R&I Achievements

There are many things to celebrate about Research here at Homerton. To discover what we have achieved, click on the drop down boxes below!

Research Conference 2024

Our annual research conference took place on the 21st March 2024. We were lucky to hear from six amazing speakers, Dr Louise Allen, Dr Veena Mohan, Catherine Atkinson, Caroline McCallum, Dr Aoife Molloy and Professor Tony Young. It was a very insightful day, filled with lots of learning and inspiration. The conference was held in a hybrid format, and the recording has been posted on YouTube for all to watch.

https://www.youtube.com/watch?v=AlXTNSZDowI

We also held the poster conference a few months earlier in October 2023. We were grateful to receive 27 submissions, which showcased a range of research being conducted at the Homerton. A big thank you to both Dr Iain Reeves and Dr Peter Timms, who took the time to judge the posters submitted. Please see below for our three winners and their posters!

  • 1st place: Optimising Cannula Usage in Homerton Emergency Department - a Green Initiative by Chloe Sanderson, Matilda Williams, Benjamin Tometzki and Sibtain Tahawar.

Optimising Cannula Usage in Homerton Emergency Department - A Green Initiative. Background - Healthcare is Responsible for 4-5% of UK CO2 emissions. The NHS has pledged to reduce its emissions to net zero by 2040. Emergency departments (EDs) focus on time efficiency, with focus on phlembotomy & cannulation at the front door, but many of these are never used. We used the Centre for Sustainable Healthcare SUSQI model to develop our aims and measurement metrics. Measuring the problem - Using 3 randomly selected patients a day, we retrospectively analysed 9 months of ED cannulation data between October 2022-August 2023 (6 months pre, 3 months post intervention). Data was collected on presenting complaint, cannula use and appropriateness of use. 47% of cannulas inserted were unused. Intervention - Using our data, NICE guidelines, trust guidelines and cannulation triage tools developed at other sites, we developed our own departmental cannula guidance tool. Promoted guidance through printed copies throughout department, teaching sessions, repeated emails and recruited HCA Eco Champion. Feedback surveys for patients and ED staff. HCA survey - We identified healthcare assistants (HCAs) as key stakeholders and surveyed them. 86% had received no formal training or guidance on when to cannulate, and wished for a resource to be developed. Results and Conclusions - Average daily reduction of 5.3 cannulas. 31% reduction in unused cannulas. Positive feedback from HCAs and ED staff. Annual Savings - £3982.77, 1.78 tonnes CO2e (this is the equivalent CO2e to a flight from London to Sydney!) – Guidance regarding indication for cannulation at the ED front door is wanted and needed. A relatively simple intervention can have significant carbon, social and financial benefits for an ED department helping our NHS strive for net zero. Limitations include small sample size for daily data, difficulties getting responses to feedback surveys. Next steps – Continued teaching sessions and emails to maintain awareness of the project, especially during changeover periods. Increase patient feedback engagement by providing QR code to scan when removing their cannula. Establish a green ED group within the department and continue to work towards bronze accreditation.

  • 2nd place: Introduction and Implementation of a Postnatal Anaesthetic Clinic to Follow-up Anaesthetic-related Complications, Improve Care amd Patient Satisfaction by A. Vishwanathan, E. Sousi, P. Chinduluri and C. Talati

A Service Change: Introduction and implementation of a post-natal anaesthetic clinic, to follow up anaesthetic related complications, improve care and patient satisfaction. Background and objectives – According to national guidance and the Ockenden report, patients with significant intrapartum complications should be offered outpatient follow up postnatally. We introduced an anaesthetic follow up service, aiming to: identify intrapartum patients sustaining complications following anaesthetic interventions, develop a referral pathway or postnatal follow-up at least 6 weeks after discharge, action within secondary care where possible, offer explanations and individualised answers about their anaesthetic care, alleviate anxieties which may negatively impact future pregnancies. Method – We worked with service managers and following group consensus, we developed a non face to face telemedicine clinic with a referral pathway. We identified specialist consultants who would review patients with longstanding neurological complications. A clinic summary letter to the GP was generated after the appointment. All patients received a patient satisfaction questionnaire. Results – The clinic is run every two months by speciality obstetric anaesthesia fellows with the local supervision of a consultant anaesthetist. Since January 2022, there have been nine clinics and 43 patients have been reviewed. When indicated, patients have had: additional investigations (eg, CT, MRI & audiology), specialist referrals (eg. neurology, ENT), direction to birth reflection and listening clinics, further postnatal anaesthesia follow up, and direction to antenatal anaesthesia clinics for future pregnancies. The patient feedback was very encouraging. Patients said they felt ‘listened to’ and that their concerns were addressed. Discussion – This clinic provides continuity and ownership of anaesthetic care postnatally, which is reassuring for patients. It provides us with a better understanding of the chronicity and natural course of anaesthetic related complications. The discussions are documented as electronic letters to the patient and primary care, available for future treating clinicians. It helps facilitate multidisciplinary input from other specialities. It provides an opportunity for patients to develop a better understanding, which may impact the outcome of future pregnancies. This clinic will help improve patient care and satisfaction with maternity services in our hospital.

