New Cambridge research institute wants to cure hospital inefficiency

A new institute opening in Cambridge later this year will specialise in operational research to find ways of improving the management of healthcare systems.

The aim is to work with National Health Service staff, patients and carers to identify, design and test potential improvements, generating evidence on how to ensure better care, experiences and outcomes for patients.

The institute will be based at the Cambridge Biomedical Campus, alongside Cambridge University Hospitals NHS Foundation Trust.

As an example of the sort of work it will carry out, the head of the institute, Mary Dixon-Woods, RAND professor of health services research at Cambridge University, points to research showing that nurses in US hospitals can expect to be interrupted every six minutes. 

In order to help keep the hospital workday schedule on track, researchers had the idea of fitting nurses with special ‘do not disturb’ vests. “It was a failure. There was no significant drop-off in interruptions,” said Dixon-Woods.

It turned out the vests were too hot to wear. However, Dixon-Woods says the exercise was not a waste of time. “We like to find out what doesn’t work, as much as what does work,” she said.

The experiment exemplifies the thinking behind the new institute, touted as the first of its kind in Europe.

The institute has £40 million in funding over 10 years from the Health Foundation charity to come up with practical, evidence-based ideas for improving healthcare and patient outcomes.

The scope will encompass quality assessment of organisational design, workflow and patient-physician encounters at every level of healthcare.

Healthcare systems are riven with fault lines, said Dixon-Woods. “And, until now, the science of how to make sustained improvements has not got the attention it needs.”

The institute’s main novelty will be the pool of experts it employs. “As well as patients and health specialists, we’re going to bring together people from a range of disciplines – engineers who know about supply chains, operations researchers who can help us with workflows, humanities [researchers], philosophers and lawyers,” Dixon-Woods said.

The institute will partner with researchers from Homerton College and the RAND Europe research institute, also based in Cambridge.

Promoting ideas for how hospitals and primary care can work better together will be one focus. “We’ll look at testing and identifying solutions here. Patients go to care homes and into hospital and out again – it has typically been a big challenge to track and optimise this long chain,” said Dixon-Woods.

The Cambridge institute was announced as another new UK health research body opened its doors. The National Institute for Health Research Innovation Observatory, based at Newcastle University, will apply data analytics to explore trends in health innovation across drugs, medical technologies, diagnostic tools and healthcare services.

The director of the Observatory, Michael Trenell said, “There is a pressing need to provide better and more efficient care, today more than ever before. In order to do this, we need to accelerate access to new medicines, devices, diagnostics, and services for the benefit of patients."

The research carried out by the Observatory will inform commissioning, policy, and strategy for research nationally and internationally, said Trenell.