Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes.

Lead Research Organisation: Imperial College London
Department Name: Dept of Medicine

Abstract

Context of the research:

Antibiotics are important to prevent infections after several types of surgery. The growing number of infections that cannot be treated with antibiotics may mean that many basic types of surgeries cannot continue. Around the world a large amount of all antibiotics are used during the surgical process. Antibiotics in surgery are used to prevent infections from happening after surgery (it is called 'prophylaxis') and for the treatment of infections after surgery. Infection after surgery is a growing concern in many countries. 23 million infections after surgery (or 'surgical site infections', SSIs) lead to 2 million deaths every year. Using antibiotics in the right manner is a sure way of preventing infections after surgery. For example, if the right antibiotics are given at the right time before surgery, then up to seven times less antibiotics are needed after surgery because less people get infections.

Aims and objectives:

The care before, during and after surgery (inside and outside of hospital) must include using the right antibiotics at the right time for the correct amount of time, making sure that there are no missed or late doses. The wellbeing of patients including nutrition and ability to move about can also affect how quickly they recover if they do get an infection. To get this care right at each stage, a lot of coordination and communication is needed between all the different health professionals (nurses, surgeons, anaesthetists, pharmacists), patients and carers involved. Because so many key parties are involved in this process, it is an ideal place to do research to understand ways of thinking about the correct use of antibiotics and behaviours such as hand hygiene which can prevent infections from happening in the first place. This study will use social science research to find out what helps individuals, teams and patients to practice safely and use antibiotics in the right way as described above.

The study will research these issues in England and Scotland as they each have different ways of organising and managing surgery. We will also carry out research in countries where there are less resources but they still manage surgery in the same way (India, South Africa and learning from Rwanda). The studies in countries outside of the UK will also tell us how behaviours can be changed when different health professionals are involved, and when antibiotics are less available within hospitals but also available from other sources.

Methods: The study will last four years and will start with an analysis of all factors within and outside of healthcare organisations which may influence how antibiotics are used. The methods we use at the moment to change behaviours of professionals and patients will be evaluated. New methods will also be designed, developed and also evaluated, and may include using new technologies such as computers or smartphones. We may also change the roles and expectations of different professionals within teams or changing the incentives or penalties associated with proper use of antibiotics. Some of these may involve patients and carers taking a more active role.

Potential applications and benefits:

By understanding the full context where surgery occurs, we will cover aspects of care within and beyond healthcare settings. As we will understand factors such as availability of antibiotics, financial pressures, regulation as well as what patients expect of their healthcare system and professionals, the solutions we will propose will be tailored for each setting. As we will be looking at how professionals, patients and carers behave and use antibiotics, it is likely that the new solutions that we propose would become part of routine practice, helping us to keep antibiotics working for much longer.

Planned Impact

The intended beneficiaries are public/patients/carers, healthcare professionals in primary, community, secondary care and public health, national/international and organisational policy makers, medical, surgical and health professional associations and networks.

The short term benefit to patients will be reduced risks of infection and better recovery after surgery. Patients and carers will be better equipped when preparing for surgery by knowing all the steps that they can take to help prevent infections. These will be about the role of general health and wellbeing as well as specific issues relating to infection control and the role of antibiotics. In the long term, future patients will still have access to surgery (currently threatened by AMR).

In addition, if we are able to streamline the antimicrobial stewardship processes around surgery in all healthcare organisations, then new and advanced forms of surgery can continue to develop. Here, industry and innovators will benefit from this research.

Healthcare professionals will benefit from this enhanced way of working and using efficient behavioural (proven) methods to optimise antibiotic use.

Policy makers will benefit by having access to a user-friendly (transparent) decision tool to look at how previously intangible behavioural effects can be modelled in real settings.

What will be done to ensure that they have the opportunity to benefit from this activity?

Because the research will be conducted in a way that includes co-design with multi-disciplinary professionals, researchers, patients and carers and informed by rich qualitative work, the proposed solutions will be relevant and realistic.

Our detailed plan of pathways to impact (enclosed) shows how this research institute and team and collaborators have a very strong track record in ensuring that research outputs are effectively translated to interventions for practitioners and patients to address antibiotic use. Nationally, the NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London (Director: Alison Holmes) is an established collaboration with Public Health England, utilising data and expertise across a range of themes and leveraging wider networks for dissemination. To address the global threat of AMR, in 2015 Imperial established the Antimicrobial Research Collaborative (www.imperial.ac.uk/arc/), led by Prof Alison Holmes. ARC is a truly multidisciplinary, cross-College approach to AMR, addressing the complex interlinking biological and societal drivers of this threat. ARC involves over 100 PIs working across the Imperial College Academic Health Science Centre. Through ARC and infrastructure awards such as the NIHR Diagnostic Evidence Cooperative we also have strong industrial networks.

