SGEM#52: Breakfast at Glenfield – Asthma, Social Media and Knowledge Translation

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Date: November 7, 2013
Title: Breakfast at Glenfield – Asthma, Social Media and Knowledge Translation

Guest skeptic – Dr. Tapas Mukherjee

As many of you know the SGEM was started as a social media project aimed at decreasing the knowledge translation window down from an average of 10 years to 1 year. It is doing this using the disruptive technology of social media. The ultimate goal was to give you free the high-quality, clinically relevant, evidence based, patient-centred information. This would enable to you to give the best care to your patients based with shared decision making.

I want to turn MedEd on its head. Turn your car into a classroom. Provide Free open access to meducation (FOAMed) allowing the best evidence to bubble up. And in the process, the medium (social media) is the message.

There have been some critics over the last year. Some of the constructive criticism has been how do you know what you are doing works? Fair question. This is a skeptical podcast and we should always be able to turn the critical eye on ourselves.

For a while my answer to critics has been – I know what doesn’t work. The traditional model of text books, guidelines, journals and conferences take too long. One definition of insanity is doing the same thing over and over again and expecting a different outcome.

If you want to know how we practiced medicine 5 years ago, read a textbook.
If you want to know how we practiced medicine 2 years ago, read a journal.
If you want to know how we practice medicine now, go to a (good) conference.
If you want to know how we will practice medicine in the future, listen in the hallways and use FOAM. (allegedly said by Dr. Joe Lex)

But now I have some proof of SoMe impacting KT. This brings me back to Tapas. This talented, enthusiastic and innovative doctor from the UK who did a proof of concept project last year. He created a youtube video that went, not fungal, not bacterial but VIRAL. It was called Breakfast at Glenfield. The project used the 1995 pop song Breakfast at Tiffany’s by Deep Blue Something to discuss asthma management.

Problem: The NHS uses outmoded methods of communication with limited finances and innovation to drive change.

Audit: An audit of 58 healthcare professionals (42 doctors) across University Hospitals of Leicester (UHL) revealed only 66% of staff were aware of hospital asthma guidelines and less than half used them. Knowledge of managing asthma was also poor.

New Guidelines March: The guidelines were updated to be user friendly with emphasis on highlighted areas of concern. But how could we ensure 100% of staff would be aware of the new guidance?

Solution: The guidelines were converted to musical lyrics, a smartphone was used to video staff acting out the treatment in tune to the song. This music video was posted on YouTube and shared across sites such as Facebook and Twitter.

Reaction: A ‘viral’ like effect resulted in spread to Facebook, Twitter, The Department of Health, The BBC News and hospitals around the UK. It received over 13000 views in the first month, and won the Award for Innovation in Respiratory Education from the British Thoracic Society. (Now has >63,000 views)

Re-Audit June 2012: 55 UHL staff participated in the repeat audit. The results were analysed using Fisher’s exact test. Awareness and use of the guidelines significantly improved (p<0.001), with 100% awareness following the project (62% before). There was significant improvement in every question relating to management of acute asthma (p<0.01).

Limitations:

small sample size (n=55)
only one study
repeat audit done one month later (what about 3, 6 12 months?)
what about patient oriented outcomes (morbidity and mortality)?
consider potential harms (more tests/more diagnosis/more treatment)
what about the quality of guidelines?
What if this method was used to improve adherence to weak/poor/controversial evidences like let’s say tPa in acute CVA

Bottom Line: Social media is a powerful tool which we have used to change clinical practice with dramatic results. What it will achieve in future will be limited only by imagination.

KEENER KONTEST: Last weeks winner was Anita Ng. She knew that there has been only ONE trial for the use of heparin in the treatment of PE. Listen to the podcast to hear this weeks question. If you know the answer be the first to send it to TheSGEM@gmail.com and I will send you a cool skeptical prize.

Doing lots of critical reviews right now for BEEM conferences. There have been some great articles published and I look forward to presenting them at SkiBEEM and SweetBEEM.

Remember to be skeptical of anything you learn, even if you heard it on The Skeptics’ Guide to Emergency Medicine.