Clinical trial NCT05772195: Central London Patient Safety Research Collaboration
Official title: Safer Services, Organisations, and Innovation: The Central London Patient Safety Research Collaboration
Study type: OBSERVATIONAL
Overall status: ACTIVE_NOT_RECRUITING
Conditions: Surgery-Complications
Safety Issues
Lead sponsor: University College London Hospitals
Sponsor class: OTHER
First posted: 2023-03-16
Enrollment: 500000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Major surgery Critical care admission

Brief summary: Patient safety is a priority for healthcare systems. In safe systems, patients would be saved from avoidable harm, both from their own conditions, and from the care and treatments provided to them. Amongst the highest risk clinical settings are Surgical, Perioperative, Acute and Critical carE services (SPACE).

The Central London Patient Safety Research Collaborative is funded to deliver world-class research into improving the safety of SPACE services, within which the investigators will evaluate major service reorganisation, compare and investigate organisational safety and quality, and investigate the disparity in postoperative complications associated with socioeconomic factors.

Detailed description: Patient safety is a priority for healthcare systems. In safe systems, patients would be saved from avoidable harm, both from their own conditions, and from the care and treatments provided to them.

International estimates suggest that of 421 million hospitalisations worldwide annually, there are 42.7 million adverse events or unsafe experiences, making avoidable harm the 14th leading cause of death and serious illness. Amongst the highest risk clinical settings are Surgical, Perioperative, Acute and Critical carE services (SPACE), treating \>25 million NHS patients annually. Patient safety risks are particularly likely in these environments, both because of what clinicians are required to do (the trauma of surgery and anaesthesia, the need for rapid recognition and decision-making in acute illness) and the patient's condition (because acute illness and surgery compound the risks from long-term conditions such as diabetes and heart disease).

The Central London Patient Safety Research Collaborative will be funded by the NIHR to deliver world-class research into improving the safety of Surgical, Perioperative, Acute and Critical carE services (SPACE) services. Three themes, using existing patient data, are included in this application:

1. Safer services The investigators will evaluate the safety of SPACE-related interventions of the NHS' post-pandemic Elective Recovery Plan. The investigators will use NHS administrative datasets to identify and explore changes in safety and quality over the implementation timeframe using advanced statistical methods.
2. Safer organisations From linked clinical and administrative datasets, The investigators will identify and seek to contextualise high- and low-performing units and hospitals across SPACE services using advanced statistical methods. This work will be followed by qualitative research, exploring why differences exist.
3. Safer innovations The investigators will identify the timeframe over which patients from deprived backgrounds develop worse postoperative outcomes (as has previously been demonstrated). These novel findings could pave the way for interventions to reduce inequality.

Eligibility criteria: Inclusion Criteria:

* as determined by clinical audits

Exclusion Criteria:

* missing key data items/ or linkage

Primary outcomes:
measure: Total number of elective operations performed within the NHS
timeFrame: 8 years (2017/18 - 2024/25) as per cohort definitions
measure: Incidence/prevalence of postoperative complications
timeFrame: Pre 2023
measure: Incidence/prevalence of postoperative complications stratified by socioeconomic and ethnic descriptors
timeFrame: Pre 2023
Secondary outcomes:
measure: Mean/median postoperative length of stay (days)
timeFrame: 8 years (2017/18 - 2024/25) as per cohort definitions
measure: Mean/Median postoperative critical care length of stay (days)
timeFrame: 8 years (2017/18 - 2024/25) as per cohort definitions
Other outcomes:
Locations:
city: London
country: United Kingdom
facility: University College London
Study officials:
References: