Anna Burhouse - Academia.edu (original) (raw)
Papers by Anna Burhouse
Now we are two, going on three: triadic thinking and its link with development in the context of Young Child Observations
Routledge eBooks, Apr 24, 2018
BMJ Open
IntroductionDigital healthcare in the UK was adopted out of necessity rather than choice during t... more IntroductionDigital healthcare in the UK was adopted out of necessity rather than choice during the COVID-19 pandemic. However, as we move forward, UK governments and healthcare services have acknowledged its evident benefits for patients, staff and the National Health Service (NHS), and are keen to sustain its improvements in the long term.ObjectiveTo understand the benefits, challenges and sustainability of a future-proof digital healthcare.DesignA semi-structured interview study was conducted.SettingIn NHS services in Wales, UK.ParticipantsWith clinical and non-clinical staff across a mix of clinical specialties.Outcome measuresSemi-structured interviews were conducted to address benefits, challenges and sustainability of a national video consulting (VC) service, and thematically coded using a quantification method of qualitative work.ResultsA total of 203 interviews were conducted and 3 dominant domains emerged, with 7 themes and 26 categories.LimitationsIt is important to ackno...
A framework for evaluating the impact of a MOOC on quality improvement in healthcare
ISQUA 37th International Conference, Jul 8, 2021
Frontiers in Psychiatry, 2020
This paper describes an eating disorder service development pilot project helping clinicians impl... more This paper describes an eating disorder service development pilot project helping clinicians implement evidence-based research for patients with anorexia nervosa and autism spectrum condition comorbidity. Currently, there are no clear guidelines or recommendations for people who have the developmental condition of autism spectrum condition and a comorbid eating disorder. The Maudsley eating disorder team is pioneering a tailored approach of adaptations for this autism and eating disorder comorbidity to improve and adapt evidenced-based treatments and improve the experience for patients, families, and clinicians involved in their care. This paper aims to support the clinical and research community to implement some of the learning and new strategies developed through the PEACE pathway. The authors aim is to collaborate with teams nationally and internationally to scale up the project to benefit patients with this comorbidity.
BMJ Quality Improvement Reports, 2015
Approximately one in four adults in the UK will experience a mental health difficulty at some poi... more Approximately one in four adults in the UK will experience a mental health difficulty at some point in their life. This figure is approximately 400 million people worldwide.[1] Depression alone is currently estimated to cost the UK 1.7% of GDP and is one of the largest causes of ill health in the world.[2] For conditions like psychosis, evidence tells us that people have poorer quality of life outcomes, are more likely to die early, become obese, smoke, be unemployed, and have long term physical conditions than average.[3] People's social situation is also likely to be more complex, with housing needs, social isolation, stigma, and poverty.[4] All of these factors can make it hard for a person with a long-term mental health condition, or those supporting them, to hold onto a sense of hope that positive change is possible or that "recovery" towards a life that holds optimum meaning to them is achievable. An innovative "pop up" Recovery College model was co-produced, delivered, and evaluated by a team of people with lived experience of mental health difficulties, known as peer trainers. The Recovery College offered courses containing the best evidence-based knowledge about recovery in mental health, self-care and self-management. Each learning session included theory, personal testament from peer trainers, and volunteers and demonstrations of practical self-care skills and techniques. The courses were open to people experiencing mental health difficulties, their families, friends, and professionals. After the college course finished each student was offered up to three individual coaching sessions to help support putting the lessons learnt from the college into practice. The project aimed to test whether this innovative educational and coaching model could offer hope, knowledge and practical skills in selfmanagement to support resilience and recovery. The project was underpinned by quality improvement methodologies to develop, deliver, and refine the model.
Now we are two, going on three: Triadic thinking and its link with development in the context of young child observations
Infant Observation, 2001
ne of the most striking features of many young child observations is the wealth of Oedipal materi... more ne of the most striking features of many young child observations is the wealth of Oedipal material in which the child 0 is seen to grapple with the difficulties and rewards of triangular relationships. This material often highlights the varied ways in which the young child experiences what it can feel like to be included, excluded, a participant or an observer in the general hubbub of family life. Such highly charged, and at times passionate encounters require underlying cognitive and emotional skills which support the child to recognise, think, and reflect upon their own position within the family. These skills include an ability to think ‘triadically’ about the inter-relatedness of objects. In this paper I intend to illustrate how fundamentally important the ability to make links and to ‘think triadically’ is to the young child. To begin with, I will describe how the ability to think triadically emerges from preceding dyadic infanthiregiver relationships formed in the first nine months of life. Next, I will demonstrate how triadic thinking is linked to both the Oedipus complex and the Kleinian concept of the depressive position and how the experience of inclusion and later exclusion help to promote a capacity for abstract and three-dimensional thought. I will illustrate some of these triangular dynamics with material from a young child observation. Finally, I will attempt to show how the observer is helped to retain an ability to think triadically about their own position within the observation, by the containment and reflective capacities offered by the seminar group and training organisation.
