Tim Stokes
Tim Stokes is Elaine Gurr Professor of General Practice in the Department of General Practice and Rural Health and a part-time GP in Dunedin.
He conducts Health Care Delivery and Implementation Research—both primary research and evidence synthesis—using a range of quantitative and qualitative methodologies. He is interested in: new ways of delivering health services for acute and chronic clinical conditions in primary care and across the primary/community—secondary care interface; the adoption of research evidence into routine practice, including the development and use of clinical practice guidelines, standards and performance measures, and how these tools can be used to promote better care within local and national health care systems.
He was Senior Clinical Lecturer in Primary Care, University of Birmingham 2013–2014; Consultant Clinical Adviser, National Institute for Health and Care Excellence (NICE) and a Visiting Professor at the Universities of Leicester and Leeds 2006–2013, and Lecturer / Senior Lecturer in General Practice, University of Leicester, UK 1997-2006.
He conducts Health Care Delivery and Implementation Research—both primary research and evidence synthesis—using a range of quantitative and qualitative methodologies. He is interested in: new ways of delivering health services for acute and chronic clinical conditions in primary care and across the primary/community—secondary care interface; the adoption of research evidence into routine practice, including the development and use of clinical practice guidelines, standards and performance measures, and how these tools can be used to promote better care within local and national health care systems.
He was Senior Clinical Lecturer in Primary Care, University of Birmingham 2013–2014; Consultant Clinical Adviser, National Institute for Health and Care Excellence (NICE) and a Visiting Professor at the Universities of Leicester and Leeds 2006–2013, and Lecturer / Senior Lecturer in General Practice, University of Leicester, UK 1997-2006.
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Methods: A mixed methods study was conducted between February and March 2014 to document practices related to the active management of third stage of labour (AMTSL) using direct observation of 154 deliveries at a Ugandan healthcare facility. The degree to which practice concurred with the World Health Organisation (WHO) PPH guideline was determined. Semi-structured interviews were conducted with 18 maternal healthcare practitioners (4 physicians and 14 midwives).
Results: Individual AMTSL in the form of giving a uterotonic in the third stage of labour, controlled cord traction and delayed cord clamping occurred in 105/154 (68.2%), 119/154 (77.3%) and 37/60 (61.7%) of women respectively. However only 18/53 (34.0%) of women received all three essential elements of AMTSL. Three major themes influencing uptake of evidence-based practice were identified: healthcare system issues; current knowledge, awareness and use of clinical guidelines and healthcare practitioner attitudes to updating their clinical practice.
Conclusion: Overall guideline adherence was low. There is a need to ensure guideline implementation to reduce maternal mortality in low resource settings addresses context specific barriers to uptake.
Methods: A mixed methods study was conducted between February and March 2014 to document practices related to the active management of third stage of labour (AMTSL) using direct observation of 154 deliveries at a Ugandan healthcare facility. The degree to which practice concurred with the World Health Organisation (WHO) PPH guideline was determined. Semi-structured interviews were conducted with 18 maternal healthcare practitioners (4 physicians and 14 midwives).
Results: Individual AMTSL in the form of giving a uterotonic in the third stage of labour, controlled cord traction and delayed cord clamping occurred in 105/154 (68.2%), 119/154 (77.3%) and 37/60 (61.7%) of women respectively. However only 18/53 (34.0%) of women received all three essential elements of AMTSL. Three major themes influencing uptake of evidence-based practice were identified: healthcare system issues; current knowledge, awareness and use of clinical guidelines and healthcare practitioner attitudes to updating their clinical practice.
Conclusion: Overall guideline adherence was low. There is a need to ensure guideline implementation to reduce maternal mortality in low resource settings addresses context specific barriers to uptake.