Publications

10 25 50

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Azevedo-Coste C (2019) Tracking Clinical Staff Behaviors in an Operating Room. in Sensors (Basel, Switzerland)

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Charani E (2017) Opportunities for system level improvement in antibiotic use across the surgical pathway. in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

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Charani E (2019) The Differences in Antibiotic Decision-making Between Acute Surgical and Acute Medical Teams: An Ethnographic Study of Culture and Team Dynamics. in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

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Charani E (2017) Understanding antibiotic decision making in surgery-a qualitative analysis. in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

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Charani E (2019) Implementation of antibiotic stewardship in different settings - results of an international survey. in Antimicrobial resistance and infection control

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Charani E (2019) Antibiotic Stewardship-Twenty Years in the Making. in Antibiotics (Basel, Switzerland)

 
Title Animation - Amrita 
Description Animation developed at Amrita Institute of Medical Sciences for patients undergoing surgery to understand the pathway and the admission process. 
Type Of Art Film/Video/Animation 
Year Produced 2018 
Impact Disseminated at Amrita hospital to patients undergoing surgical procedures. 
 
Title Antibiotic prescribing in hospitals across different countries 
Description Summary of findings from a qualitative study depicting interviews carried out in several healthcare settings around the world unearthing the pressing need for global antibiotic management, the current obstacles that stand in its way and the areas in which action is required. 
Type Of Art Film/Video/Animation 
Year Produced 2019 
Impact Animation on youtube, project website and in related publication from this work: https://www.youtube.com/watch?v=3MLvQXCK7bg This animation has been shared widely on multiple social media platforms: LinkdIn, Facebook, Twitter. 
URL https://www.youtube.com/watch?v=3MLvQXCK7bg
 
Description Our qualitative research to date has identified a lack of engagement in antimicrobial stewardship with the wider healthcare professionals (PLOS ONE Charani et al 2019), including nurses and pharmacists. We have appointed two pharmacists to the ASPIRES research in India, one of whom is now registered to undertake a PhD at Amrita with supervision from Imperial and UCT to investigate the contribution of pharmacists to antimicrobial stewardship programmes.
Exploitation Route This will be determined in later stages of the research.
Sectors Communities and Social Services/Policy,Creative Economy,Education,Financial Services, and Management Consultancy,Healthcare

 
Description Progress: Progress against all project milestones is on track. Secondary data collection for all countries for WP1 is complete and analysis in progress, with primary data collection for India and England in progress. For WP2 data collection in India is near completion and for SA planned from June 2019. For W2 and 4, quantitative cohort data collection is in progress and for WP3 a scoping literature review is complete as is an inventory of interventions in the India research site. Identification of clinical, health and economic variables available in the context of India in progress. Boundary identification for modelling for WP4 is now in progress. Synthesis and validation of the emerging findings from across WP1-4 have been considered in WP5 and suggestions to enhance relevance to current policy trajectory have been included in work plans. The project benefits from an International Advisory Board which has convened x 2 [Appointed Chair Thomas Weiser from The Lancet Commission on Global Surgery]. The 3rd meeting is scheduled for May 2019, with the 4th scheduled for Nov. 2019 in South Africa. Some highlights of impact arising from this project include: Capacity Building • This grant has enabled us to recruit four researchers in Kerala, India, employed by our research partner on this award, Amrita Institute of Medical Sciences (Amrita). These researchers have backgrounds in pharmacy, epidemiology and anthropology and modelling have undergone an extensive period of training: 6 weeks in India led by Charani; weekly supervision and mentoring from the Early Career Researchers in the UK; funded from the additional Impact Acceleration Grant (above), to attend a capacity building workshop (7th Feb 2019): "Social Science Research Methodologies workshop: tackling Antimicrobial Resistance" http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/medicine/arc/eventssummary/event_4-10-2018-13-37-28 This trip was extended to a two-week training programme across the research methodologies. • Supported Vrinda Nampoothiri, Clinical Pharmacist at Amrita, in obtaining competitive funding to attend the "Fresh Perspectives: Social Research on AMR" symposium held at the British Academy in London on 10th September 2018 (Dr Clare Chandler and Antimicrobials In Society (AMIS). Related blog: https://www.imperial.ac.uk/news/189111/practising-antibiotic-stewardship-india-blog-from/. • Early Career Researchers at Imperial (Charani, Birgand, Castro-Sanchez, Ahmad) have developed their research management and supervisory skills through co-leading packages. • Dr Lebcir was promoted to Reader in Management Systems, Dr Raheelah Ahmad promoted to Lecturer. Dissemination • Project meeting and advisory board meeting in Kerala (October 2018) were followed by a two-day International Conference on Antibiotic Stewardship and Infectious Diseases "No action today, no cure tomorrow" for a wider network of practitioners, policy makers and researchers in India. https://www.imperial.ac.uk/news/188926/international-collaborative-networks-optimise-infection-related/. The timing of these events were to maximise impact, as these coincided with the launch of the Kerala state AMR action plan. • Early Career researchers (Birgand, Ahmad, Charani, Castro-Sanchez) led a workshop on implementation in infection control Nantes France, the first regional event in France. Implementation sciences applied to infection control and antimicrobial stewardship (11th October 2018) International Impact • Early career researchers (UK) invited speakers and participants in a range of national and international scientific meetings and policy conferences including the Grand Challenges Meeting 2018 (Berlin) and the WISH 2018 summit in Qatar. • Dr Charani: scoping visit to Bangladesh visiting Prof Samir Saha's team at the Child Health Research Foundation (CHRF) and Dr Atonu Rabbani, behavioural economist (University of Dhaka), learning about effective surveillance systems for childhood invasive bacterial infections. Bilateral visit planned https://www.imperial.ac.uk/news/187467/dr-esmita-charani-returns-from-research/ Other: Other hospitals and healthcare providers in India have contacted us to discuss our research and potential to expand/replicate work at other hospitals or provide support in advisory capacity to support them undertaking similar work. This may provide the opportunity to engage with government funded healthcare in India which is representative of the majority of healthcare system in the country.
First Year Of Impact 2018
Sector Communities and Social Services/Policy,Education,Healthcare
Impact Types Cultural,Societal,Economic,Policy & public services

