Healthcare Associated Infection Visualisation and Ideation Research Network (HAIVAIRN)

Lead Research Organisation: Glasgow School of Art
Department Name: School of Design

Abstract

Healthcare associated infections (HAIs) caused by pathogens such as MRSA and Clostridium Difficile are a substantial problem in countries around the world, with very significant human and economic costs (Allegranzi, 2010). Global and national strategies to address these have primarily been driven by knowledge from epidemiology, microbiology, pharmacology and behavioural psychology. To date the knowledge contribution from the arts and humanities has been limited and fragmented. However recent AHRC funded multidisciplinary collaborative projects (Visinvis www.visinvis.org ; Vision On http://visionon.org ) focusing on clinical staff's conceptions and perceptions of pathogens in context, and the educational potential of more dynamic visualisations, suggest much potential for benefits such as those outlined in the related recent case study of economic impact commissioned by AHRC (Oakleigh Consulting). Although these visualisation focused projects have involved designers, artists, cleaners, microbiologists, doctors and nurses, they have also suggested that added value could be realised by coalescing a wider range of UK and international expertise from arts, humanities and related disciplines (e.g. human geography; literature; health humanities; cognitive psychology; sociology). Our review of literature and other media to date suggests that no national or international networks of this nature and scope exist. As such, we are proposing a new arts and humanities driven network called HAIVAIRN (Healthcare Associated Infection Visualisation and Ideation Network) focusing on the question: How can we better address the problem of healthcare associated infections (HAIs) through visualisation-related ideation and applications?
While the network's website will provide a virtual hub for ongoing processes and outputs, interactive work will be structured around a series of workshop events which will explore and identify areas of research need and opportunity, articulating possible cross-disciplinary contributions. Each workshop event will involve 12 invited participants drawn from a range of relevant disciplines, plus members of the Network Advisory Group (NAG), and further individuals from the hosting institution. Our proposal identifies expert international and UK based speakers who will give "priming" presentations to inform workshop activities. The first event will focus on micro-phenomena such as pathogens, movement and the mind's eye. The second will focus on macro-phenomena such as human interactions and behaviour in healthcare environments. A set of visual mappings of workshop processes and emergent themes and questions will be constructed which are likely to include conceptual, theoretical, methodological and praxis aspects. These will then inform the final workshop and symposium event which will articulate visions and pathways to proximal and distal impacts, with foci on cross-disciplinary research proposals and knowledge exchange of relevance to academia, clinical practice, education, and policy.
From the basis of the three events, the final report will be produced, summarising these aspects and mapping future research and knowledge transfer work. The report will capture key processes and outputs in a format that is accessible to all interested academic, clinical and lay stakeholders. The project website will act as the key repository for network knowledge and outputs (see www.visinvis.org as exemplar). Network members will be encouraged to write joint academic papers and editorials, and publish them in journals amenable to cross-disciplinary thinking. This would span arts and humanities, science and health profession journals. Health service conferences involving infection control will also be a natural forum for sharing emergent ideas, as will design for health conferences. Such activities and outputs will ensure that the network has both national and international impacts.

Planned Impact

In addition to the benefits for academics detailed elsewhere, the project is designed to generate a range of cross-disciplinary ideas that have the potential for proximal impacts (e.g. the use of movement modelling techniques to visualise pathogens in particular clinical contexts leading to enhanced understandings for clinical educators and practitioners) that may then be tailored and targeted to bring distal impacts for other groups (e.g. resultant related environmental design changes to ward areas and staff routines that impact directly on the prevention and control of healthcare associated infections for patients, their families and the public). The applicants and a number of members of the network have strong links to NHS clinical practice either through current or past professional roles, or through ongoing collaborative research and knowledge exchange work. Accordingly there are clear pathways to a range of impacts. Importantly, some of these pathways have already been tested through the Visinvis and Vision On projects where dynamic visualisation prototypes have been generated through collaborative work with healthcare staff and are now informing development and evaluation of a training tool. A key feature of the latter process has been collaboration with a private sector company with very broad reach across the NHS (Gama Healthcare's Clinell training products). The recent AHRC commissioned study of the economic impact of these projects (Oakleigh Consulting 2015) suggests that a reduction of just one case of HAI in each of the existing 200 Gama Healthcare training sites in the UK could lead to a cost saving of £959,000 to the healthcare sector (based on the assumption that increasing staff contextual awareness of pathogens, risk and roles will have a positive impact on HAI occurrence).

The proposed arts and humanities led network will expand the nature and scope of cross-disciplinary work so as to involve disciplines such as psychology, sociology and geosciences. This is highly likely to increase the range of ideas that could be developed into feasible research and knowledge exchange projects with NHS staff and private companies or the third sector in the UK. Moreover the proposal will add value through expanding activity internationally. For example Associate Professor Brett Mitchell (see letter of support) will advise on the suitability of outputs for some organisations external to the UK, including the relationship to policy and practice initiatives in Australia. Dr Julia Hussein (Network Advisory Group) will undertake a similar role in relation to developing countries. The integration of a symposium into the final key network event also offers the chance to showcase our work to relevant policy professionals and for their input to further enhance our dissemination strategies and related pathways to impact. The final project report will capture key processes and outputs in a format that is accessible to all interested academic, clinical, lay, third sector, private sector and policy stakeholders. In turn this will enable these stakeholders to consider relevant issues and to develop related initiatives. The project website will act as the key repository for network knowledge and outputs (see www.visinvis.org as exemplar). The applicants' ongoing conferencing work during the project will raise its profile to practitioner communities so as to encourage engagement and network members' collaborative papers will also serve to broaden the range and reach of potential impacts.
 
