Introduction to EQUIPS
EQUIPS is a network of researchers, healthcare professionals, patients and public who are working together to enhance the patient safety and quality research we do in Ireland.
Many people are harmed every year in Irish healthcare; many others don’t get the quality of care they deserve. We do a lot very good research aimed at changing this, but we can do better if we connect the diverse stakeholders to:
- Link people with similar interests and complementary roles and expertise
- Effectively engage patients and the public in research.
- Agree research priorities and strategies.
- Identify and address barriers to effective research.
- Build capability and capacity.
- Connect with international best practice.
EQUIPS brings together the research capacity of Irish Universities with the knowledge users across the healthcare system to address these objectives. This network is co-funded by the Health Research Board (HRB) and HSE National Quality and Patient Safety (NQPS).
EQUIPS' Aims
The aim of EQUIPS is to coordinate and accelerate Quality and Patient Safety (QPS) research in Ireland, by meeting the following objectives:
- Co-produce QPS research priorities and strategies
- Build a vibrant and robust QPS research community
- Make QPS research everyday practice
- Contribute to better, safer care
EQUIPS aims to bring together three types of stakeholders:
- Knowledge Generators (e.g. academic and healthcare staff doing research)
- Knowledge Users (e.g., healthcare staff looking to implement evidence-based research)
- Patient and public partners
EQUIPS terminology explained
Quality can mean different things to different people. For example, a report by the Committee on Quality of Health Care in America, which is often cited by researchers in quality and patient articles describes six indicators of quality:
- Timeliness
- Efficiency
- Safety
- Patient-centredness
- Effectiveness
- Equity
Other proposed quality indicators include environmental sustainability, leadership, resilience, and kin-centredness (see this article by Lachman and others) for a recent discussion.
Quality Improvement is defined by The Health Foundation as being ‘about giving the people closest to issues affecting care quality the time, permission, skills and resources they need to solve them. It involves a systematic and coordinated approach to solving a problem using specific methods and tools with the aim of bringing about a measurable improvement’.
One of the tasks of EQUIPS is to identify existing quality frameworks and interpret which are most suitable for the Irish healthcare context. See the EQUIPS’ work page to read more.
The Health Services Executive Patient Safety Strategy 2019-2024, state ‘patient safety can, at its simplest, be defined as: the avoidance, prevention and amelioration of adverse outcomes or injuries stemming from the process of healthcare’ (p. 5).
Similarly, the World Health Organization defines patient safety as ‘the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care to an acceptable minimum in healthcare’. Whilst some harm in healthcare is unavoidable (for example, some people may need to take medication which has side effects to manage another illness), the ‘avoidable’ or ‘preventable’ harm described in the above definitions refer to harm which arises as the result of an ‘adverse event’ or ‘Serious Reportable Events’. The WHO describes examples such as medication, surgical, or diagnostic error, amongst others. Whilst the term ‘error’ is used, it is now widely accepted that most adverse events occur because of multiple systemic factors, rather than simply ‘human error’.
We know from the Irish National Adverse Event Study (INAES) that an adverse event occurred in approximately 1 in 8 acute hospital admissions in 2009 and that this had not significantly changed by 2015 according to a follow-up study, suggesting there is still improvement work to be done in patient safety in Ireland.
An evidence-base is important to help people make informed decisions about quality and patient safety which are informed by robust research. In this case, the EQUIPS Research Network aims to provide evidence related to quality improvement and patient safety (QPS/QIPS) research in the Irish context.
The WHO highlighted the importance of conducting applied multi-disciplinary research specific to local contexts, to generate and share knowledge, to improve patient safety and care quality. O’Connor et al. identified a modest but growing evidence base regarding QIPS in Ireland, but this has been somewhat disjointed. McCarthy et al. suggest how the Irish health system has been successful in developing a culture of Quality Improvement (QI) activity over the past decade. Gaps exist however, in the conduct of equity-focussed QI work, the initiation of programmes of QI in primary care and the assessment of cost-effectiveness.
A network refers to ‘an interconnected group of people’ (Oxford English Dictionary). Research networks promoting collaboration between different institutions and stakeholders are growing. Such networks can increase knowledge transmission and trustworthiness (e.g., Nyierenda et al., 2021). In Great Britain, patient safety research collaborations addressing strategic priorities are believed to have impacted patient care positively, through evidence-based changes.
EQUIPS’ network will consist of academics, knowledge users (e.g., healthcare staff), and patients and the public.
How EQUIPS is structured
The work of EQUIPS is supported and informed by a Steering Group, International Advisory Group, and Patient Partner Advisory Board.
EQUIPS Director of Research
Prof. Sam Cromie is Co-Director of the Centre for Innovative Human Systems in TCD and Director of Research for EQUIPS. He has 30+ years’ experience of action research, education, and training in diverse sectors from aviation to road and rail, pharmaceuticals, manufacturing, maritime and healthcare. He brings a human factors and systems lens to his research which spans learning from incidents, just culture implementation, healthcare design and sustainable behaviour.
National Clinical Lead of Quality and Patient Safety in the HSE
Dr Orla Healy MD, MPH FRCP FFPHM (I) is a graduate of UCC, Orla worked in hospital medicine for five years before embarking in a career in Public Health Medicine. She has occupied a range of senior executive and clinical leadership roles at regional and national levels in the health services including Director of Quality, Governance and Patient Safety, Director of Strategy, Planning and Population Health and Chief Operations Officer. In 2018, she was made Adjunct Clinical Professor in the School of Public Health UCC. Since taking up post as National Clinical Lead of Quality and Patient Safety in the HSE in April 2021, Orla has reconfigured the Corporate Quality and Patient Safety, to deliver on the organisations Patient Safety Strategy.
Network Manager
Dr. Jill Poots has been Network Manager for EQUIPS since June 2024. Prior to taking up this role, she undertook a PhD in Psychology at Leeds Beckett University, which investigated patient safety risks in telephone triage in primary and Integrated Urgent Care. Her role predominantly involves connecting and communicating with members, organising events, and undertaking research and evaluation of the network.
How EQUIPS is funded
EQUIPS is co-funded by the Health Research Board and HSE National Quality and Patient Safety. Together, 40 co-applicants and collaborators representing 7 academic institutions, and various healthcare and patient organisations designed the structure and scope of the network.
The Principal Investigator for EQUIPS is Prof Sam Cromie based in the Centre for Innovative Human Systems at Trinity College Dublin. The Lead Knowledge User is Dr Orla Healy, National Clinical Director for Quality and Patient Safety in the HSE.
The network is initially funded for five years until 2028. Read the press release from HRB here.