 
Description Global Core Standards for hospital Antimicrobial Stewardship Programs
Geographic Reach Multiple continents/international 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
URL http://www.wish.org.qa/wp-content/uploads/2018/11/IMPJ6078-WISH-2018-LHSN-AMR-181026-1.pdf
 
Description International Journal of Infectious Diseases paper, Charani et al April 2017
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
URL http://dx.doi.org/10.1016/j.ijid.2017.04.020
 
Description Leadership Team meeting - Med Res Funded National PhD Training Programme in AMR
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
URL http://www.rcuk.ac.uk/documents/amr/avison-the-mrf-national-phd-training-programme-in-amr-pdf/
 
Description Primary Healthcare Reforms Project webinar
Geographic Reach Asia 
Policy Influence Type Influenced training of practitioners or researchers
Impact R Ahmad gave webinar for primary healthcare reforms project on 'Theoretical frameworks for analysis of provider and user behaviour'. 30 minute talk and then discussion.
 
Description Research meeting lecture: "Antimicrobial Stewardship must be a behavioural programme" (EC - Portugal)
Geographic Reach Europe 
Policy Influence Type Influenced training of practitioners or researchers
 
Description Scientific Advisor to Science in Parliament Initiative, Spain (ECS)
Geographic Reach Europe 
Policy Influence Type Participation in a advisory committee
 
Description Social Science Research Methodologies Workshop: Tackling AMR
Geographic Reach Multiple continents/international 
Policy Influence Type Influenced training of practitioners or researchers
URL https://www.eventbrite.co.uk/e/social-science-research-methodologies-workshop-tackling-antimicrobial...
 
Description Visit to Khartoum, Sudan (EC - Imperial delegation to Sudan)
Geographic Reach Africa 
Policy Influence Type Influenced training of practitioners or researchers
Impact Numerous enquiries about internships, studentship support and other related research enquiries. Work in progress and will likely lead to further funding applications, new collaborations and joint publications.
 
Description WHO Policy Brief - Cultural Contexts of Health and Well-being
Geographic Reach Europe 
Policy Influence Type Citation in other policy documents
 
Description WISH Delphi consensus
Geographic Reach Multiple continents/international 
Policy Influence Type Influenced training of practitioners or researchers
Impact E Charani has collaborated on a WISH funded international Delphi consensus to develop core elements and checklist items for global hospital antimicrobial stewardship programmes: a consensus apprpoach.
 
Description ESRC Impact Acceleration Award
Amount £20,000 (GBP)
Organisation Imperial College London 
Sector Academic/University
Country United Kingdom
Start 01/2018 
End 04/2018
 
Description ESRC Theme 4 supplementary award
Amount £82,412 (GBP)
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 04/2018 
End 03/2019
 
Description ESRC additional funding (STEP-UP)
Amount £82,412 (GBP)
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 04/2018 
 
Description Medical Research Foundation National PhD Training Programme in Antimicrobial Resistance Research
Amount £123,800 (GBP)
Organisation Medical Research Council (MRC) 
Department Medical Research Foundation
Sector Charity/Non Profit
Country United Kingdom
Start 11/2018 
End 11/2022
 
Description NIHR Senior Investigator Award
Amount £75,000 (GBP)
Funding ID NF-SI-0617-10176 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 04/2018 
End 03/2023
 
