Clinical Operational Research Unit


Embedded operational researchers within health care teams

We have between 1 and 3 researchers embedded within health care teams at any one time, spending a few days a week on site helping teams achieve their goals.

CORU staff involved: Christina Pagel, Sonya Crowe, Martin Utley, Luca Grieco

GOSH (2012 - Current)

Great Ormond Street Hospital (2012 – current)
Since 2012, CORU has had one to two researchers embedded with the critical care teams at Great Ormond Street Hospital (GOSH). This has involved researchers spending between one to three days a week sitting with the team at GOSH, flexibly responding to the needs of the team. This includes:
  • supporting doctors and nurses in their research projects (project design, analysis, write up and applying for grant funding);
  • leading new research projects responding to local clinical needs;
  • building capacity within the GOSH critical care units for planning and carrying out research to support the delivery of intensive care.

Selected publications:

  • Pagel, Banks, Pope, Whitmore, Brown, Goldman, Utley, “Development, implementation and evaluation of a tool for forecasting short term demand for beds in an intensive care unit”, Operations Research for Health Care, https://doi.org/10.1016/j.orhc.2017.08.003 , 2017
  • Ray, Rogers, Pagel, Raman, Peters, Ramnarayan, “Pao2/Fio2 Ratio Derived From the Spo2/Fio2 Ratio to Improve Mortality Prediction Using the Pediatric Index of Mortality-3 Score in Transported Intensive Care Admissions”, Paediatric Critical Care Medicine, DOI: 10.1097/PCC.0000000000001075, 2017
  • Chapman, Wray, Oulton, Pagel, Ray, Peters, “’The Score Matters’: Variability in Performance of Early Warning Systems”, Archives of Diseases in Childhood, doi: 10.1136/archdischild-2016-312136, 2017
  • Chapman, Wray, Oulton, Pagel, Ray, Peters, “Evidence-based vital signs do not improve predicted performance of effective paediatric track and trigger systems”, European Journal of Pediatrics 175(11):1573-1573, 2016
  • Pagel, Lutman, Polke, Ray, Ramnarayan, “Evaluating the impact of additional clinical resources to manage the winter surge in demand for emergency paediatric intensive care retrieval”, British Journal of Healthcare Management 22:7, doi: http://dx.doi.org/10.12968/bjhc.2016.22.7.370,2016
  • Pagel, Ramnarayan, Ray, Peters, “Development and implementation of a real time statistical control method to identify the start and end of the winter surge in demand for paediatric intensive care”, European Journal of Operational Research, http://dx.doi.org/10.1016/j.ejor.2016.08.023, 2016
  • Pagel, Ramnarayan, Ray, Peters, “A novel method to identify the start and end of the winter surge in demand for pediatric intensive care in real time”, Pediatric Critical Care Medicine, 16(9):821-7, 2015
  • Marshall, Pagel, French, Utley, Allwood, Fulop, Pope, Goldman, Banks, “Moving improvement research closer to practice: developing the Researcher-in-Residence model”, BMJ Quality & Safety, doi:10.1136/bmjqs-2013-002779, 2014
UCLH (2014 - 2017)

University College London Hospitals (2014 - 2017)

CORU staff have been contributing to a multidisciplinary embedded research team at University College London Hospitals NSH Foundation Trust (UCLH) since 2014. The team, which currently includes two medical anthropologists and a health economist in addition to CORU operational researchers, undertake research projects in close collaboration with health professionals and managers at UCLH and help to build capacity for health services research within the Trust. Being ‘embedded’ within the health care setting increases the potential for well-designed research, conducted in the context in which findings will be applied. The embedded approach also supports researchers, health care professionals and other staff in understanding and valuing each other’s roles, knowledge, and approaches, as well as developing complementary skills.

Our research and input has had, and continues to have, a direct impact on practice at UCLH, including informing:

  • the method currently being used to define the accreditation status of 47 wards at UCLH and the broader rollout strategy for this programme;
  • UCLH’s rollout strategy and effective implementation of a novel perioperative medicine pathway;
  • the planning of the UCLH@Home service (including the re-negotiation of UCLH’s contract with Healthcare at home);
  • the training and deployment of nurse specials within UCLH.

Selected publications:

Care City (2015 - current)

CORU staff have been supporting Care City, an innovation centre focused on health ageing in North East London since its launch in 2015, with an Improvement Scientist in residence and a Researcher in Residence focused on shaping the research strategy of Care City and strengthening links between Care City and London’s Universities. Activities include

Supporting Care City in its successful bid to be an NHS England Innovation Test Bed

Conducting evaluations of debt mentoring and fuel poverty programmes led by the London Borough of Barking and Dagenham.

Reviewing literature and advising on a “boilers on prescription” programme.

Successful bid to the Health Foundation for a major programme of work exploring how Operational Research could improve the delivery of home-based health care (the WORKTECC project)