Clinical Measurement

The clinical measurement section is a team of scientific, technical and clerical staff who help to deliver a number of key clinical services as well as engage in various innovation, research and development (R&D) and training activities.

The James Cook University Hospital Middlesbrough

Physiological measurement

The primary activity of the clinical measurement section is in providing scientific support for the delivery of key physiological services throughout the trust. These include:

• Spinal cord monitoring
During complex operations that require instrumentation to be implanted in the spine, the spinal cord may be at risk of damage. However, in most cases is it possible to reverse any damage if action is taken quickly. Using specialised equipment, we are able to monitor the signals passing through the spinal cord and let the surgical team know of any issues early, so that they can take corrective action. Most often, we deliver this service for patients undergoing correction of scoliosis (a curvature of the spine).

• Intra-cranial pressure monitoring
The fluid that cushions the brain is known as cerebrospinal fluid (CSF), and is produced in the brain and drains away slowly into the bloodstream. Some patients produce too much CSF or don’t drain it away quickly enough, with the result being that there is too much CSF. The causes of this are varied and often unknown, and it is useful to know what the pressures are inside of the skull. In the intra-cranial pressure monitoring service, patients go to theatre for implantation of a small device through a small hole in their skull that measures pressure. We then connect a piece of specialised equipment to this measurement device to record and monitor pressure overnight to give the doctors high quality information that they can use to decide how best to treat the patient.

• Home oximetry measurement
Many patients have sleep disorders such as obstructive sleep apnoea (OSA), that may require specialised care and treatment. Part of the diagnosis of these conditions is an oximetry study. This involves wearing a device on your finger overnight. This device measures heart rate and the amount of oxygen in your blood. The clinical measurement section will provide the special oximetry equipment and produce complex reports of the data to the doctors to help them make the best diagnosis.

• Urodynamics investigations
Knowledge of the pressures inside the bladder gives us information to help urologists make decisions on how to treat patients with incontinence or other urological or gynaecological problems. The clinical measurement section is responsible for ensuring that the specialised equipment used to make these measurements is maintained and that the measurements are as accurate and consistent as possible. We deliver comprehensive training to all staff in the use of this equipment and ensure that all collected data are kept safe and secure.

• Assistive technology
Disabled patients in the hospital with complex needs often have highly specific needs that may be met with technology, such as switches, equipment holders, or other custom devices that help them communicate, improve their safety, or help them to get out of hospital and back home sooner and more effectively. Our assistive technology service aims to develop these custom devices to improve patient care for these dependent people with specific and complex needs.

Innovation

NHS staff are continuously having new bright ideas that could lead to improvements in the way we care for patients. Putting these ideas into practice by developing new systems, processes, ways of working, technologies or devices requires the NHS to work with many other groups such as patients and members of the public, universities, charities, private businesses, local authorities and many more.

The clinical measurement section is involved in harvesting these ideas from staff and helping to make them a reality. We are involved in the development and testing of devices, improvements in the way services are delivered, and continuous quality improvement processes.

The James Cook University Hospital Middlesbrough

Research

Key to improving the care we deliver is finding evidence that new techniques and technologies are better than those that we currently use. The scientists in the clinical measurement section can identify opportunities to study such new techniques and technologies to gather this evidence. This can involve working with patients and members of the public to make sure that research activities are carried out safely and with the best interests of our patients.

Mechanical and electronic development and prototyping

Spanning all of the clinical measurement section’s roles with physiological measurement, research and innovation is the production of prototypes. We have electronic development, a mechanical workshop, and software development capabilities to allow us to design, build and test an array of different devices for use clinically, in research projects and to demonstrate brand new innovative ideas to commercial partners, universities and patient and public groups.