Tag Archives: ambulance

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ASCQI paper rated highest in Implementation Science top social papers in 2014

ascqilogoA paper published by the CaHRU team in the journal Implementation Science, ‘The effect of a national quality improvement collaborative on prehospital care for acute myocardial infarction and stroke in England‘ came top in the journal’s measures of social media circulation (altmetrics) in 2014.

EMAS - A&E 9_750The study was funded as part of the Ambulance Services Cardiovascular Quality Initiative (ASCQI) by the Health Foundation under their Closing the Gap in Clinical Communities programme and led to improvements in care for heart attack and stroke in England. More recently the ASCQI team have been funded by the Health Foundation under their Widening Improvement programme to spread the learning from ASCQI to other clinical areas in ambulance services in the Improving Prehospital and Ambulance Care and Treatment following ASCQI (ImPACT-ASCQI) project. This work was presented recently at the EMS99 Forum conference in Nottingham.

EMAS - A&E 5_750The findings from ASCQI and resources are also being disseminated in a new website and the result are having impact in other areas of the world such as Quatar and the United States.

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Reassurance important for ambulance services users: new qualitative study published in Health Expectations

photo2italiccolourWORDSResearchers from CaHRU with colleagues from the School of Health and Related Research (ScHARR) at the University of Sheffield have published a new study: “Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study” in the journal Health Expectations. The study’s lead author was Fiona Togher, PhD student and Graduate Research Assistant in CaHRU. She was supported in the work by Alicia O’Cathain, Professor of Health Services Research at the University of Sheffield, Viet-Hai Phung, Research Assistant in CaHRU, Janette Turner, Research Fellow at the University of Sheffield and Professor Niro Siriwardena, director of CaHRU. The study is part of a five year NIHR Programme for Applied Health Research, Prehospital Outcomes for Evidence Based Evaluation (PhOEBE).

EMAS - PTS 2_750The authors aimed to investigate the aspects of emergency ambulance care that were most valued by users of the service. Fiona and Viet-Hai interviewed people (patients and carers) that had used the ambulance service for a range of different conditions such as diabetes, suspected stroke, breathing difficulties and falls. The participants had also received various types of ambulance service response i.e. ‘hear and treat’ in which the participants received enhanced clinical assessment and advice over the telephone only, ‘see and treat’ in which the participants were treated on-scene by appropriately skilled clinicians without the need for hospital admission and the more familiar, ‘see and convey’ in which the participants received pre-hospital assessment and treatment before transportation to acute care.

NThe authors found that regardless of their specific clinical problem people valued similar aspects of their emergency ambulance service experience. Participants had often been extremely anxious about their health, and they most valued the reassurance they felt from receiving appropriate advice, treatment and care from ambulance service staff. It was found that the ability of the emergency ambulance service to allay the high levels of fear and anxiety felt by users is crucial to the delivery of a high quality service.

The qualitative interview data collected from this research is now being re-analysed as part of Fiona’s doctoral studies to develop a Patient Reported Experience Measure (PREM) for use in UK ambulance services.

 

Fiona Togher

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Three minutes to present two years’ work on prehospital care for ethnic minorities at European Congress on Emergency Medicine, Amsterdam 2014

VIt was a pleasure to attend the European Congress on Emergency Medicine in the beautiful environs of Westerpark, Amsterdam from Sunday 28th September – Wednesday 1st October. I had been invited to give a three-minute presentation on the systematic review that I had been working on for two years, ‘Barriers, facilitators, disparities and consequences for people from minority ethnic groups accessing prehospital care: systematic review and narrative synthesis’.

vhp1Prior to going to Amsterdam, I had rehearsed the presentation many times. This carried on right through to an hour before the Monday afternoon Lightning Session I was due to present in. The ‘Lightning Session’ itself was due to last 90 minutes with 23 presenters summing up their research. I was 18th up so at least I could get a feel for what to expect. I was nervous, but not shaking, as I made my way up to the podium, without notes. Before I started, I familiarised myself with how to work the slideshow to avoid any embarrassments, which previous presenters suffered. I knew exactly what I was going to say on each slide. There were minor departures from what I had planned to say, but I got the underlying message across to the audience. I felt I answered the question from the chair about uneven translation service provision in the UK competently. And that was that. Thorough preparation had made a seemingly daunting task manageable.

image.jpeg_(1)[1]There were other interesting lightning presentations on prehospital care from around the world, but the conference focused more on clinical and emergency department research. However, I gained another valuable professional skill and spent some time in lovely Amsterdam. Which were no bad things at all!

