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

Coster, Joanne, Turner, Janette, Siriwardena, A. Niroshan , Wilson, Richard and Phung, Viet-Hai (2013) Prioritising outcomes measures for ambulance service care: a three stage consensus study. Journal of Epidemiology and Community Health, 67 (Supp.1). A33-A34. ISSN 0143-005X

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

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.

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; and 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; and incident or start of symptoms to calling the ambulance service.

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.

Additional Information:Oral Presentation at the Society for Social Medicine 57th Annual Scientific Meeting, 11–13 September 2013 Brighton and Sussex Medical School
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:14600
Deposited On:04 Aug 2014 08:13

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