Prioritising outcomes measures for ambulance service care: a three stage consensus study

Coster, Joanne and Turner, Janette and Siriwardena, A. Niroshan and Wilson, Richard and Phung, Viet-Hai and O'Cathain, Alicia and Togher, Fiona and Nicholl, Jon (2013) Prioritising outcomes measures for ambulance service care: a three stage consensus study. In: Society for Social Medicine 57th Annual Scientific Meeting, 11-13 September 2013, University of Sussex, Brighton.

Documents
Prioritising outcomes measures for ambulance service care: a three stage consensus study
[img]
[Download]
[img]
Preview
PDF
Prioritising outcomes measures for ambulance service care final.pdf - Presentation
Available under License Creative Commons Attribution Non-commercial Share Alike.

594kB
Item Type:Conference or Workshop contribution (Presentation)
Item Status:Live Archive

Abstract

Background
Historically ambulance care quality and performance has been measured by response times rather than clinical need or effectiveness. This limits the evidence about the effectiveness of the care the ambulance service provides. The Pre-hospital Outcomes for Evidence Based Evaluation (PhOEBE) project is a 5 year research programme which aims to develop new ways of measuring the performance, quality and impact of ambulance service care that better reflect the care provided.
Methods
We held a 1 day consensus event with a multi-stakeholder group to identify and prioritise which features of ambulance service care are important and worth further development as measures of performance and quality. The day comprised a series of small group discussions to share opinions about measures identified from literature reviews and the opportunity for participants to add their ideas, together with a live vote to help identify and rank measures for further development. Time measures were considered in a separate online questionnaire. The results from the online questionnaire and Consensus Event were fed into a Delphi study.
Results
43 participants attended the consensus event, representing a range of participant groups including patient and public, ambulance services, commissioners and policy groups. The top 5 outcome measures prioritised by the participants were: Accuracy of dispatch decisions; Completeness and accuracy of patient records; Accuracy of call taker identification of different conditions or needs (e.g. heart attack, stroke, suitable for nurse advice); Pain measurement and symptom relief; Patient experience.
From the online survey of time measures the top 5 measures were Time of call to time of arrival at scene; Time symptoms start (e.g. chest pain) to time of treatment with balloon for heart attack; Time taken to answer the emergency call; Total time spent on scene; Incident or start of symptoms to calling the ambulance service
Conclusions
Using consensus methods we have identified a set of outcome measures that can potentially be used to measure the performance and quality of ambulance service care. Some of these measures fit with existing government targets, such as response times and time taken to answer the emergency call. However most measures are new ways of measuring ambulance service care and the importance of these measures and methods of measurement will be assessed as part of an on-going Delphi study.

Keywords:Emergency Medical Systems, ambulance services, quality improvement, outcome measures, consensus methods
Subjects:B Subjects allied to Medicine > B990 Subjects Allied to Medicine not elsewhere classified
A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Social Science > School of Health & Social Care
ID Code:12666
Deposited On:11 Dec 2013 14:12

Repository Staff Only: item control page