Tag Archives: EMS

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CaHRU receives university team award for achievement in research

CaHRU2017webThis year members of the Community and Health Research Unit received the University of Lincoln team award for Achievement in Research at the Individual Merit and Team Achievement Awards 2017. This was the team’s fifth team award over the past 6 years and the fourth time the team have received the team award for achievement in research. Members of the team include Prof Niro Siriwardena (director), Prof Graham Law, Dr Murray Smith, Dr Zahid Asghar, Dr Coral Sirdifield, Dr Stephanie Armstrong, Dr Julie Pattinson, Dr Rebecca Marples, Viet-Hai Phung, Despina Laparidou, Michael Toze, Laura Simmons, Joseph Akanuwe, Dr Nadeeka Chandraratne, Dr Ravindra Pathirathna and Sue Bowler (administrator).

ResearchTeamAward2017CertificateThe CaHRU team are striving to conduct research which will make a difference to patients and healthcare delivery. The group conducts basic and translational interdisciplinary research in collaboration with health service and academic partners.  It currently has over 30 active projects in progress across a range of research methods from systematic reviews (e.g. role of community first responders, ethics of ambulance trials), major clinical trials (investigating conditions such as hyper-acute care of stroke, prehospital pain management, ambulance hypoglycaemia pathways and primary care for insomnia), observational studies (investigating prehospital pain and seizure management), qualitative designs (community first responders, dementia carers, ethics of ambulance trials, fairness of medical licensing exams), consensus methods (ambulance indicators), and surveys (healthcare for offenders on community sentences) to quality improvement programmes (prescribing safety) and international research networks (ethics of ambulance trials). Details of current studies are available on the CaHRU website (http://cahru.org.uk/research/).

CaHRU_logotypeThis has led to over 20 publications in the past year covering research on development of new pathways and indicators for ambulance services, assessment and treatment for insomnia and use of health technology innovations, in major journals such as Resuscitation, Annals of Emergency medicine, Health Technology Assessment, Health Expectations and Lancet Psychiatry. The team have  received several major grants over the past year, particularly from the National Institute for Health Research, as well as continuing to work on studies funded by the Wellcome Trust, Health Foundation and Falck Foundation. This year we have also welcomed international fellows from the University of Colombo to the team for the first time.

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Viet-Hai Phung presents at Emergency Medicine Congress, Lisbon

vhp2Viet-Hai Phung presented his work on the perceptions and experiences of Community First Responders (CFRs) in Lincolnshire at the recent Mediterranean Emergency Medicine Congress (MEMC). The Congress, organised by the American Academy of Emergency Medicine (AAEM), took place in the very smart surroundings of the Corinthia Hotel in Lisbon, Portugal from 8-10 September 2017. Despite the title of the Congress, this was a truly international conference, with delegates from North America, the Middle East, Africa and Australasia presenting.

Professor Lee Alan Wallis, Head of Emergency Medicine for the Western Cape Government, was the keynote speaker at the opening ceremony. He talked about the particular challenges of lisbon1emergency medicine provision in southern Africa, where in some countries the infrastructure is extremely basic. Other plenary speakers included: Professor James Ducharme from McMaster University in Toronto, who talked about the complex relationship between pain relief, patient satisfaction and addiction and Dr Eveline Hitti from the American University in Beirut, who spoke about the glass ceiling for women working in emergency medicine.

Viet-Hai presented the interview study that has been undertaken with colleagues Prof Niro Siriwardena, Ian Trueman and Prof Roderick Ørner on the first morning of the conference. The presentation was well-received with only minor points of clarification from the audience concerning the extent of their use in the UK and the levels of training they undertake.

What was interesting about the conference was the sharing of best practice from around the world on many salient problems in emergency medicine, such as alleviating patient overcrowding in the emergency department. All this within the setting of the wonderful city of seven hills, Lisbon.

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By Viet-Hai Phung

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Spotlight on new ambulance performance measures

photo2italiccolourWORDSTwo key articles on development and prioritization of new ambulance performance measures were published this autumn 2017 in Health Expectations. The studies come from, Prehospital Outcomes for Evidence Based Evaluation (PhOEBE), funded by a five year National Institute for Health Research Programme Grant for Applied Health Research led by Professor Niro Siriwardena from CaHRU and Janette Turner of the Centre for Urgent and Emergency care research (CURE).

EMAS - A&E 6_750The first article, ‘Prioritizing novel and existing ambulance performance measures through expert and lay consensus: a three-stage multimethod consensus study‘ involved a multistakeholder consensus event, modified Delphi study, and patient and public consensus workshop, which together identified a shortlist of ambulance outcome and performance measures important to ambulance clinicians and service providers, service users, commissioners and academics.

N0030773 Paramedic driving an ambulanceThe final set of measures included change in pain score, accuracy of call identification, average response time, proportion of patients with a serious condition who survived to 7 days post-admission, death (within 3 days) from a low risk condition, proportion of patients transported to the Emergency Department who were discharged without treatment or investigation, and the proportion of those with specific conditions treated according to current guidelines.

The public consensus workshop, ‘A coproduced patient and public event: An approach to developing and prioritizing ambulance performance measures‘, was effective for obtaining public feedback on which ambulance performance measures were most highly favoured by lay participants. These measures have been developed to be used in future by ambulance services or commissioners to benchmark care quality between services or regions or to measure performance over time.

By Prof Niro Siriwardena

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First publication from the NEAT project on consent in ambulance trials

Got-Consent-Logo-2CaHRU are pleased to announce the first publication from the Wellcome Trust funded project, NEAT: Network exploring Ethics in Ambulance Trials. The article, entitled ‘Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review‘, sought to understand the main ethical considerations when conducting clinical trials involving ambulance services.

NThe review found  issues with consent were the most significant ethical issue for ambulance trials. The type of consent gained differed depending on the condition or intervention being studied, but the country in which the research took place had less influence on the type of consent. The terminology used to describe consent varied widely with multiple terms used to describe the same processes. This, coupled with the the wide range of consent types used led to the conclusion that standardisation of consent models and terminology used to describe them was warranted.

The systematic review  was published in BMC Medical Research Methodology and is available open access at the following link: http://rdcu.be/vUxW

By Stephanie Armstrong.