BMJ Open, 2019
IntroductionMassive open online courses (MOOCs) offer a flexible approach to online and distance ... more IntroductionMassive open online courses (MOOCs) offer a flexible approach to online and distance learning, and are growing in popularity. Several MOOCs are now available, to help learners build on their knowledge in a number of healthcare topics. More research is needed to determine the effectiveness of MOOCs as an online education tool, and explore their long-term impact on learners’ professional practice. We present a protocol describing the design of comprehensive, mixed-methods evaluation of a MOOC, ‘QualityImprovement (QI) inHealthcare: the Case for Change’, which aims to improve learner’s knowledge and understanding of QI approaches in healthcare, and to increase their confidence in participating, and possibly leading QI projects.Methods and analysisA pre-post study design using quantitative and qualitative methods will be used to evaluate the QI MOOC. Different elements of the RE-AIM (reach, effectiveness and maintenance) and Kirkpatrick (reaction, learning and behaviour) mod...
BMJ open quality, 2017
Magnesium sulphate has been demonstrated to be an effective neuroprotectant for babies delivered ... more Magnesium sulphate has been demonstrated to be an effective neuroprotectant for babies delivered prematurely (under 37 weeks' gestational age). Antenatal administration reduces infant mortality and cerebral palsy (CP); however, uptake in the UK has been significantly lower than other countries. A quality improvement (QI) project (PReventing Cerebral palsy in Pre Term labour (PReCePT)) was carried out in the West of England, UK, to raise awareness of evidence and to improve the uptake of magnesium sulphate as neuroprotectant in preterm deliveries. Five National Health Service (NHS) Trusts and the West of England Academic Health Science Network participated in the QI project. The project was underpinned by a multifaceted QI approach that included: patient and clinical coproduction of resources; recruitment of clinical champions to support the local microsystems and create a stimulating/supporting environment for change; Plan, Do, Study, Act cycles; training for over 600 NHS staff ...
BMJ Open Quality, Apr 1, 2019
et al. Establishing a tele-clinic service for kidney transplant recipients through a patientcodes... more et al. Establishing a tele-clinic service for kidney transplant recipients through a patientcodesigned quality improvement project.
National Health Service (NHS) trust boards adopt statistical process control reporting: the impact of the Making Data Count Training Programme
BMJ Leader
BackgroundRed, amber, green (RAG) reports persist as the tool most commonly used by NHS trust boa... more BackgroundRed, amber, green (RAG) reports persist as the tool most commonly used by NHS trust boards to understand performance and gain assurance, despite statistical process control (SPC) being a more reliable way of presenting data over time. The aim of this study is to report board members’ feedback on an educational intervention focusing on the use of SPC in NHS trust performance reports, review the presence of SPC charts in performance reports and explore board members’ experience of behavioural changes in their board or fellow board members following the intervention.MethodsA 90-minute board training session in the use of SPC—Making Data Count—was delivered to 61 NHS trust boards between November 2017 and July 2019. This paper describes the approach taken with boards to enable them to understand the limitations of RAG reports and the benefits of using SPC and analyses the extent to which the Making Data Count training has led to boards adopting SPC. The paper provides quantita...
Remote mental health services: a mixed-methods survey and interview study on the use, value, benefits and challenges of a national video consulting service in NHS Wales, UK
BMJ Open
Social distancing laws during the first year of the pandemic, and its unprecedented changes to th... more Social distancing laws during the first year of the pandemic, and its unprecedented changes to the National Health Service (NHS) forced a large majority of services, especially mental health teams to deliver patient care remotely. For many, this approach was adopted out of necessity, rather than choice, thus presenting a true ‘testing ground’ for remote healthcare and a robust evaluation on a national and representative level.ObjectiveTo extract and analyse mental health specific data from a national dataset for 1 year (March 2020–March 2021).DesignA mixed-methods study using surveys and interviews.SettingIn NHS mental health services in Wales, UK.ParticipantsWith NHS patients and clinicians across child and adolescent, adult and older adult mental health services.Outcome measuresMixed methods data captured measures on use, value, benefits and challenges of video consulting (VC).ResultsA total of 3561 participants provided mental health specific data. These data and its findings dem...