Description Healthcare associated infections (HAIs) are a major global problem and the pathogens that cause them are invisible within everyday life (this issue sits within the major global challenge of the rise of antimicrobial resistance (AMR)). They are a substantial problem in developed and developing countries around the world and within the NHS. In addition to the distress caused to patients who are infected, the cost of HAIs to acute services in the NHS is high. Science has helped to make these causative pathogens visible through the microscope, and there are a variety of populist images of 'bugs', but what other ways of seeing (and thinking) could be helpful for better understanding pathogens' interactions with contexts, processes and people? And how then could visualisation-based approaches used in the arts and humanities, along with those in other disciplines, contribute to better prevention and control of these HAIs? These questions gave impetus to the development of the AHRC funded HAIVAIRN (Healthcare Associated Infection Visualisation and Ideation Research Network) cross-disciplinary project (which ran from July 2016 to January 2018). HAIVAIRN's exploration was focused around one central question: "How can we better address the problem of HAIs through visualisation-related ideation and applications?' Until very recently, the contribution of the arts and humanities to the prevention and control of HAIs has been very limited indeed. The HAIVAIRN report summarises its collaborative work. The potential value of cross-disciplinary research focusing on use of visualisation to help prevent HAIs and antimicrobial resistance (AMR) is highlighted for practice developers, researchers, educators and policy makers. Within this context the report seeks to stimulate further creative thinking and associated developments. Educational interventions are a major component in the battle against HAIs but a key challenge underlying attempts to explain and instruct in these areas is that the pathogens responsible for HAIs are invisible to the naked eye. As such, expertise from the arts and humanities in visualisation and associated ideation would seem to have much relevance in addressing such a challenge. Moreover, as clinical scientific data on spread of infections has become more complex and sophisticated, the role of visualisation to better communicate this information in a way that engenders meaningful engagement is also highlighted. Following description of objectives and networking processes, the report explores and maps areas of perceived need and opportunity for research in this field. To exemplify some of these areas and intersections, brief insights into relevant ongoing and new research studies are then shared. Final reflections focus on the nature and wide scope of enquiry, and the need for more in-depth work within and across key areas.
Exploitation Route Based on the processes of enquiry, findings and reflection on lessons learned, three recommendations are made:
1. That researchers, educators and practice developers with interest in applying visualisation approaches to HAIs (and AMR) consider how our findings may relate to, or inform, their own endeavours.
2. That researchers, educators and practice developers who may be setting up similar time-limited formal networks consider how our methodology may relate to, or inform, their own endeavours.
3. That organisations and individuals with interest in better articulating the potential contribution of arts and humanities led approaches within healthcare generally, and the field of AMR particularly, consider the extent to which this project may have value as an exemplar.
Sectors Creative Economy

Education

Healthcare

Pharmaceuticals and Medical Biotechnology

URL http://radar.gsa.ac.uk/5642/1/HAIVAIRN_Final_online.pdf
 
Description The findings were widely distributed after publication on 29 January 2018. It is imagined they will have an impact, particularly in articulating the arts and humanities' potential contribution to the AMR challenge. As a consequence of this work the PI (Macdonald) and Co-I (Macduff) were invited to contribute a chapter each to 'The Routledge Companion to Health Humanities' edited by Paul Crawford, Brian Brown & Andrea Charise, Taylor & Francis/Routledge, which was published in 2020. The approach adopted in this work was followed up by the Co-I Dr Colin Macduff, in his AHRC-funded project 'CODA AMR: the contribution of arts and humanities disciplines to addressing antimicrobial resistance' who examined the outcomes from all 11 awarded AHRC-funded AMR theme 3b projects. Findings were reported in the following publication. 'The Contribution of Disciplines from the Arts and Humanities to addressing Antimicrobial Resistance (CODA AMR)' ISBN: 978-1-9999073-3-4 available at https://radar.gsa.ac.uk/7418/ Dr Macduff has since retired from academia.
First Year Of Impact 2020
Sector Creative Economy,Healthcare,Other
Impact Types Cultural

 
Description 'Lifting the Lid on Bacteria': Designing ambient communications to improve hygiene in primary school toilets
Amount £196,732 (GBP)
Funding ID AH/R002029/1 
Organisation Arts & Humanities Research Council (AHRC) 
Sector Public
Country United Kingdom
Start 09/2017 
End 09/2019
 
Description AHRC AMR in the Indoor and Built Environment
Amount £197,399 (GBP)
Funding ID AH/R002126/1 
Organisation Arts & Humanities Research Council (AHRC) 
Sector Public
Country United Kingdom
Start 01/2018 
End 01/2020
 
Description AHRC AMR in the Indoor and Built Environment
Amount £247,994 (GBP)
Funding ID AH/R002088/1 
Organisation Arts & Humanities Research Council (AHRC) 
Sector Public
Country United Kingdom
Start 12/2017 
End 12/2019
 
Description Re-envisaging Infection Practice Ecologies in Nursing (RIPEN) through Arts and Humanities Approaches
Amount £212,467 (GBP)
Funding ID AH/R002126/1 
Organisation Arts & Humanities Research Council (AHRC) 
Sector Public
Country United Kingdom
Start 01/2018 
End 01/2020