Tag Archives: impact

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CaHRU to contribute to Institute for Healthcare Improvement Web and Action on Improving Prehospital Emergency Care

NProfessor Niro Siriwardena will join Dave Williams and EMS leaders from the United States and abroad, conducting pioneering work in the field of prehospital quality improvement, for an Institute for Healthcare Improvement Web and Action on Improving Prehospital Emergency Care the spring (March and April 2015). The Web and Action will consist of five sessions over the next two months.

NIn Session One, Introduction to Improving Prehospital Emergency Care Systems (Thursday, March 5, 2015, 12:00 PM – 1:00 PM Eastern Time), David Williams and Kedar Mate will introduce the agenda for the Web & Action Series, providing an overview of the history of ambulance service, the current state of the profession and improvement opportunities for prehospital care. Jerry Overton and Paul Gowens join Session Two, Early Identification of Deteriorating Patients (Thursday, March 19, 20, 12:00 PM – 1:00 PM ET), introduce the concept of early identification, resource allocation, and intervention and present the use of a prehospital early warning score to identify prehospital patients who are deteriorating (e.g., sepsis) to expedite transport, intervention, and emergency department notification.

NProf Niro Siriwardena and Jonathan Studnek present key care pathways for improving core prehospital care processes and outcomes in Session Three, Key Care Pathways – Change Package and Measurement of Time Sensitive Conditions (Thursday, April 2, 2015, 12:00 PM – 1:00 PM ET). They go on to discuss the development of a change package and measurement strategy in the NHS England Ambulance Trusts and profile case examples of improving care reliability in stroke and STEMI in the U.S. and U.K.

NIn Session Four, Prehospital Emergency Care Trigger Tool (Thursday, April 16, 2015, 12:00 PM – 1:00 PM ET), Loua Al Shaikh introduces the concept of trigger tools and the application the prehospital care ecosystem. Finally, Mike Taigman and Brenda Staffan lead Session Five, Paramedic Care in the Community (Thursday, April 30, 2015, 12:00 PM – 1:00 PM ET) where they define the emerging opportunity of utilising paramedics in the community through prevention, partnerships, intervention, and post discharge care.

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CaHRU supports Newham general practices in prescribing safety Quality Improvement Collaborative

ludwiggutmann1Prof Niro Siriwardena spoke at the first engagement event of a new multi-organisational general practice quality improvement collaborative at the Stratford Olympic Park this February. The collaborative led by Professor Martin Marshall and his team at University College London, under the auspices of the Guttmann Academic Partnership launched in 2014, will involve working with NHS Newham Clinical Commissioning Group (CCG) and UCL Partners to support safer prescribing in Newham general practice.

QIlogoProfessor Siriwardena gave an introduction to quality improvement science approaches in his talk ‘How can QI methods in general help to solve these [safety] challenges?’ at the inaugural meeting together with other experts in collaboratives, including Prof Marshall and Dr Neil Houston from NHS Scotland, and local general practitioners. The talk was based on experience from regional and national quality improvement collaboratives such as the Resources for Effective Sleep Treatment project and the Ambulance Services cardiovascular Quality Initiative. Prof Siriwardena has recently been part of a team awarded funding from the Health Foundation for a new regional collaborative aimed at ‘Improving prescribing safety in general practices in the East Midlands through the PINCER intervention.’

Niro@RSM2014._750The engagement event took place at the Sir Ludwig Guttman Health and Well Being Centre situated in the Olympic Park in Stratford, originally designed as the medical practice for the London 2012 Summer Olympics. It was well attended by general practitioners, patients and academic experts supporting the initiative and is part of the impact activity of CaHRU’s new research centre.

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Research from CaHRU helping to improve prehospital care around the world

EMAS - A&E 5_750Research undertaken by CaHRU with East Midlands Ambulance Service and other English ambulance services which has led to improvements in care in the UK is having an impact on improvement efforts in North America and the Middle East according to an article published in EMS World, ‘Improving Prehospital Care Around the World‘ by Dr David Williams CEO of Medic Health, improvement advisor and lead prehospital care and ambulance service system faculty at the prestigious Institute for Healthcare Improvement in the United States.

ascqilogoCaHRU’s work has informed improvement efforts in the United States such as American Medical Response’s Caring for Maria improvement collaborative and the EMS performance measures initiative in partnership with the National Highway Traffic Safety Administration and the National Association of State EMS Officials. It has also informed ongoing innovation work in United States and Middle East at the Institute for Healthcare Improvement.

EMAS - A&E 9_750The research which led to development of national indicators for English ambulance services and improvements in prehospital care for heart attack and stroke through the Ambulance Services Cardiovascular Quality Initiative is having worldwide impact.

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New implementation study to improve prescribing safety in general practice

P011354Professor Niro Siriwardena and the CaHRU team have been awarded a major grant from the Health Foundation under their Scaling Up Improvement programme. The project is led by Lincolnshire Community Health Services NHS Trust supported by the University of Lincoln, University of Nottingham, the East Midlands Academic Health Science Network and 17 of the region’s Clinical Commissioning Groups.

medication_pillsThe aim of the study is to spread an intervention called PINCER (pharmacist-led information technology intervention for reducing clinically important errors in medication management) across East Midlands general practices and then more widely across the United Kingdom using a quality improvement collaborative, a model which CaHRU have used in previous projects.

reading1The project will provide participating GP practices access to computer software that automatically reviews prescriptions together with expert support from a pharmacist who will work with practice staff to review prescriptions and drugs monitoring. This will reduce the risk of drug errors and failure to monitor, particularly in those people with more than one long term condition on a combination of drugs. Pharmacists and GPs will share learning as part of the project.

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Ambulance Services Cardiovascular Quality Initiative resources now online

ascqilogoThe new Ambulance Services Cardiovascular Quality Initiative (ASCQI) website was launched this month. The website describes how the ASCQI project, funded by the Health Foundation’s Closing the Gap in Clinical Communities Programme, achieved its aims as the first national quality improvement collaborative involving all English ambulance services.

The aims of ASCQI were to improve ambulance care for heart attack and stroke across England and specifically:

  • To improve the delivery of care bundles for AMI from 43% to over 70% within two years of the project
  • To improve delivery of care bundles for stroke from 83% to over 90% within two years of the project
  • To increase diffusion of quality improvement methods to frontline staff in ambulance services.

EMAS - A&E 5_750As a result of the collaborative nine out of twelve ambulance trusts showed a significant improvement in either the stroke or AMI care bundle, and seven out of twelve showed significant improvements for both AMI and stroke. Performance for the care bundle for AMI increased from 43 percent to 79 percent, and for stroke 83 percent to 96 percent during the two years of the project and these improvements have been maintained. These results were published in the journal Implementation Science. A secondary aim of the initiative was to begin to develop patient reported experience measures (PREMs) for AMI and stroke. Preliminary qualitative work for development of PREMS for ambulance services was published in the EMJ, and this work is being continued by Fiona Togher of CaHRU through a funded doctoral study.

EMAS - A&E 9_750The website includes a range of resources which were used by ambulance services to deliver the improvements that we saw nationally. The work is now helping to inform similar prehospital improvement initiatives in the Middle East and North America and will be featured in a session on key care pathways in a Web and Action webinar series developed by the Institute for Healthcare Improvement, a world leader in healthcare quality improvement based in the United States, starting in March 2015.