Working on COVID-19 studies – A day in the life
We were fortunate to be able to catch up with Vikki Smith and Karen Verrill this week. We caught up by Star Leaf and talked about all things Research in light of the COVID Pandemic.
I asked Karen and Vikki, to briefly explain their current job focus and tell me what a typical day looks like… Karen is a Midwife by background and is currently working on COVID-19 studies as a Research Midwife, she said:
“A typical day involves liaising with the clinical midwives to identify any pregnant women who may be eligible to participate in one or more of our research studies. An important part of my role is to promote research and raise awareness of the COVID-19 studies that we are running in Reproductive Health. It feels like there are new studies being set up and changes made on existing studies almost weekly at the moment, so a major aspect of the role is to get up to speed with the protocol and eligibility criteria etc. I also need to ensure that we are liaising with the right people in the Trust so that studies can be set up quickly and implemented effectively.”
Vikki is a Midwife Sonographer by background; she holds a multi-faceted joint Clinical Academic role between Northumbria University and Newcastle Hospitals, she said:
“From an Academic perspective, I am continuing to support the ongoing education of our Undergraduate midwifery students and Post Graduate researchers. My role also involves coordinating Ethics reviews at the University (which has been busy of late). From a Clinical perspective, I have also been working to support the clinical antenatal ultrasound Service at Newcastle upon Tyne Hospitals an extra day per week. I am fortunate that Northumbria University has enabled clinically trained staff to offer their services to local trusts experiencing workforce challenges, so I have been able to offer that extra day for an agreed period of time.
On a Friday morning I am involved in a fetal ultrasound telemedicine clinic, which has been established for a five years, linking Newcastle Hospitals Fetal Medicine Unit with West Cumberland Hospital in Whitehaven. We had plans to extend the service to other trusts and because of the COVID situation we have very rapidly set up a fetal ultrasound telemedicine link with NSECH for patients at Northumbria Healthcare Trust.
The extension of the service was up and running very quickly with the excellent support of the team at Northumbria Healthcare Trust and is working well. The main benefits are that we have reduced the footfall to the Fetal Medicine Unit and patients can been seen without having to travel from their local hospital for a fetal medicine consultation. The sonographers at West Cumberland Hospital, Whitehaven have also been great and are seeing some patients from Cumberland Infirmary, Carlisle who would have previously had to come over to Newcastle. Within the last week, I have also had the go ahead to progress the research elements of the project that will focus around patient and staff experiences of the service. I also run a regional specialist clinic for women who at higher risk of having an abnormally invasive placenta on Friday afternoons but for patients from Carlisle, Whitehaven and Northumbria Trust this can be done via the tele medicine link which again reduces face to face consultations.”
I asked Karen what she had been primarily focusing on before the COVID outbreak.
She told me that prior to taking up her current role, Karen was working non-clinically as a Project Manager on two specific R&D Service Improvement projects. One of these projects had come to an end and the other project became challenging to progress due to resources being diverted to COVID-19 activities. Karen had recently been successful in securing a secondment to a Regional Lead Midwife post on a large NIHR national study looking at screening pregnant women for Group B Strep. This was due to start in April but along with most other studies, this has been put on hold so she welcomed the opportunity to help out with COVID-19 research and combine her R&D experience with using her midwifery clinical knowledge again.
During the discussion what struck Karen was the learning potential from how COVID has influenced the rapid set up and approval of research. One of the projects Karen had previously been working on was exploring delays in setting up commercial studies. This involved a lot of work to streamline and speed up, as delays often lead to frustrated sponsors. Karen had been working with external consultants and using lean methodology to see where waste could be eliminated from the process. What has been really valuable to Karen is that she is able to see things from the other side by seeing studies being set up and implemented in practice.
Karen said “There are some valuable lessons to be learned from how we have set up COVID studies which have been initiated in a matter of days whereas previously this would normally take weeks or months. I think that everyone recognises the need to work together to try to improve how we set up and implement studies going forward. The brilliant thing to come out of all this is that, whilst there has always been a will to try to improve the R&D process set up, I think now we have proved that it can be done. We need to capture what worked and come together to introduce improved, streamlined processes.”
On asking Vikki and Karen what the atmosphere had been like in their team/ward/office, they were very positive about experiences.
Karen said “I have absolutely loved working with the other research midwives, nurses, trial co-ordinators and support staff and have learnt an incredible amount about how research is delivered in other clinical areas. The atmosphere has been fantastic. I think we all share a sense of us living through unprecedented times both in our professional and personal lives and we have all pulled together and supported each other. I completed my midwifery training here over 6 years ago but I worked in another Trust once I qualified. Since starting in this role, I have bumped into lots of clinical midwives who I worked with when I was on placement here which has been brilliant and brought back many fond memories. It reminds me just how much I have learnt and experienced since I was a student midwife.”
Karen also talked about a sense of being responsive, adjusting to the swift pace, but all the while supporting each other.
Vikki recognised the opportunity for increased visibility of her clinical academic role that COVID had brought. She described how beneficial working with the wider clinical team had been, though she recognised it had been stressful for the clinical team as workload is quite significant with fewer staff.
Vikki said “It is very fast paced but a very positive environment as everyone supports each other so the women have the best experience they can despite not being able to have a partner or whoever is supporting them present at the scans. I feel very much a part of the team and am enjoying working with clinical team. Its beneficial undertaking standard care, it’s good to use those skills and feels like I have not been away”
Karen said she feels there is more awareness of research from the midwives and there is more curiosity – generating conversations. “People are joining in with those conversations, helping to spread the message about research especially among the newer midwives”.
Finally, I asked Karen and Vikki how important they feel research is in helping to tackle COVID-19.
Karen said “I think most people would agree that research is vitally important in tackling COVID-19. Without research, we would not be able to find effective treatments for people who already have the virus, identify accurate diagnostic and antibody tests and develop a vaccine to prevent further people being infected. A vaccine has been described as a ‘game changer’ as it would be a significant step forward in slowing down the pandemic and enabling us all to get back to some sort of normality. Research also plays a key role in furthering our knowledge regarding how the disease affects the population and understand the demographics around why certain groups of people appear to be more susceptible to COVID-19 and experience poorer outcomes.”
Vikki agreed with Karen and talked about the growing opportunities for research to be more fore fronted as a result of COVID, but also for it to influence how we practice in the future.
She said “There has been a lot of focus on reducing face to face visits for patients, it is an excellent opportunity to capture the perspectives of staff and patients in relation to remote consultations where possible, does it work and is it something we can continue going forward? There are so many other ways to interact with patients and we have a real opportunity to understand more about what patients actually prefer, in many cases it may be possible for women (and partners) to be reviewed via video link or telephone rather than coming to a hospital antenatal clinic when they could be in the comfort of their own home.”
Karen talked about the potential of follow up for research patients specifically and how this too could be done virtually. She said “This may also generate more interest as patients would know that they wouldn’t have to visit the hospital for the follow up visits. This could also be beneficial as there may not be as many ‘did not attends.”