Description Research England Global Challenges Research Fund (Internal Support)
Amount £147,723 (GBP)
Organisation Higher Education Funding Council for England 
Sector Public
Country United Kingdom
Start 11/2018 
End 07/2019
 
Description Wellcome Trust Institutional Strategic Support Fund Faculty Fellowship
Amount £21,476 (GBP)
Organisation Imperial College London 
Sector Academic/University
Country United Kingdom
Start 10/2017 
End 03/2018
 
Description Amrita 
Organisation Amrita Vishwa Vidyapeetham University
PI Contribution Imperial College London led successful application to ESRC for grant funding Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes.
Collaborator Contribution Collaboration with Dr Sanjeev Singh, Medical Superintendent of large hospital in Kerala, India and Mr Puneet Dhar, surgeon, they bring expertise in hospital management, infection prevention and control and surgery to the project.
Impact ESRC Grant funding for Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes. Multi-disciplinary: management science, behavioural research, infection prevention and control, surgery, pharmacy, implementation science, health economics, modelling.
Start Year 2017
 
Description Butare University Teaching Hospital 
Organisation University Teaching Hospital of Butare
PI Contribution Imperial College London led successful application to ESRC for grant funding Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes.
Collaborator Contribution Collaboration with Dr Jules Ndoli Minega and Mr Christian Ngarambe who bring expertise in anaesthesia, surgery and hospital management to the project.
Impact ESRC Grant funding for Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes. Multi-disciplinary: management science, behavioural research, infection prevention and control, surgery, pharmacy, implementation science, health economics, modelling.
Start Year 2017
 
Description India Collaborative on Surgical Prophylaxis 
Organisation University of Antwerp
Country Belgium 
Sector Academic/University 
PI Contribution Dr Sanjeev K Singh involved in India Collaborative on Point Prevalence Survey of Surgical Prophylaxis.
Collaborator Contribution Support and participation in this Indian collaborative for PPS in surgical prophylaxis
Impact None yet
Start Year 2018
 
Description King's College London 
Organisation University of Sao Paulo
Department Institute of Psychiatry
Country Brazil 
Sector Academic/University 
PI Contribution Imperial College London led on the successful application to the ESRC for this grant funding.
Collaborator Contribution Profs N Sevdalis, E Ferlie, Mr A Leather are the collaborators from King's College London on this ESRC grant funding.
Impact ESRC Grant funding for Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes. Multi-disciplinary: management science, behavioural research, infection prevention and control, surgery, pharmacy, implementation science, health economics, modelling.
Start Year 2017
 
Description Royal College of Anaesthetists 
Organisation The Royal College of Anaesthetists
Country United Kingdom 
Sector Academic/University 
PI Contribution Research Partnership with RCoA - Imperial College London led successful application to ESRC for grant funding 'Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes'.
Collaborator Contribution Collaboration with Professor Ramani Moonesinghe, Professor of Perioperative Medicine, UCL, Honorary Consultant in Anaesthesia and Perioperative Medicine, UCLH, Director of the Health Services Research Centre (HSRC) at the Royal College of Anaesthetist (RCoA), and the NIHR funded Surgical Outcomes Research Centre (SOuRCe) at UCL/UCLH. Ramani brings expertise in anaesthetics and surgical outcomes.
Impact ESRC Grant funding for Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes. Multi-disciplinary: management science, behavioural research, infection prevention and control, surgery, pharmacy, implementation science, health economics, modelling.
Start Year 2017
 
Description STEP UP, Oxford 
Organisation University of Oxford
Department Nuffield Department of Primary Care Health Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution Collaborated with other ESRC AMR Funded Consortium to win additional funding to run a workshop: 'Social Science Research Methodologies workshop: tackling Antimicrobial Resistance'. Event was co-chaired by PIs from each consortium and researchers from both consortiums ran the workshops and presented.
Collaborator Contribution Collaborated with ASPIRES ESRC AMR Funded Consortium to win additional funding to run a workshop: 'Social Science Research Methodologies workshop: tackling Antimicrobial Resistance'. Event was co-chaired by PIs from each consortium and researchers from both consortiums ran the workshops and presented.
Impact Collaborated with other ESRC AMR Funded Consortium to run a workshop: 'Social Science Research Methodologies workshop: tackling Antimicrobial Resistance'. Event was co-chaired by PIs from each consortium and researchers from both consortiums ran the workshops and presented. The event provided introductory training in social science research skills utilised across the current Antimicrobial Resistance (AMR) Theme 4 research programmes that is supported by the Antimicrobial Resistance Cross Council Initiative from the seven research councils in partnership with other funders. The event was multidisciplinary and included expertise in social science, epidemiology, statistics, public health, implementation science, anthropology.
Start Year 2018
 
