START DATE AND DURATION: September 2020This PhD study is identifying patient safety indicators that span community, primary and secondary care, which could be collected from a digital integrated care record. It is identifying where gaps lie and some of the challenges to data collection. The findings will be used to develop a framework to guide the monitoring of the safety of patient care across organisations and time. As a case study, this research focuses on developing measures of insulin safety within the integrated digital systems of North Central London Integrated Care System.
There are two developing areas that could improve the safety of insulin use when people go into hospital and return home. The first is the creation of Integrated Care Systems (ICSs). ICSs are being developed across the country, and they will bring all health care (including general practice, hospital, social care, mental health) provided by different organisations into one co-ordinated system. The second area is the further development and communication using digital health systems so that health and care professionals have appropriate access to up to date information for the person they are treating. Digital health systems can be used within the ICSs to share information with all the health professionals who need it, reducing the risk of mistakes. They can also be used to highlight where people are at risk, for example, by showing when blood tests are overdue.
This research aims to explore how digital health systems in ICSs can be used to indicate how safe the use of insulin is, both for individuals and across the whole ICS. It will explore how this can be measured in real time and how current results can be compared with previous results to show whether there has been an improvement. To do this, the researcher will explore the experiences of people who use insulin and have had a hospital stay as well as those of the health and care staff who looked after them. A detailed picture of insulin use when people move between hospital and home will be developed. The research will explore what goes well, where problems can occur, and where improvements can be made. Ways in which digital health systems can support these improvements will be examined. Using this very detailed map, possible measures that can provide an indication of safety for insulin use will be considered and recommended.
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