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Dr Dimitrios Siassakos

Dr Dimitrios Siassakos

Dr Dimitrios Siassakos
MBBS(Athens), MD (Res), MSc(Lond), MRCOG(RCOG), PGDiploma MedEduc (TLHP), DLSHTM (HSM)

Consultant Senior Lecturer in Obstetrics

Department of Obstetrics and Gynaecology,
The Chilterns, Southmead Hospital BS10 5NB
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Summary

Clinical Interests and Expertise: High-risk pregnancy starting from recurrent implantation failure and early pregnancy loss, and continuing into antenatal care (maternal medicine, obesity, pregnancy in women with bariatric surgery), advanced intrapartum care and leadership, obstetric emergencies, umbilical cord prolapse, fetal distress, fetal monitoring, operative birth, stillbirth, bereavement, and beyond (interprofessional team training, simulation/medical education, litigation).

Methodological Interests: Health economic evaluation, stepped-wedge cluster RCTs, service user involvement in research, systematic reviews, mixed methods research, qualitative meta-analysis, triangulation, improvement science, patient reported outcomes and experience.

Dimitrios Siassakos (aka Siasakos) is a Senior Clinical Lecturer & Honorary Consultant in Obstetrics in the Academic Centre for Women's Health at the University of Bristol and Southmead Hospital.  He is Directorate Lead for Research, Children and Women's Health, at North Bristol NHS Trust. He is National Simulation Adviser to the Royal College of Obstetricians and Gynaecologists, Chair of the National Simulation Network, Regional Postgraduate Lead for Obstetric Simulation in the South West, and Lead for Obstetric Undergraduate Education at the University of Bristol. He is also an Executive Scientific and CPD Editor for BJOG (www.bjog.org), as well as PPI (Public/Patient Invovlement in Research) Lead. Dimitrios is also Co-Chair of the Scientific Committee of the International Stillbirth Alliance, working to create change through the Lancet Ending Preventable Stillbirth Series 2016.

Dimitrios has an MD (Clinical Research) by publications in Obstetric Team Training with the University of Bristol, an MSc in Health Systems Management with the London School of Hygiene and Tropical Medicine, and a Postgraduate Diploma in Medical Education (TLHP) with the University of Bristol.

Dimitrios is a member of the National Institute for Health Research (NIHR) HTA Maternal, Newborn, and Child Health (MNCH) Panel, the Lancet Ending Preventable Stillbirth Series 2016 Group, Executive Board of the International Stillbirth Alliance, the Executive Committee of three national Clinical Study Groups (Intrapartum care, Stillbirth, and Global Health), three Department-of-Health Task Groups (Stillbirth Data, Perinatal Mortality Review, and Brain Injury Measurement), and several regional, national, and international initiatives to reduce stillbirths and improve bereavement care. He coauthored two invited papers for the Lancet Ending Preventable Stillbirth Series, leading one of the relevant studies. He is a member of the University Ethics Committee (Faculty of Medicine and Dentistry) and the Alumni Foundation Committee who decide grants and scholarships. He has served as a member of the national RCOG Consent Group.

Dimitrios leads the PEARL (Perinatal care and Reproductive Loss) research team, conducting studies to understand and improve outcome of women in any stage of pregnancy; including women with recurrent miscarriage and implantation failure (e.g. RePROFILE study). He holds grants for research into bereavement care (InSight study), the involvement of parents in perinatal mortality reviews (PARENTS study supported by SANDS and PARENTS2 study funded by the Health Foundation), the economical and psychosocial impact of stillbirth (Lancet Ending Preventable Stillbirth Series 2016 funded by SANDS), a systematic review of mixed-methods stillbirth literature, and research into the impact of culture and religion on bereavement. He also supervises a study to develop a Core Outcome Set (COS) for bereavement care research after stillbirth in collaboration with the COMET and CROWN initiatives (iCHOOSE); and to investigate parental invovlement in the development of this Set. He is co-investigator in an international collaborative awarded $2.5 million by the Australian Governement to research stillbirth.

Dimitrios leads, with relevant funding, several studies of gastric banding and pregnancy (Cochrane, UKOSS, ENGAGE study), a national cohort study of gastric bypass and pregnancy (NPEU). He has just established the OPTIMISE centre for further research into obesity and pregnancy, starting with a David Telling grant to develop and evaluate a smartphone App to inform and support women with bariatric surgery who get pregnant, and staff who look after them.

Dimitrios is chief or principal investigator in several studies of team training and its impact on real patient outcome (THISTLE stepped-wedge cluster RCT funded by CSO Scotland and Evaluation of Operative Birth training funded by the Health Foundation); as well as implementation science (ViCPROMPT funded by VMIA, THISTLE Plus funded by the Health Foundation). Dimitrios is joint lead for a 4-year ESRC grant to investigate teamwork in real-life obstetric emergencies (TREAT). He has developed and is now directing one national course for the RCOG (ROBuST - RCOG Operative Birth Simulation Course) and one regional course for the Severn Deanery (SMASH-Saving Mothers with Advanced Simulation of High-risk situations). He has also been directing for several years the Bristol Basic Practical Skills course. He regularly coordinates invited workshops worldwide. He has helped establish and disseminate PROMPT obstetric emergencies courses in several countries. As Regional Simulation Lead for Severn and Peninsula, he has worked on a review of the postgraduate curriculum aiming to implement and disseminate novel educational solutions. He is about to start a number of national training initiatives through his recent appointment as national simulation adviser. He supervises several undergraduate and postgraduate students, clinical research and clinical teaching fellows, social scientists, a medical statistician, and two BJOG journal associate / trainee editors.