Description University of Cape Town 
Organisation University of Cape Town
Country South Africa 
Sector Academic/University 
PI Contribution Imperial College London led successful application to ESRC for grant funding Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes.
Collaborator Contribution Collaboration with Professor Marc Mendelson and Mr Mark Hampton who bring expertise in healthcare management, infection prevention and control and surgery.
Impact ESRC Grant funding for Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes. Multi-disciplinary: management science, behavioural research, infection prevention and control, surgery, pharmacy, implementation science, health economics, modelling.
Start Year 2017
 
Description University of Hertfordshire 
Organisation University of Hertfordshire
Country United Kingdom 
Sector Academic/University 
PI Contribution Imperial College London led successful application to ESRC for grant funding Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes.
Collaborator Contribution Collaboration with Dr Reda Lebcir who brings expertise in System Dynamics to the project.
Impact ESRC Grant funding for Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes. Multi-disciplinary: management science, behavioural research, infection prevention and control, surgery, pharmacy, implementation science, health economics, modelling.
Start Year 2017
 
Description University of Leicester 
Organisation University of Leicester
Country United Kingdom 
Sector Academic/University 
PI Contribution Imperial College London led successful application to ESRC for grant funding Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes.
Collaborator Contribution Collaboration with Dr Carolyn Tarrant who brings expertise in Health Psychology to the project.
Impact ESRC Grant funding for Optimising antibiotic use along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes. Multi-disciplinary: management science, behavioural research, infection prevention and control, surgery, pharmacy, implementation science, health economics, modelling.
Start Year 2017
 
Description 3rd International Conference on Clinical Pharmaciy, Karnataka (VN) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Oral Presentation on 21-1-2018 on "Clinical Pharmacist driven Antimicrobial Stewardship program in a tertiary care centre" at 3rd International Conference on Clinical Pharmacy -New Era of Pharmacy Practice: Beyond Traditional Patient Care Kasturba Medical College , Manipal Academy of Higher Education, Karnataka, India.
Year(s) Of Engagement Activity 2018
 
Description AMR Cross Council Initiative Workshop 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact 2 day Cross-Research Council meeting, specifically on Antimicrobial Resistance (AMR) for award holders, workshop to explore challenges and opportunities. Presented in the 'Research Challenges (UK and global setting) session on 'Clinical, Social, Cultural and Historical Challenges', followed by round table discussion. Day two was an open session. Keynote speaker was Sally Davies, presentations and representation from funders and policy makers.
Year(s) Of Engagement Activity 2017
 
Description Amrita School of Pharmacy invited talk (VN) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Invited talk on 26-10-2017 on " Roles and Responsibilities of Clinical Pharmacist in Antibiotic Stewardship Program at Amrita School of Pharmacy, Kochi, kerala, India.
Year(s) Of Engagement Activity 2017
 
Description Antimicrobial Resistance Students' Conference: Advocating Behavioural Change 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact All day conference held at collaborator's King's College London, event on advocating behavioural change to tackle AMR run by students, for students. Interesting, broad programme which sparked good discussion. Has led to a number of enquiries about internship opportunities and an abstract being submitted to ECCMID 2018. Further impact will be realised. R Ahmad and E Charani gave lecture 'Behaviour change wheel and Antimicrobial Resistance' and ran workshop 'How to Run a Public Health Campaign'.
Year(s) Of Engagement Activity 2017
 
Description Application for surgical prophylaxis in adult CVST 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Dr Sanjeev K Singh presented PDCA- Application for surgical prophylaxis in Adult CVST at Institute of healthcare Improvement,Boston
Year(s) Of Engagement Activity 2017
 
Description BMC Medicine - invited blog - 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Invited blog
Year(s) Of Engagement Activity 2016
URL http://blogs.biomedcentral.com/blog/author/timothymilesrawson/
 
Description Collaboration meeting on Addressing AMR in North Africa, University of North Sussex (EC) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Esmita Charani speaking at University of North Sussex Collaboration meeting on Addressing AMR in North Africa, Sep 2018, at the Centre for Global Health Policy.
Year(s) Of Engagement Activity 2018
 
Description College of Pharmaceutical Science, Kottayam (VN) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Vrinda Nampoothiri, Clinical Pharmacist, Amrita Hospital, India, Invited talk on 25-9-2018 on "Role of clinical pharmacist in Antibiotic Stewardship" at World Pharmacist Day Program conducted by College of Pharmaceutical Science, Kottayam Medical College, Kottayam,Kerala, India
Year(s) Of Engagement Activity 2018
 
Description ECCMID 2017 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact following posters accepted to ECCMID

Rawson et al. Mapping decision pathways for acute infection management in UK secondary care: a qualitative study

Rawson et al. : Patient-centred interventions to promote citizen engagement with infection-related decision making

