Healthcare Associated Infection Visualisation and Ideation Research Network (HAIVAIRN)

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.

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.