PILLAR ONE – Quality Improvement and Implementation Science

Using health systems thinking and implementation science to transform burn care in resource-poor and conflict environments

The first pillar is researching a number of areas aiming to make a positive impact to burn care in low and middle income environments. It is composed of three main work streams and a fourth specific one on research capacity building;

Stream 1.1

This first work stream will evaluate the impact and effectiveness of a burn unit Quality Improvement (QI) approach, and will develop a toolkit and implementation framework which will enable the QI approach to be scaled up and replicated in other countries

The QI approach assesses and measures burn units against international operational standards, and supports local teams to transform burn care through a series of tailored interventions. The QI approach was developed by Interburns – an international volunteer network of expert health professionals working to transform global burn care and prevention. A DfID funded programme from 2013-2016 delivered this programme in Nepal and Bangladesh and received a final project score of A+ for its impact on over 15,000 burn patients.

The aim of this workstream is to review into the effectiveness of the QI approach and to understand how it can be implemented in a variety of low and middle income countries (LMIC’s)

Stream 1.2

Will investigate whether there are simple, objective measures which can be applied in a burn care setting, which might be able to measure the outcomes from burn care provision.

Our PhD student Ruth-Ann Fanstone is researching whether a simplified tool to classify burn contractures can be developed to assess the quality of burn service provision, and whether this measure can be applied at scale to analyse the impact of Quality Improvement interventions on patients.

Stream 1.3

The Swansea Centre for Health Economics (SCHE) team, which is based in the College of Human and Health Sciences, will work with the Centre for Global Burn Injury and Policy Research to conduct specific studies relevant to the global burn injury field.

The SCHE team are currently working on a study to quantify the cost effectiveness of using specific dressings in mass casualty scenarios in low resource settings, and will also utilise economic modelling techniques to quantify the long-term costs of burn injuries and the cost benefits of improved care and prevention.

This work will provide the foundation for making evidence based recommendations on the optimal use of available resources to deliver cost effective interventions in resource poor settings.

Stream 1.4

This is a specific work stream which will aim to develop research skills among health professionals working in burn service provision in LMICs.

The CGBIPR will develop and deliver a portfolio of training specifically designed to develop skills in implementation science and burns research in LMICs. These programmes will be used to train an international network of researchers to work in the global burns and trauma field.

This work stream will then enable those individuals with the greatest knowledge of research needs in their local context – the local healthcare professionals – to carry out relevant studies, and to translate findings into action.

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