Viet-Hai Phung

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CaHRU attends College of Paramedics National Conference at Warwick University, October 2014

ASCQI poster at WarwickViet-Hai Phung, researcher at CaHRU, recently attended the College of Paramedics national conference at Warwick University on 6-7th October 2014. This organisation, formerly the British Paramedic Association, represents the professional interests of prehospital clinicians in the UK. Viet-Hai was one of the few health researchers attending the conference, albeit one with an interest in prehospital care. He presented a poster entitled, ‘Leadership, innovation and engagement in quality improvement in the Ambulance Services Cardiovascular Quality Initiative: cross sectional survey’ which showcased the team’s work exploring leadership and innovation through the Ambulance Service Cardiovascular Quality Initiative (ASCQI). Delegates were interested in the collaboration between the University of Lincoln and East Midlands Ambulance Service (EMAS), so from that point of view, CaHRU did indeed raise its profile.

 

 

EMAS - A&E 5_750The College’s Chair, Andy Newton, opened the proceedings on both days. There were a number of enlightening presentations from the UK, including the problems the ambulance service faces in delivering an effective response to mental health issues and how it deals with end-of-life care. Professor Keith Willett, who is leading the review into urgent and emergency care in England, outlined the future challenges for prehospital care in the UK.

EMAS - A&E 6_750As well as the domestic picture, delegates learned more about how ambulance services operate in countries as diverse as the USA, South Africa, Australia, Austria and Switzerland. Professor Jerry Overton highlighted that the USA, like the UK, is focusing too much on outputs rather than outcomes. Kai Kranz, from the Swiss Paramedic Association, emphasised the fragmented nature of their ambulance service, arising from regional and linguistic differences. It was a well-organised, informative conference, giving all delegates much to think about. Looking forward to the next one in 2015!

Viet-Hai Phung

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Ambulance Services Cardiovascular Quality Initiative findings published in Implementation Science

EMAS-PTS2_750The results of a national Quality Improvement Collaborative study, the Ambulance Services Cardiovascular Quality Initiative (ASCQI) were published this week in the international academic journal Implementation Science. The article entitled The effect of a national quality improvement collaborative on prehospital care for acute myocardial infaction and stroke in England showed large and significant improvements in the quality of care provided by 11 ambulance services (out of 12) in England for people with heart attack and stroke. Members of the CaHRU team involved in the study included Professor Siriwardena, Dr Zowie Davy and Fiona Togher together with visiting fellows at CaHRU who are members of the research team at EMAS including Anne Spaight, Debbie Shaw and Nadya Essam. Professor Michael Dewey, chair in epidemiological statistics in London was the statistician on the project.

EMAS - A&E 9The project has been part of a programme of work, Prehospital and Emergency Quality and Outcomes, developed through collaboration between academics from the Community and Health Research Unit and ambulance services across the United Kingdom, particularly East Midlands Ambulance Service NHS Trust (EMAS). This collaboration has enabled a strategic partnership between the University of Lincoln and EMAS to undertake research which is relevant to ambulance services, focusing on health issues of regional and national importance, and conducted with ambulance staff in order to increase the impact of the research by improving prehospital care for emergencies.

EMAS - A&E 6bThe study examined the period between January 2010 and February 2012. Across England overall, the percentage of emergency cases where care bundles (packages of essential care) were delivered in full increased from 43% to 79% for heart attack and from 83% to 96% for stroke. ASCQI supported frontline staff, and their management, to introduce improvements using checklists, aide memoires, individual and group feedback and sharing of information within and between different trusts to improve the reliability of care for people with heart attack and stroke. The project was shortlisted for an HSJ award in 2012.