JRCALC Conference 2004 10 th November 2004. Royal College of Physicians Mark Cooke BMed. Sci(Hons) MSc National Clinical Effectiveness Manager Ambulance Service Association
Move towards National Audit • 2002/4 ~ 1 st ever national audit within NHS Ambulance Services – Patients presenting with ST Elevation/? AMI ~ Over 13, 000 patients • 2002/4 ~ National audit of prehospital thrombolysis – 92% in 60 mins ~ Mean ‘call to needle’ = 40 mins • 2003/4 ~ 1 st ever national audit of ‘Oo. H Cardiac Arrest’ in NHS – Over 22, 000 patients in first 6 months • 2003/4 ~ National Audit of Benzyl Penicillin (2 yrs combined data) – Report in Jan 2005
National Audit of Thrombolysis • 24/31 Services now providing thrombolysis • 4 more services planning introduction before end 2004 • GMAS and LAS evaluating alternative approaches to revascularization • Over 1300 patients thrombolysed to date • 1070 patients during last 12 months
National Audit of Thrombolysis
National Audit of Thrombolysis Ambulance Service Avon Beds & Herts Cov & Warwickshire Cumbria Dorset East Anglia East Midlands Essex Gloucestershire Hampshire Hereford & Worcs Kent Lancashire Lincolnshire Mersey North East Oxfordshire Royal Berkshire Staffordshire Sussex Tenyas Two Shires West Midlands Westcountry Jan-04 Mar-04 May-04 Jul-04 Sep-04 Nov-04 3 10 5 65 1 36 37 36 5 10 7 125 1 0 0 8 6 12 6 79 2 37 53 40 5 5 18 18 155 3 1 1 20 5 10 14 8 101 6 45 78 0 50 32 6 26 0 33 194 6 1 3 26 9 12 15 9 127 23 57 105 1 0 73 5 51 11 30 0 38 244 10 1 2 6 35 17 15 20 13 145 43 82 123 1 0 85 10 78 15 42 1 0 44 284 14 1 5 9 47 20 19 26 15 160 75 108 146 3 0 97 13 101 19 62 2 0 47 330 18 1 8 13 66 1349 Agent TNK TNK TNK r. PA TNK r. PA/TNK TNK TNK
Clinical Performance Indicators • Documented clinical care provided – JRCALC v 3 • Like for like benchmarking • Identification of best practice – Areas for development ~ transferable lessons
Clinical Outcome Measures • Mortality as hard measure of performance • PIAG approval / MINAP / ASA / CCAD / DH – Access to patient outcome data – Development of ambulance outcome database (ASA/MINAP) • Lotus Notes – Fully funded as part of DH Funding to ASA
Ambulance Service Performance • Now possible to collect more useful information • A better and more useful indicator of ambulance service performance that reflects patient care • 1. Speed of response • 2. Clinical Care Provided • 3. Clinical Outcome (alive/dead)
What’s Next? National Audit of PAIN Management 2005/2006 ASA/JRCALC Workplan • Patient Survey • Pain Assessment – Documentation – Use of pain scores • Pain Management – Use of analgesia
Conclusions • The shift towards national audit and standards – Working with senior key partners, DH, MINAP, HCC, NICE – Engaging with member services • Major headway made – Milestones ~ National Benchmarking • Priorities in line with national policy/guidance – NSFs (CHD, Older People, Children) – NICE
International Developments Cochrane Collaboration Dedicated Prehospital and Emergency Health Field Details at www. cochranepehf. org Or information flyers available here today
Thank you ?
Скачать презентацию JRCALC Conference 2004 10 th November 2004 Royal
7af3a97da55124bc25b4e27019c3ddfe.ppt