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Rapporteur report

HRB 30 Conference - Rapporteur's main summary

30 January 2017

Looking beyond ‘bench to bedside’ – opportunities for research in healthcare

A summary video about the conference is available at the link below the article text

‘Bench to bedside’ – it’s a term used to describe how scientific discoveries translate into clinical practice. But we need to look beyond that linear model in the complex environment of health systems and human behaviours. We need to research more about how healthcare itself is delivered, and we need to engage the public, policymakers, healthcare professionals and patients alike in health research.

Those were key themes that emerged during the HRB 30 conference, which celebrated the Health Research Board’s 30 years of supporting health research in Ireland.

Healthcare outcomes from research: it’s complicated

Research can lead to better outcomes for patients and, more generally, it can keep the public healthier. But the line between a study or a discovery and these health outcomes is not always straight.

At the HRB 30 conference, Professor Mike Kelly, a former Director within the National Institute for Health and Care Excellence in the UK urged delegates were to ‘think slow’  about how research moves to influence policy and practice, and the need for health researchers to engage with policy makers, journalists and end users to translate their research.

Dr Tony Holohan, Chief Medical Officer with the Department of Health, reinforced that bringing health research into practice is complex, and needs active participation from providers and patients. He outlined how Healthy Ireland provides a framework for engagement and information to fuel research and stressed the need to build a culture of listening to and involving patients. 

New paradigms, new beginnings

At the HRB30 Conference, Minister for Health, Simon Harris, TD, emphasised the need to communicate about how health research improves outcomes for patients. The talks that followed his opening speech delivered the goods.

Dr Shoo K. Lee, a Scientific Director at the Canadian Institutes of Health Research, outlined how building a network of neonatal intensive care units (NICUs) first in Canada and then internationally allowed research to improve health outcomes without the need for new technology.

Dr Shoo and colleagues combined scientific studies and business-inspired approaches to quality and implementation, and they involved parents directly in the care of their babies. They improved health outcomes by reconfiguring existing resources and technology, and by challenging assumptions that only healthcare professionals can deliver healthcare.

Also on the topic of pregnancy and babies, the HRB 30 conference heard from Professor Louise Kenny from the INFANT Centre about how HRB investment has supported developments designed to improve how we monitor for complications such as pre-eclampsia and fetal growth restriction. 

Professor Fidelma Dunne from NUI Galway described how the HRB-funded Atlantic DIP project in the west of Ireland uncovered stark figures about how often and how deeply diabetes in pregnancy affects the health of the mother and baby, and how their interventions have turned the dial back:  pregnancy outcomes for women with pre-existing diabetes in the region are now almost comparable to the background population.

Gathering and using data

Professor Ella Arensman described how research is helping us to understand the prevalence and patterns of self-harm and suicide in Ireland, and to direct resources to emergency departments for people who have self-harmed.

Clinician-scientist Professor Orla Hardiman and her team have discovered new genes involved in Motor Neurone Disease and clusters of occurrence in Ireland, and have made ground-breaking discoveries about links between MND and other conditions, as well as showing how patients with MND who receive multi-disciplinary care tend to do better.

Professor Kathleen Bennett described studies on how long-term aspirin use can reduce the risk of metastatic breast cancer, and ongoing research to identify who will benefit from long-term aspirin. She also showed findings from research about why women with breast cancer stop taking prescribed long-term hormone therapy.

Changing behaviours and cultures for health

In many respects our health can depend on our behaviours and attitudes, and Dr Molly Byrne spoke at the conference about the HRB-supported Health Behaviour Change Research Group that she leads. They are developing evidence-based Interventions for cardiac sexual health, hand hygiene, supporting young people with Type 1 diabetes and many other areas. 

Attitudes and behaviours are also key to strengthening entire health systems, the HRB 30 Conference heard from Professor Eilis McAuliffe, who described research that has shown the benefit of ‘task sharing’ in healthcare, where less broadly trained staff do specific tasks to make more of resources, and that pay is not always the motivation for staff. Her work as a HRB Research Leader will now assess how collective leadership can help to build a culture of reporting to improve safety reporting in healthcare.

Communicating nuance

Two major strands emerged at the HRB30 Conference: the complexity of health research and the need to communicate more widely about that research so that its evidence can have an impact.

As both a health researcher and a journalist, Dr Sara Burke has a foot in both camps and she brought a rounded perspective.

Her own HRB-funded research has uncovered evidence about the impact of specific healthcare policy decisions and funding cuts on healthcare delivery in Ireland.

Meanwhile, Dr Burke has worked for several years as successful writer and broadcaster about health issues in Ireland. She described to the conference how health issues in the media are often portrayed black and white, yet the reality is many shades of grey, and research needs to shine a light on those shades.

Dr Burke’s research is directly informing the Department of Health and the Oireachtas Committee on Future of Healthcare, and she urged health researchers to ensure they communicate the evidence they find, so that it is used to inform healthcare policy decisions.

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