Patient Safety
Professor Andrew Carson-Stevens, Director of the World Health Organization Collaboration Centre for Patient Safety Learning and Improvement, leads the Patient Safety research theme.
This area of work focuses on conceptualising harm and risk, including the investigation and measurement of healthcare-associated harm experienced by patients and families, and understanding how to optimise care and reduce avoidable unscheduled and emergency care admissions for those with palliative and end-of-life care needs.
Research areas of the theme
Conceptualising harm and risk
Our research demonstrates how important context, autonomy and patient-and-family preference can be to an appraisal of what is considered safe or unsafe. Without a better understanding of safety, risk and potential benefits/harms for these patients, the ability to measure the consequences of service failures is limited and hindering the identification of the changes needed to improve systems and future practice, including safeguarding against harm for all those involved in caregiving.
Our research seeks to advance the methodological approaches used, and to build system capability, to measure healthcare-associated harm where palliative and end of life care is delivered across the health and social care continuum.
Optimising care quality and safety in the last year of life
We work nationally with organisations (NHS Wales, Wales Value in Health Centre, Digital Health and Care Wales) to develop a ‘Last Year of Life Digital Dashboard’ comprised of data about the care received by patients that have died in Wales since 2018 (c. 204, 576 people between 2018 and 2023). Many attendances result in unnecessary hospital admissions and/ or interventions risking harm at the end-of-life.
Using the Last Year of Life Digital Dashboard, we characterise common trajectories of care, in terms of use of services across the health and social care landscape by underlying disease or condition, which in combination with data about various characteristics and social variables, informs understanding about where and how solutions can be targeted to optimise care for future patients.
Advancing measurement of core outcomes
Our research has developed core outcome sets, standardised lists of key things to measure for a specific disease, focusing on what matters most to patients, which support improvements in care for vulnerable patient populations. These include symptoms, how well someone can function in daily life, and overall health-related quality of life. They help doctors make better decisions, allow healthcare services to be evaluated effectively, and ensure research uses consistent, meaningful measures.
Our outcome sets for palliative care are used for patients with malignant bowel obstruction and brain tumours. The Centre has also identified priority outcomes for people living with glioma to guide UK clinical trials. Ongoing work, in partnership with national organisations (including NHS Wales, the Wales Value in Health Centre, Digital Health and Care Wales, and the Tessa Jowell Brain Cancer Mission), is helping to develop tools to capture meaningful data in NHS settings, ultimately improving care for people with glioma. Collaborations with the End of Life Care Board in Wales and the Wales Value in Health Centre have led to the development of a core outcome set for evaluating the effectiveness of adult palliative care services in Wales. This work is providing additional data to be included in the ‘Last Year of Life Digital Dashboard’.
By combining different types of routine healthcare data, alongside the intel from the development of novel ways of measurement (patient-reported measures, core outcome sets), we are advancing ways to understand how existing care systems can be optimised and designed for safer care delivery to future recipients.
