stevens, a GP Registrar and Patient Safety researcher

Q: What is your main area of interest, and how did that develop?

A: Patients experience medical errors every day, in all healthcare settings, all over the world. In primary care, we know that 2-3 patient safety incidents occur for every 100 consultations. Given the volume of consultations each day in general practice, this represents a major threat to patient health and wellbeing. It seems common sense that we should learn from these episodes of unsafe care to improve the design of future services for patients. 

The majority of such incidents and near misses in healthcare go either unnoticed or unreported. This message of missed opportunities is not unique to the United Kingdom - there are few places where patient safety data are being effectively utilised to inform improvement in outcomes for patients and staff. Back in February 2012, I left the World Health Organization's Safer Primary Care Expert Group with a plan to learn from primary care incidents reported to the England and Wales National Reporting and Learning System. There was an opportunity to learn from the quarter of a million patient safety incident reports in the national system and identify priorities for intervention. 

Q: What does your research involve?

A: Generating learning from patient safety incidents is complex. Incident reports only provide one snapshot reveal about what happened, why it occurred and the outcome for the patient. My research demonstrates that analysis of large volumes of similar reports can be used to start to build a more complete understanding of the systemic weaknesses underpinning unsafe care outcomes. There has been a lot of effort in trying to understand patient safety, but little attention given to how we structure investigations and importantly communicate our findings back to healthcare staff. With many research collaborators, I have developed the methods for application to generate learning from patient safety incidents, particularly from incident reports and clinical case note review. 

The priority given to Universal Health Coverage by the WHO and other global agencies, together with the continuing emphasis on primary care as the bedrock of successful health systems, is prompting debate about how to design high quality and safe, yet cost-effective care models. My work demonstrates it is possible to delineate systemic risks to patients receiving primary healthcare services, communicate learning with practitioners and staff, and support them to use quality improvement tools to drive system-wide quality improvement in health care. 

Q: What will the RCGP / SAPC Yvonne Carter Award enable you to do? 

A: Patient safety research is a relatively new academic field and I sought to grow the specialty at Cardiff University by founding the Primary Care Patient Safety Research Group (the 'PISA group'). The PISA group has trained over 45 clinical academics / health services researchers to independently use a mixed-method. With many researchers coming from other universities or health organisations from around the world, I plan to use the RCGP / SAPC Yvonne Carter Award to develop a training package to enable others to utilise the PISA method and learn from their own patient safety incidents in primary care. I will work with the Istanbul Faculty of Medicine in Turkey to design and implement an incident reporting system, and present lessons learnt at the WONCA European conference, allowing recruitment of additional partners to adopt methods for learning from patient safety incidents in primary care. 

Q: Based on your experience, what advice do you have for people who are interested in working in the research field?

A: To succeed as a clinical academic, I try to apply the following principles:

  1. Find mentors. Surround yourself with experienced mentors from research, education, policy and other subject disciplines. Identify who you enjoy thinking with. Embrace humility and find enjoyment in being challenged. Never stop learning. 
  2. Nurture an idea. Apply for 'seed corn' funds to begin cultivating an acorn into a potential oak tree. The preliminary findings can help reassure grant reviewers that you have evidence supporting your proposal. 
  3. Share a vision. Articulate the goals you expect to achieve and then work backwards to identify key concepts (and accompanying ideas) that you think are needed to achieve this.
  4. Be resourceful. Need a team? Got no money to hire researchers? Plan creatively to enable you to achieve your goals. Students and junior doctors can make insightful, hardworking research assistants. Be clear about what is expected from them and have curiosity to learn what can be achieved with them. Learn from failures and have a process for capturing the learning. 
  5. Make time to invest in others. Medicine has no shortage of very good people, although not everyone gets the support they need. Make time to support others to achieve their goals. 

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