Meet the team!

1. PhOEBEPatient and Public Involvement DayAmbulance service qualityWhat matters to you? 4th June 2014

2. Meet the team! Janette Turner Andrea Broadway-Parkinson Viet-Hai Phung Joanne Coster Maggie Marsh Dan Bradbury Richard Wilson Andy Irving Dan Fall

3. What is PhOEBE? • Develop better ways of measuring the performance, quality and impact of ambulance service care. • Prioritisation of outcome measures. • Provide better information about effectiveness and quality of care.

4. Why is this important?

5. Why it is important • The ambulance service is a gateway for many people with a range of health problems • Everyone should think they are getting the best service that can be offered • Measuring how well services are doing allows us to ensure this happens – identifies good and bad • Also helps us assess whether new innovations are working and worthwhile

6. Aims & objectivesof today Meet the PhOEBE research team Understand the PhOEBE process so far Have an opportunity to discuss shortlisted measures Choose the measure in each category which is most important to you Feel that you have been involved and your view has been listened to Understand how this day contributes to the process of selecting emergency ambulance quality measures. Understand how the measures selected will be used in the next steps of the PhOEBE project.

7. Today’s Programme

8. Voting process 8 votes in 3 groups

9. Voting test! Question: Who is going to win the World Cup!? Answer: • England! • Brazil • Spain • I don’t care!

10. Today’s Programme

11. Patient outcome measures What are patient outcomes? • Capture the effects, consequences or impact (good or bad) of care provided • Direct e.g. survival, disability, reduction in pain • May reflect people’s views and opinions about the care they received.

12. Patient Outcomes 1. Pain 2. Survival 3. Re-contacts

13. Pain Why do we measure pain? • Pain is a major issue for people who are ill or injured • Pain management - recognising patient pain • Providing proportionate pain relief • Pain relief drugs or e.g. applying splints to fractures

14. Pain

15. Survival Why do we measure survival ? • May indicate how well an ambulance service is performing • Illness or injury may be so serious a patient cannot be saved • Important to take this into account. Cardiac arrest - very small chance of surviving, stubbed toe – should be OK • Many ways survival can be measured (all patients, specific groups of patients, and at different time points after health problem)

16. Survival

17. Re-contacts What makes re-contact rates so important? • Some people re-contact services because their condition may get worse despite good treatment • If the number of people re-contacting services is high it suggests the response to the first call for was not adequate • Call may not have been properly assessed or patient not properly assessed at scene • Risk to patients - seriousness of their condition is not recognised. • Re-contact rates can be used as a measure of patient safety - high rates of re-contact suggest low levels of patient safety

18. Re-contacts

19. Coffee break

20. Today’s Programme

21. Clinical ManagementMeasures • What makes clinical management measures important? • Triage • Accuracy • Call categories

22. Clinical Management Measures Appropriateness and accuracy of triage Compliance with protocols and guideline

23. Appropriatenessand accuracy of triage

24. Appropriatenessand accuracy of triage

25. Compliance with protocols and guideline measures • Why are protocols and guidelines important? • Documents that specify how, or in what manner, a particular clinical problem or incident is to be treated • Incorporates best practice for the condition so patients receive the most up to date and effective care • Measure is about how often ambulance crew follow a protocol and provide the specified care • A high rate of protocol compliance = optimum care • A low rate suggests improvements are needed

26. Compliance with protocols and guideline measures

27. Lunch 1 – 1:45pm

28. Today’s Programme

29. Whole service measures • Time measures 2. Accuracy of call identification

30. Time measures How well the ambulance service organises itself: • to answer the call • correctly identify the problem • dispatch a suitable vehicle • ensure that the patient is transported to the most suitable place for treatment • Definitive care = getting to the best place for the problem - stroke patient to a specialist stroke centre, fall patient with no injury left at home and referred to a falls service

31. Time measures(Definitive care)

32. Time measures (Response time)

33. Accuracy of call identification and assessment • Under-triage – level of care not high enough • Category A call is not recognised - slower response with treatment delay may have serious consequences • Over-triage – level of care too high • Sending a fast response using lights and sirens - risks to both ambulance crews and the public • Efficient use of resources

34. Accuracy of call identification measures

35. Comfort break 14:45 – 15:15(receive your expenses & grab a coffee to bring into the room)

36. Evaluation Yes = 1, No = 2 Have you; • Understood what PhOEBE is all about? • Had an opportunity to be involved and contribute your thoughts? • Felt listened to? • Enjoyed the day? Please add any further comments on your evaluation forms

37. Thank you!

38. For further information Email: phoebeprogramme@sheffield.ac.uk Post: Andy Irving, The PhOEBE Project, The University of Sheffield, Regent Court, 30 Regent St, Sheffield, S1 1DA. Tel: 0114 2224292. Fax: 0114 2220749