  • 3rd place: A Meta-Analysis of Necrotising Enterocolitis and Mortality in Fetal Growth Restricted Preterm Infants by Ceri Murphy, Michael Willis, Felix Asamoah, Claire Howarth Paul Fleming, Jayanta Banerjee and Narendra Aladangady

A Meta-Analysis of Necrotising Enterocolitis and Mortality in Fetal Growth Restricted Preterm Infants. Background – Abnormal placental blood flow with Fetal Growth Restriction (FGR) is associated with risk of fetal loss, and reduced perfusion of all organs, especially the gut. Necrotising enterocolitis (NEC) may be more prevalent in preterm infants with FGR and causes worse outcomes compared with appropriately grown (AGA) counterparts. Risk of mortality and NEC associated with FGR is not directly quantified in literature and underrepresented in most neonatal RCTs; better understanding would aid neonatologists in making clinical decisions postnatally (eg. implementing higher risk feeding regimens). This systematic review and meta analysis compared the risk of NEC and mortality in FGR and AGA preterm infants. Methods – Registered with PROSPERO and conducted according to PRISMA guidelines. CM & MW searched independently for articles published in English between 2005-2022 inclusion criteria: neonatal study comparing risk of NEC in FGR v AGA preterm infants <37 weeks gestational age (GA). Exclusion criteria: studies investigation multiples only; articles not in English; not evaluating NEC or FGR. Meta analysis of LogOR was performed using STATA 17 using fixed effects model. Results – 83,050 preterm infants (<37 weeks) included across 25 studies (FGR: 9,886, AGA: 73,164). Odds of NEC in FGR infants was 64% greater than AGA (LogOR = 0.64, CI: 0.45, 0.83; p<0.00001). Odds of mortality was 47% greater in FGR groups (LogOR 0.47; 0.35, 0.59; p=0.014) Subgroup analysis performed based on GA groups: <33+6 weeks (15 studies, n=65, 151, FGR: 7,857, AGA: 57,294) and <32 weeks (8 studies, n=20,443, FGR:3,587, AGA: 16,856). Odds of NEC was significantly greater in FGR v AGA infants in both: 50% greater in <33+6 weeks infants (LogOR 0.5, 0.29, 0.71; p<0.00001); and 34% greater in <32 weeks infants (LogOR 0.34; 0.21, 0.047; p<0.00001). Mortality was significantly greater in both subgroups by 46% and 48% retrospectively. Conclusion – The risk of NEC and mortality was significantly greater in FGR infants compared with their AGA counterparts; the independent effect of FGR on NEC increased with higher GA groups indicating that FGR has stronger impact than prematurity on the risk of NEC at higher gestations. The FGR infants are at higher risk for NEC; therefore, higher vigilance and preventative strategies are warranted. Funding and Acknowledgements – With thanks to Barts Charity, and all of the recruited infants and their families. Colleagues at the Neonatal Unit, Homerton University Hospital, London, UK.

Research Midwives study summary 2022/2023

Research Midwives Team Activity April 2022 to April 2023. We recruited 419 people into 15 different studies. The study designs of these studies included: 3 RCT studies, 3 observational studies, 1 case study, 2 cohort studies, 2 national report systems, 3 PHD/Qualitative studies and 1 national register. The conditions investigated were: The role of the immune system in pre-eclampsia, Epidural related fever, Twin to twin transfusion syndrome, LGBTQ+ Community, Aspirin in twin pregnancies, Endometriosis, Previous CS and risk of preterm labour, LMUP implementation, GBS care, HIV and preterm labour, Drug dependency in pregnancy, Gestational diabetes and advanced maternal age in birth centres, High blood pressure treatment in pregnancy, Implementation of preterm pathway. Stay tuned, more exciting studies are on their way to Homerton! For more information, please contact the research team on huh-tr.researchmidwives@nhs.net

Verbo app

The Speech and Language Therapy (SaLT) department have created an app called Verbo. The app provides schools with a toolkit and access to SaLT support via a virtual platform to help communication skills in children and young people in both primary and secondary schools. Subscriptions are being provided to both schools and other settings across the country!

Verbo has also won awards, such as both the DigiLeaders Healthtech & DigiLeaders Peoples Choice Award at the Impact & Summit Awards. In addition to a Highly Commended Award at the HSJ awards! We are extremely proud of Verbo's development!

To read more about Verbo, visit the following link:  Home - Verbo - A virtual speech and language toolkit for schools (verboapp.co.uk)

Red4Research Day

We celebrated Red4Research day, which aims to get as many people as possible wearing red to support those participating in and conducting research. We hosted a table at the hospital reception, where we shared information on a variety of reseach studies we are running. We would like to thank everyone who stopped to speak to us and filled in a survey. We filled 108! 

Staff members at the Red4Research day table

Staff members at the Red4Research day table