Dimitrios is also joint investigator in very large NIHR funded or supported intrapartum trials; incluidng IMOX for prevention of postpartum haemorrhage (PPH), and COPE for treatment of PPH.

Currently, Dimitrios is leading EMBRACING CHANGE, an initiative to develop and evaluate integrated care pathways, tools, and training to improve care after stillbirth and neonatal death. He is also leading the PARENTS portfolio (Parents' Active Role & ENgagement in Their Stillbirth/Perinatal death review); studies funded by the Health Foundation and HQIP to explore how best to involve bereaved parents in the NHS probe of their baby's death. He is leading the update of the international RCOG Stillbirth guideline, and an initiative to develop an international consensus statement in bereavement care. He is finally bringing together the stillbirth and obesity research portfolios, aiming to reduce preventable harm by optimising weight before, during and after pr egnancy.

Dimitrios has won several national and international awards as leader of multiprofessional teams. He has authored several original papers, invited editorials, national guidelines (RCOG), and book chapters. He has edited the trainee and trainer manuals for a national course (ROBuST). He is a peer reviewer for Cochrane, most NIHR streams, Wellbeing of Women, overseas Funders, RCOG, IHI, and several journals (including the BMJ), conferences, and publishing groups.

Dimitrios is leading several initiatives to improve public/patient involvement (PPI) in research and care impovement including: involvement of lay editors in a BJOG stillbirth themed issue and overall leadership of PPI for the journal; grant holder for a Health Foundation funded project to establish a national process for parental invovlement in perinatal death / stillbirth reviews; lead of PPI for a £1m grant to integrate parental involvement into a standardised perinatal mortality review procedure and tool; and Chief Investigator of a grant to explore bereaved parents' involvement in the development of Core Outcome Sets (COS) for research.

Overall, he aims to improve the management of high-risk obstetric situations, in collaboration with other disciplines and professions, as well as with women and their companions, and develop advanced scientific methods for the evaluation and implementation of complex health care interventions.

Activities / Findings

InSight (INvestigation into Stillbirth to Improve and Guide Healthcare staff Training):

A qualitative study with bereaved parents and staff to determine good and not so good examples of bereavement care; following the publication of national guidance developed by our team where the paucity of evidence in some issues was identified. A medical and a midwifery student are also working on INSPIRE, a study to investigate cultural and ethnic variation in bereavement needs.

 

UKOSS National Surveillance Study of Women with prior Obesity Surgery (gastric banding, bypass) in Pregnancy: 

A study in collaboration with the National Perinatal Epidemiology Unit in Oxford, to determine current management and outcomes for women with gastric banding in pregnancy. This study is about to be published, and we are about to start a study of gastric bypass in pregnancy.

 

Cochrane Review of Gastric Banding:

A systematic review of RCTs on the same subject. The review has been completed and no eligible studies have been identified, so we have continued with a systematic review of observational studies (in preparation)

 

ENGAGE Study - patient experience of gastric banding in pregnancy:

To supplement the previous studies, we have obtained funding to study women's experience of pregnancy when they have gastric banding, compared to other women.

 

Bluebelle Study - a study of dressing versus no dressing for caesarean sections and other elective surgery.

My team are collaborating in this study.

We are also in the process of getting funding for other studies of women having a caesarean section, including obese and overweight women.

 

THISTLE study - Stepped-Wedge Cluster RCT of Obstetric Emergency Training:

We have obtained funding from CSO Scotland, and we are about to start this cluster trial of training across Scotland.

We are separately preparing a process and a health economics evaluation.

 

Teamwork in managing acute healthcare emergencies:

We have published findings from several mixed-methods studies. The findings show that few simple behaviours can significantly improve the management and outcome of catastrophic emergencies. We have determined simple practical ways to teach these behaviours to frontline teams and leaders, and have applied them to practice via the PROMPT and SMASH courses. We are now at the final stages of development of a study of video-recorded real-life emergencies, to enrich further the evidence base.

 

Other Research (in preparation for publication):

Team training in non-obstetric areas, rotational operative deliveries, undergraduate interprofessional simulation, induction of labour after stillbirth, meta-synthesis of stillbirth studies

Expertise

Dimitrios directs two training courses and regularly coordinates workshops. He has conducted many research projects, and has won several awards as leader of multiprofessional teams. He has authored several original papers, reviews, national guidelines (RCOG), book chapters, and is currently preparing a Cochrane review. He is a peer reviewer for the Cochrane Pregnancy and Childbirth Group, NIHR, Wellbeing of Women, RCOG, IHI and several journals and publishing groups. He has served as a member of the RCOG Consent Group, and has recently been jointly commissioned to develop an operative delivery training course by the RCOG. Dimitrios is interested in high-risk pregnancy, starting from early pregnancy (recurrent miscarriage, 2nd trimester complications) and continuing into antenatal care (maternal medicine), labour (advanced labour care, obstetric emergencies) and beyond (psychological care, medicolegal issues, medical education, team simulation, interprofessional training).

  • obstetrics & gynaecology
  • medical education research
  • health economics
  • health systems management
  • medical emergencies
  • teamwork; leadership
  • mixed-methods research
  • Memberships

    Organisations

    Bristol Medical School (PHS)

    Recent publications

    View complete publications list in the University of Bristol publications system

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