Now we are two, going on three: triadic thinking and its link with development in the context of Young Child Observations
Routledge eBooks, Apr 24, 2018
BMJ Open
IntroductionDigital healthcare in the UK was adopted out of necessity rather than choice during t... more IntroductionDigital healthcare in the UK was adopted out of necessity rather than choice during the COVID-19 pandemic. However, as we move forward, UK governments and healthcare services have acknowledged its evident benefits for patients, staff and the National Health Service (NHS), and are keen to sustain its improvements in the long term.ObjectiveTo understand the benefits, challenges and sustainability of a future-proof digital healthcare.DesignA semi-structured interview study was conducted.SettingIn NHS services in Wales, UK.ParticipantsWith clinical and non-clinical staff across a mix of clinical specialties.Outcome measuresSemi-structured interviews were conducted to address benefits, challenges and sustainability of a national video consulting (VC) service, and thematically coded using a quantification method of qualitative work.ResultsA total of 203 interviews were conducted and 3 dominant domains emerged, with 7 themes and 26 categories.LimitationsIt is important to ackno...
A framework for evaluating the impact of a MOOC on quality improvement in healthcare
ISQUA 37th International Conference, Jul 8, 2021
Frontiers in Psychiatry, 2020
This paper describes an eating disorder service development pilot project helping clinicians impl... more This paper describes an eating disorder service development pilot project helping clinicians implement evidence-based research for patients with anorexia nervosa and autism spectrum condition comorbidity. Currently, there are no clear guidelines or recommendations for people who have the developmental condition of autism spectrum condition and a comorbid eating disorder. The Maudsley eating disorder team is pioneering a tailored approach of adaptations for this autism and eating disorder comorbidity to improve and adapt evidenced-based treatments and improve the experience for patients, families, and clinicians involved in their care. This paper aims to support the clinical and research community to implement some of the learning and new strategies developed through the PEACE pathway. The authors aim is to collaborate with teams nationally and internationally to scale up the project to benefit patients with this comorbidity.
BMJ Quality Improvement Reports, 2015
Approximately one in four adults in the UK will experience a mental health difficulty at some poi... more Approximately one in four adults in the UK will experience a mental health difficulty at some point in their life. This figure is approximately 400 million people worldwide.[1] Depression alone is currently estimated to cost the UK 1.7% of GDP and is one of the largest causes of ill health in the world.[2] For conditions like psychosis, evidence tells us that people have poorer quality of life outcomes, are more likely to die early, become obese, smoke, be unemployed, and have long term physical conditions than average.[3] People's social situation is also likely to be more complex, with housing needs, social isolation, stigma, and poverty.[4] All of these factors can make it hard for a person with a long-term mental health condition, or those supporting them, to hold onto a sense of hope that positive change is possible or that "recovery" towards a life that holds optimum meaning to them is achievable. An innovative "pop up" Recovery College model was co-produced, delivered, and evaluated by a team of people with lived experience of mental health difficulties, known as peer trainers. The Recovery College offered courses containing the best evidence-based knowledge about recovery in mental health, self-care and self-management. Each learning session included theory, personal testament from peer trainers, and volunteers and demonstrations of practical self-care skills and techniques. The courses were open to people experiencing mental health difficulties, their families, friends, and professionals. After the college course finished each student was offered up to three individual coaching sessions to help support putting the lessons learnt from the college into practice. The project aimed to test whether this innovative educational and coaching model could offer hope, knowledge and practical skills in selfmanagement to support resilience and recovery. The project was underpinned by quality improvement methodologies to develop, deliver, and refine the model.
Now we are two, going on three: Triadic thinking and its link with development in the context of young child observations
Infant Observation, 2001
ne of the most striking features of many young child observations is the wealth of Oedipal materi... more ne of the most striking features of many young child observations is the wealth of Oedipal material in which the child 0 is seen to grapple with the difficulties and rewards of triangular relationships. This material often highlights the varied ways in which the young child experiences what it can feel like to be included, excluded, a participant or an observer in the general hubbub of family life. Such highly charged, and at times passionate encounters require underlying cognitive and emotional skills which support the child to recognise, think, and reflect upon their own position within the family. These skills include an ability to think ‘triadically’ about the inter-relatedness of objects. In this paper I intend to illustrate how fundamentally important the ability to make links and to ‘think triadically’ is to the young child. To begin with, I will describe how the ability to think triadically emerges from preceding dyadic infanthiregiver relationships formed in the first nine months of life. Next, I will demonstrate how triadic thinking is linked to both the Oedipus complex and the Kleinian concept of the depressive position and how the experience of inclusion and later exclusion help to promote a capacity for abstract and three-dimensional thought. I will illustrate some of these triangular dynamics with material from a young child observation. Finally, I will attempt to show how the observer is helped to retain an ability to think triadically about their own position within the observation, by the containment and reflective capacities offered by the seminar group and training organisation.