Rawson et al. Evaluating behaviour change in antimicrobial stewardship interventions: a review of UK state-of-the-art conferences

Rawson et al. Optimizing intermittent vancomycin therapy using C-reactive protein: investigating the role for AUC:EC50 in secondary care

Rawson et al. Clinical decision support systems for antimicrobial management: a systematic review of interventions in primary and secondary care
Year(s) Of Engagement Activity 2017
 
Description ECCMID 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Conference Posters submitted on the following:(1) Evaluating behaviour change in antimicrobial stewardship interventions: a review of UK state-of-the-art conferences (2) What does a systematic review of clinical decision support systems for antimicrobial management tell us? (3) Demonstrating the effectiveness of sustainable, long-term, bundled interventions to reduce blood culture contamination (4) Mapping decision pathways for acute infection management in UK secondary care: a qualitative study (5) Patient-centred interventions to promote citizen engagement with infection-related decision making (6) Optimizing intermittent vancomycin therapy using C-reactive protein: investigating the role for AUC:EC50 (7) Clinical decision support systems for antimicrobial management: a systematic review of interventions in primary and secondary care (8) Exploring the epidemiology and diversity of fungal isolates in a large tertiary haematology unit in London, UK
secondary care
Year(s) Of Engagement Activity 2017
 
Description ECCMID oral presentation - Gabriel Birgand 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Infection control specialists' perception of antimicrobial resistance in European hospitals: the Percept-R study. G Birgand, N Mutters, E Tacconelli, JC Lucet, A Holmes. Increasing research capacity to tackle AMR internationally and improve the consistency of practices and strategies.
Year(s) Of Engagement Activity 2018
 
Description EUCIC Course HCAIs (GB) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Gabriel Birgand on organising faculty for EUCIC Module: Surveillance and early warning systems of healthcare associated infections.
European Committee on Infection Control (EUCIC) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID)
Title of the module: Surveillance and early warning systems of healthcare-associated infections
Title of the presentation: How to use practice and outcome indicators through surveillance: Practical experience from my hospital.
Date: Paris, France 4 - 6 July 2018
Audience: 41 persons. IPC, ID and micro physicians from 17 European countries
Surveillance and alert systems are key for controlling HAI. They require the use of current and advanced epidemiological methods.
This course is designed to provide the tools and methods used in epidemiological surveillance and outbreak detection, as well as major applications in the field.
Case studies from the literature and personal experience of faculty members, and actual data from surveillance networks driven by faculty members will be used to illustrate the real-world application of these tools and methods.
Year(s) Of Engagement Activity 2018
 
Description Esmita ICID (Buenos Aires) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The study on the International implementation of antibiotic stewardship been accepted as a poster at ICID (Buenos Aires) conference.

Presented: Antimicrobial stewardship across the surgical pathways in low and middle income countries
Year(s) Of Engagement Activity 2018
 
Description Esmita poster ECCMID, Madrid 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The study on the International implementation of antibiotic stewardship has been accepted as a poster at ECCMID (Madrid)
Year(s) Of Engagement Activity 2018
 
Description GI Surgery Conference, Jaipur, India (EC) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Esmita Charani presented ASPIRES work at national GI Surgery conference in Jaipur, India, February 2019.
Year(s) Of Engagement Activity 2019
 
Description Healthcare Infection Society Foundation Course on Infection Control (RA) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Contribute to teaching on organisational change and policy for effective infection prevention and control.
Year(s) Of Engagement Activity 2018,2019
 
Description Imperial delegation to Haggar Foundation, Khartoum, Sudan (EC) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Esmita Charani participated in Imperial College delegation to Khartoum, Sudan, to present on "Tackling Antimicrobial Resistance in Different Healthcare Settings and Capacity Building for Research"
Year(s) Of Engagement Activity 2018
 
Description Implementation Scienes applied to infection control and antimicrobial stewardship (GB) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Organised by Gabriel Birgand and colleagues, conference: Implementation Sciences applied to infection control and antimicrobial stewardship, held 11th October 2018, Nantes.
Various investigators/researchers from this grant presented.
https://www.youtube.com/watch?v=73bg-E3iOxM&feature=youtu.be
https://www.youtube.com/watch?v=aW5eTNsqID4&feature=youtu.be
https://www.youtube.com/watch?v=qt7kFepRDdg&feature=youtu.be
https://www.youtube.com/watch?v=FeHGqE8rqZY&feature=youtu.be
https://www.youtube.com/watch?v=F3ZObWB8Hik&feature=youtu.be
Year(s) Of Engagement Activity 2018
 
Description Infection Prevention Society 2018 (EC) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Spoke at IPS Conference 24th Sep 2018.
Year(s) Of Engagement Activity 2018
 
Description International Conference on Antibiotic Stewardship, Kochi 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact International Conference on Antibiotic Stewardship, 27th-28th Oct 2018, Kochi, India. International meeting organised and hosted by Amrita colleagues. To raise awareness of antimicrobial stewardship activities across India and Internationally, showcase how Amrita and the state of Kerala are leading the way in India in tackling antimicrobial resistance.

