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Case study: Immunology education

Published: 26 Feb 2015

Client: AbbVie

Agency: Lucid

Campaign: Arena for Immunology

Timescale:

A quick look

Overlap exists in the clinical experiences of specialist nurses treating inflammatory diseases in dermatology, rheumatology and gastroenterology. Established in 2005 and led by top UK specialist nurses, Arena for Immunology is a cross-therapy nurse education programme that aims to empower specialist nurses to make a difference in the delivery of immunology care. About 150 specialists attend Arena national events yearly, and hundreds more are reached through regional vehicles. Utilising latest academic thinking, developed in partnership with an advisory board of psychologists, Arena has been evolved into a multichannel programme that changes clinical practice and improves patient outcomes.

Challenge

There are immunological links between immune-mediated inflammatory diseases (IMIDs) in dermatology, gastroenterology and rheumatology, with patients often presenting with multiple conditions. Specialist nurses play a vital role in managing IMID patients, and clear overlaps exist in clinical experiences and needs. However, the ever-evolving NHS presents significant challenges to UK specialist nurses, and they often feel demotivated.

Led by a multidisciplinary Steering Committee (SC), Arena for Immunology launched in 2005 as a cross-therapy nurse education programme. In 2011, AbbVie, the SC and Lucid began work to evolve Arena into a programme that advances real-life clinical practice in immunology nursing with a specific focus on appropriate IMID treatment; tight disease monitoring, and improving communication with patients and across the three specialities.

Solution

A robust strategy for driving change in clinical behaviour was developed to:

1. Identify specific gaps in IMID care and understand real-life barriers to change via 1:1 interviews with specialist nurses and 1-day SC meetings

2. Target specialist nurses at the right ‘stage of change’ using clear criteria

3. Develop impactful practice-changing programmes using multiple touch points – annual conferences; regional workshops; awareness campaigns at key congresses; Arena web portal and newsletters. Proven techniques were adopted to address identified gaps, including:

  • Simulation exercises
  • Peer-to-peer exchange
  • Interactive workshops
  • Commitment to change’ cards

4. Celebrate successful Arena-inspired changes through Arena ‘Network for Change’ (NfC), where Arena participants submit posters of real-life Arena-inspired clinical innovations that have made an impact in their practice.

Results

Approximately 150 immunology nurses attend Arena national events yearly, and hundreds more are reached through regional vehicles. In Q1 2014, a simple email survey of 80 Arena nurses highlighted positive changes in:

  • Appropriate treatment of moderate-to-severe psoriasis: 80%
  • Standardised disease assessments in rheumatoid arthritis (RA): 90%
  • Innovative approaches to biologic therapy monitoring in IBD: 88%
  • Collaborative working: 78%
  • Improving patient communication: 87%

Poster submissions via Arena NfC have detailed specific Arena-inspired changes across UK immunology units, further demonstrating real-life change, including:

  • Audit of systemic therapy in psoriasis patients, leading to appropriate treatment (Birmingham Skin Centre)
  • Setting up a virtual biologics clinic (Manchester Royal Infirmary)
  • Initiation of nurse-led combined dermatology–rheumatology clinic (Sherwood Forest Hospital)

Overall, between 2011 and 2013, an average of 99% rated Arena as ‘good’ or ‘excellent’; and 98% would recommend Arena to colleagues.

Client verdict

Sue Oliver, chair of the European League Against Rheumatism (EULAR) Healthcare Professionals Standing Committee said: “My personal experience as Arena Chair was a rewarding and exciting one. As chair of the RCN Rheumatology Forum I was seeing specialist nurses across the country feeling demoralised and struggling to understand the immense health policy changes, and ensure adequate evidence-based care despite pressures on the service and minimal recognition of the role of the specialist nurse. Over the years I saw nurses attending Arena grow in confidence, not only in their clinical skills but importantly their managerial and leadership skills.”

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