BMJ Open, 2019
IntroductionMassive open online courses (MOOCs) offer a flexible approach to online and distance ... more IntroductionMassive open online courses (MOOCs) offer a flexible approach to online and distance learning, and are growing in popularity. Several MOOCs are now available, to help learners build on their knowledge in a number of healthcare topics. More research is needed to determine the effectiveness of MOOCs as an online education tool, and explore their long-term impact on learners’ professional practice. We present a protocol describing the design of comprehensive, mixed-methods evaluation of a MOOC, ‘QualityImprovement (QI) inHealthcare: the Case for Change’, which aims to improve learner’s knowledge and understanding of QI approaches in healthcare, and to increase their confidence in participating, and possibly leading QI projects.Methods and analysisA pre-post study design using quantitative and qualitative methods will be used to evaluate the QI MOOC. Different elements of the RE-AIM (reach, effectiveness and maintenance) and Kirkpatrick (reaction, learning and behaviour) mod...
BMJ open quality, 2017
Magnesium sulphate has been demonstrated to be an effective neuroprotectant for babies delivered ... more Magnesium sulphate has been demonstrated to be an effective neuroprotectant for babies delivered prematurely (under 37 weeks' gestational age). Antenatal administration reduces infant mortality and cerebral palsy (CP); however, uptake in the UK has been significantly lower than other countries. A quality improvement (QI) project (PReventing Cerebral palsy in Pre Term labour (PReCePT)) was carried out in the West of England, UK, to raise awareness of evidence and to improve the uptake of magnesium sulphate as neuroprotectant in preterm deliveries. Five National Health Service (NHS) Trusts and the West of England Academic Health Science Network participated in the QI project. The project was underpinned by a multifaceted QI approach that included: patient and clinical coproduction of resources; recruitment of clinical champions to support the local microsystems and create a stimulating/supporting environment for change; Plan, Do, Study, Act cycles; training for over 600 NHS staff ...
BMJ Open Quality, Apr 1, 2019
et al. Establishing a tele-clinic service for kidney transplant recipients through a patientcodes... more et al. Establishing a tele-clinic service for kidney transplant recipients through a patientcodesigned quality improvement project.
National Health Service (NHS) trust boards adopt statistical process control reporting: the impact of the Making Data Count Training Programme
BMJ Leader
BackgroundRed, amber, green (RAG) reports persist as the tool most commonly used by NHS trust boa... more BackgroundRed, amber, green (RAG) reports persist as the tool most commonly used by NHS trust boards to understand performance and gain assurance, despite statistical process control (SPC) being a more reliable way of presenting data over time. The aim of this study is to report board members’ feedback on an educational intervention focusing on the use of SPC in NHS trust performance reports, review the presence of SPC charts in performance reports and explore board members’ experience of behavioural changes in their board or fellow board members following the intervention.MethodsA 90-minute board training session in the use of SPC—Making Data Count—was delivered to 61 NHS trust boards between November 2017 and July 2019. This paper describes the approach taken with boards to enable them to understand the limitations of RAG reports and the benefits of using SPC and analyses the extent to which the Making Data Count training has led to boards adopting SPC. The paper provides quantita...
Remote mental health services: a mixed-methods survey and interview study on the use, value, benefits and challenges of a national video consulting service in NHS Wales, UK
BMJ Open
Social distancing laws during the first year of the pandemic, and its unprecedented changes to th... more Social distancing laws during the first year of the pandemic, and its unprecedented changes to the National Health Service (NHS) forced a large majority of services, especially mental health teams to deliver patient care remotely. For many, this approach was adopted out of necessity, rather than choice, thus presenting a true ‘testing ground’ for remote healthcare and a robust evaluation on a national and representative level.ObjectiveTo extract and analyse mental health specific data from a national dataset for 1 year (March 2020–March 2021).DesignA mixed-methods study using surveys and interviews.SettingIn NHS mental health services in Wales, UK.ParticipantsWith NHS patients and clinicians across child and adolescent, adult and older adult mental health services.Outcome measuresMixed methods data captured measures on use, value, benefits and challenges of video consulting (VC).ResultsA total of 3561 participants provided mental health specific data. These data and its findings dem...