Generated wide press interest including:
1. Times of India
2. The Hindu
3. New Indian Express
4. Deccan Chronicle
5. Mathrubhumi
6. Malayalam Manorama
7. Veekshanam
8. Chandrika
9. Deepika
10. Deshabhimani
11. Mangalam
12. Siraj
Online Links
Hindu - Clip 1
https://www.thehindu.com/news/cities/Kochi/experts-warn-against-rampant-use-of-antibiotics/article25340372.ece
Hindu - Clip 2
https://www.thehindu.com/news/cities/Kochi/action-plan-for-restricted-antibiotic-use/article25340406.ece
Deccan Chronicle
https://www.deccanchronicle.com/nation/current-affairs/271018/call-to-rationalise-use-of-antibiotic-medicines-especially-in-kerala.html
New Indian Exp.
http://www.newindianexpress.com/states/kerala/2018/oct/27/widespread-irrational-use-of-antibiotics-a-cause-of-worry-1890525.html
Year(s) Of Engagement Activity 2018
 
Description Kerala State Health Secretary meeting (SS) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact Sanjeev Singh (PI from India collaborator, Amrita) met with Kerala State Health Secretary and discussed ASPIRES project and our research collaboration.
Year(s) Of Engagement Activity 2018
 
Description King's Global Health Institute Launch (AH) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Participated in panel discussion at launch of Global Health Institute at King's College London, partly in recognition of the international collaborations through this grant which investigators at KCL are also on. Discussion focussed on the role of the Global Health Institute in partnership, collaboration and capacity-building,
Year(s) Of Engagement Activity 2018
 
Description Knowledge, Culture and Change in Organizations (RA) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact 18th International Conference on Knowledge, Culture and Change in Organizations, University of Konstanz, Germany, 15th-16th March 2018.
Year(s) Of Engagement Activity 2018
 
Description LSHTM Antimicrobials in Society blog (EC) 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Esmita Charani invited to write a blog on the experience of working in India, following on from being invited to present at their conference
Year(s) Of Engagement Activity 2018
 
Description Leading Health Systems Network webinar on Antimicrobial Stewardship across different healthcare economies 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Policy influence by presenting the proceeds of the work in Qatar WISH (World Innovation Summit for health) chaired by Dame Sally Davies.
Year(s) Of Engagement Activity 2008
URL https://www.youtube.com/watch?v=kg1hE8IywDU
 
Description National Seminar, Cherthala, Kerala (VN) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Invited talk on 25-1-2018 on "Antibiotic Stewardship-A new arena for clinical pharmacists" at National Seminar on "Emerging trends in Clinical Pharmacy in India-An experience sharing for the aspirants" ,Cherthala, Kerala,India
Year(s) Of Engagement Activity 2018
 
Description Online course "Antimicrobial Stewardship: A competency-based approach" 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Online course "Antimicrobial Stewardship: A competency-based approach" launched on OpenWHO. This course provides a framework for approaching each clinical encounter from the perspective of combating antimicrobial resistance. Using case-based examples the course will highlight how antimicrobial stewardship principles can be applied to common clinical scenarios.
Year(s) Of Engagement Activity 2017,2018
URL https://openwho.org/courses/AMR-competency
 
Description PSG college of Pharmacy, Coimbatore (VN) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Invited talk on 22-6-2018 on "Role of clinical pharmacist in Antibiotic Stewardship" at Continuing Pharmacy Education (CPE) conducted by PSG college of Pharmacy, Coimbatore, Tamil Nadu, India
Year(s) Of Engagement Activity 2018
 
Description Patient feedback for patient enagement module and engagement with patient rep on steering committee 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Patients, carers and/or patient groups
Results and Impact 18 patients were successfully recruited to pilot the PPI/E module. Their feedback was all positive and validated that the tool was appropriate and acceptable to the target audience. 87% of participants reported that they would like to use the module again. The Project's Patient and Public Representative,Fran Husson, the patient representative on our steering group has been involved in the development of a draft manuscript reporting these findings and will be a named author. Fran is also a regular attendee at the research steering Group/Oversight Committees allowing regular updates on the projects progress to be provided. We also updated our wider "potential patient/public panel" writing to them to update them on project progress, and sending electronic copies of two publications which had resulted from the work. Those written to were also offered an incentive to comment further on the patient engagement module, however no further comments were received despite the incentive.
Year(s) Of Engagement Activity 2017
 
