PhD Study : Redesigning care pathways for diabetes

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Summary

Diabetes is a lifelong condition that requires a high degree of patient self-management. Acute problems with blood glucose control may arise, especially during inter-current illness that result in the patient attending for unscheduled care with community health care teams out of hours, emergency department attendance or hospital admission. The impact of living in a rural area may complicate access to appropriate health care facilities when urgent care needs arise and will be taken into account.

Severe hypoglycaemia is a serious problem, can have a rapid onset, may lead to coma and requires urgent attention. Individuals with diabetes and out of hours community health care teams may encounter such problems infrequently and lack the specialist knowledge and problem solving skills necessary for effective assessment and management. Augmented ambulance and paramedical services could be part of the solution to reducing the need for unscheduled admissions and their integration into care pathways could form an element of this studentship. A revised care pathway potentially involving the ambulance services and incorporating the measurement of metabolic and inflammatory markers by point-of-care testing to enhance patient assessment will be developed. Educational software and algorithms may also be required.

The objective of this project is to develop and evaluate the clinical impact of patient and health care professional facing educational packages that can be accessible in times of acute hypoglycaemia. These packages should support decision-making and problem solving to enhance management of severe hypoglycaemia. The augmented role of the paramedical / ambulance services and point of care testing may also form a part of this studentship. Development of the educational tools will take place in conjunction with patients and clinical teams [including the ambulance service] in both Altnagelvin Hospital; Letterkenny University Hospital and NHS Highland hospitals.

The impact of the redesigned care pathway on unscheduled care episodes will focus on WHSCT and Letterkenny University Hospital and augmented with data from Scotland. Data relating to unscheduled care episodes will be collected from ambulance services, hospital administration systems and other relevant databases. The information collected will include relevant outcomes measure [hospital admission/non-admission, diagnosis, treatment, educational need, patient follow up]. Patient and health care professional evaluation of the augmented role of the ambulance service and educational tools will be assessed by questionnaire and semi-structured interviews. The impact of the redesigned care pathway incorporating the educational tools on unscheduled care episodes will be evaluated and compared to baseline.

Additional Essential Applicant Criteria:

Successful applicants should be able to travel flexibly to meet the needs of the cross-border research (data gathering across north west of Northern Ireland and also Donegal).
Candidates must be available to commence the studentship by enrolment date of 20 September 2018.
Candidates should note that a lower Second Class Honours Degree accompanied by a relevant Masters degree and/or clinical experience may be deemed equivalent to an upper Second Class Honours Degree.

Essential criteria

Applicants should hold, or expect to obtain, a First or Upper Second Class Honours Degree in a subject relevant to the proposed area of study.

We may also consider applications from those who hold equivalent qualifications, for example, a Lower Second Class Honours Degree plus a Master’s Degree with Distinction.

In exceptional circumstances, the University may consider a portfolio of evidence from applicants who have appropriate professional experience which is equivalent to the learning outcomes of an Honours degree in lieu of academic qualifications.

A comprehensive and articulate personal statement

Desirable Criteria

If the University receives a large number of applicants for the project, the following desirable criteria may be applied to shortlist applicants for interview.

Practice-based research experience and/or dissemination
Experience using research methods or other approaches relevant to the subject domain
Work experience relevant to the proposed project
Use of personal initiative as evidenced by record of work above that normally expected at career stage.
Relevant professional qualification and/or a Degree in a Health or Health related area