Population Health Sciences PhD Studentship

Population Health Sciences Competition Funded Studentship- One studentship to be awarded selected from applicants from the following two projects:

Applicants should select their preferred project and refer to the How to Apply section below before submitting their application using the application tab at the bottom of the page.

PROJECT PSRC-1

Project Title: Exploring patient safety incident investigation capability and capacity in healthcare.

Supervisors:Dr Mohammad Farhad Peerally, m.f.peerally@le.ac.uk; Prof Natalie Armstrong natalie.armstrong@leicester.ac.uk 

Project Description
Background
Patient safety incidents are often caused by multi-faceted factors originating across the whole ecology of healthcare and are intrinsic to its properties as a complex adaptive system. Identifying the contributory factors to patient safety incidents requires investments in skills and resources to conduct thorough investigations. Investigative capability and capacity within healthcare organizations are thus crucial in achieving effective incident management and improving patient safety. Yet an in-depth understanding of what constitutes “strong” investigative capability and capacity in healthcare settings is currently lacking.

Proposed project
This PhD studentship thus aims to research organizational responses following incident investigations in healthcare, with a focus on capability and capacity at an organizational and sector-wide level.  The PhD studentship will involve the use of mixed methods to develop insights into the current resources deployed at organizational level to conduct patient safety incident investigations in the NHS, explore the factors influencing strong investigative capability and capacity in healthcare, and relevant lessons that can be learnt for healthcare from practices in other safety-critical industries, with the aim of developing a framework for strong investigative capability and capacity adapted to the specifics of healthcare.

This project is particularly timely given the current implementation of a new patient safety incident response framework in the NHS to assist healthcare organisations to develop appropriate system structures and shared cultural values to respond to patient safety incidents.
Impact of this project

The outcomes of this PhD project are anticipated to have significant implications for policy, practice and research. The findings are expected to support the development of evidence-based policies to improve healthcare responses following patient safety incidents and inform national and international policies related to investigative resource allocation and the development of investigation expertise. 
This PhD studentship has the potential to provide a scaffold for future research in incident investigations, with transferrable findings across industries. The findings are expected to generate theoretical and practical insights into the practice of incident investigation as a social activity influenced by multiple contextual factors, which will further inform future cross-disciplinary research efforts on the topic.

PROJECT PSRC-2

Project Title: Workload, Staffing and Patient Safety in Healthcare: Examining Practices and Contexts.

Supervisors: Dr Jennifer Creese Jennifer.creese@leicester.ac.uk, Associate Professor Nicola Mackintosh Nicola.mackintosh@leicester.ac.uk   

Project Description

Within the NHS (and many other health services internationally), healthcare staff consistently report high workloads, often accompanied by (both causing and caused by) understaffing. This has manifested in longer waiting times and potential safety risks to patients, and working over hours or over-burdened rotas and potential burnout for staff. Through this, services strive to remain functional and maintain patient safety; this may happen in different ways for different units, departments and services, and for different teams. The practices of functionality and safety are often understood at the team, organisational or specialty level. However, by looking across different services and specialisations at how practice is formed and used to mediate understaffing and overwork to maintain functionality and safety, insights may be generated to inform broader service improvement.  

This doctoral studentship will undertake a rigorous analysis of the way staffing and workload manifest in service functionality as shaped by practice, drawing on practice theory (Schatzki). The studentship will undertake a mixed methods analysis of staffing levels, workload levels and workload practices across multiple NHS sites and services, utilising NHS internal workforce data and ethnographic methods. 

The overall aim for the studentship is to develop new insights into how different contexts in healthcare services shape practices and perceptions around workload, staffing and patient safety Impact from this PhD may include contributing to greater understanding of the relationship between staffing, workload and patient safety in different contexts for healthcare improvement .

The objectives for this studentship are:

1. To analyse internal NHS staff survey data around workload/job demand, perceived staffing levels, safety in clinical practice and care quality, identifying positive outliers (positive deviancy).
2. To gather ethnographic observational data and interview data on site from services/units where high workloads and low staffing levels are correlated with high care quality and safety, using practice theory to examine practices of work in these services.
3. To develop models for understanding links between workloads, staffing levels and care quality and safety mediated through context and practice.