Description Portuguese Programme on Prevention of Antimicrobial Resistance (EC) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Esmita Charani invited to talk at University of Porto, Portugal, as organiser had been inspired by several of her papers. Spoke to research group on "Antimicrobial Stewardship must be a behavioural programme" to an audience of around 50-70 people. Lectured for around 30 mins with 2-3 commentators invited to discuss the topic and open to audience discussion.
Year(s) Of Engagement Activity 2019
 
Description Reda Lebcir - Herts 6th Dec 2017 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Reda Lebcir presented on the project "Health, systems, and health systems: The public health threat of Antimicrobial resistance". 6th Dec 2017, the University of Hertfordshire
Year(s) Of Engagement Activity 2017
 
Description Royal Institution: Technology vrs Infectious 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Royal Institution: Technology vrs Infectious Diseases summit, took place on 26 September 2017. The summit brought together leaders in academia, industry, NGOs and young entrepreneurs to reveal how the best in UK technology is helping to combat bacterial, viral, parasitic and fungal diseases. Following an afternoon of presentations, the audience enjoyed a showcase of technologies that included EPIC IMPOC (this award) as well as ProMED, an Internet-based reporting system dedicated to rapid global dissemination of information on outbreaks of infectious diseases; POCAST and Target, facilitating navigation, access and use of national antimicrobial guidelines to support clinical prescribing decisions; and Microreact, open data visualisation and sharing for genomic epidemiology. Over 20 people signed up to receive our newsletter/further information about our work. There was also a mention of the event in the Evening Standard newspaper.
Year(s) Of Engagement Activity 2017
 
Description Santosh Rath, peer to peer 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Santosh Rath, surgeon, Imperial College London, presented on barriers to implement evidence into practice in India and issues encountered during AMR work.
Year(s) Of Engagement Activity 2017
 
Description Social Science Research Methodologies workshop: tackling Antimicrobial Resistance 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The event aimed to provide introductory training in social science research skills utilised across the current Antimicrobial Resistance (AMR) Theme 4 research programmes that is supported by the Antimicrobial Resistance Cross Council Initiative from the seven research councils in partnership with other funders.

Chaired by:
Professor Ann Sarah Walker (Professor of Medical Statistics and Epidemiology, Modernising Medical Microbiology, University of Oxford)
Professor Alison Holmes (Professor of Infectious Diseases, Director of the NIHR Health Protection Research Unit (HPRU) in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London)

Keynote speakers:

Professor Helen Lambert (TBC, Professor of Medical Anthropology, University of Bristol)
Professor Nick Sevdalis (Professor of Implementation Science & Patient Safety, King's College)
Professor Helen Ward (Professor of Public Health, Imperial College)

Two parallel crossover workshops:

Workshop 1 - Ethnographic methods and face-to-face interviews
Workshop 2 - Realist review

The goals of the workshops were to provide: insight into current social science research tackling AMR across different healthcare economies, practical recommendations and examples of applying the research methodologies using case studies from England, India and South Africa, and an opportunity for developing new insights into how these methods can be implemented into AMR research. Some of the workshop materials will be incorporated into an e-learning module that will be launched later in 2019.
Year(s) Of Engagement Activity 2019
URL https://www.eventbrite.co.uk/e/social-science-research-methodologies-workshop-tackling-antimicrobial...
 
Description Students for Global Health Cambridge/King's College London (EC) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Postgraduate students
Results and Impact As a result of student AMR event at KCL, Esmita Charani, Research Pharmacist, invited to give presentations at Cambs and KCL on societal impact of AMR covering both HIC and LMIC activity.
Year(s) Of Engagement Activity 2018
 
Description Theory and practice in optimising antibiotic use in hospitals internationally (CT/EC) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Interdisciplinary Workshop on Theory and practice in optimising antibiotic use in hospitals internationally organised and held at University of Leicester, 4th-5th Oct 2018.
Featured national and international speakers and included sessions on policy, stewardship and practice, and, social theory.
Year(s) Of Engagement Activity 2018
 
Description UKCPA masterclass (EC) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presented at UKCPA masterclass (National Meeting of Clinical Pharmacists UK), Oct 2018
Year(s) Of Engagement Activity 2018
 
Description Vanderbilt University Medical Centre presentation (EC) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Esmita Charani invited to present to infectionologists, microbiologists and pharmacists on the role of behaviour in prescribing at VUMC, Jan 2019.
Year(s) Of Engagement Activity 2019
 
Description Workshop on how to successfully implement behaviour change interventions in IP and AMS, ICID Buenos Aires 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact E Castro Sanchez and E Charani held a work shop for international attendees at ICID Buenos Aires on how to successfully implement behaviour change interventions in infection prevention and stewardship in hospitals
Year(s) Of Engagement Activity 2018