Authors and affiliation Research, University of Sheffield, 3 East Midlands Ambulance Service Study...
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Authors and affiliation Research, University of Sheffield, 3 East Midlands Ambulance Service Study flow Conclusion In addition to measures relating to survival, length of stay and place of discharge, we identified 144 additional outcome measures. Few studies included patient reported or cost outcomes. By identifying a wide range of outcome measures this review will inform further research looking at the feasibility of using a wider range of outcome measures and developing new outcome measures in pre-hospital research and quality improvement. Aim We aimed to review the international evidence base to describe the range and scope of outcome measures for prehospital performance and quality. This will seek to inform discussion about what measures might be relevant for a wider pre-hospital population. Introduction Ambulance service performance measurement has previously focused on response times and survival. We conducted a systematic review of the international literature on quality measures and outcomes relating to pre-hospital ambulance service care, aiming to identify a broad range of outcome measures to provide a more meaningful assessment of ambulance service care. Method We searched a number of electronic databases including CINAHL, the Cochrane Library, EMBASE, Medline and Web of Science. The next stage involved developing a data extraction tool, which established the eligibility criteria for inclusion. We included studies if they: were research or evaluation; referred to the pre- hospital phase of care; reported Results Overall, 181 full-text articles were included: 83 (46%) studies from North America, 50 (28%) from Europe and 21 (12%) from the UK. A total of 176 articles were obtained after examining 257 full-text articles in detail from 5,088 abstracts screened. A further five papers were subsequently identified from references of the articles examined and studies known to the authors. There were 140 articles (77%) which contained at least one survival-related measure, 47 (34%) which included information about length of stay and 87 (48%) which identified at least one place of discharge as an outcome. Limitations We encountered a problem of incomplete information, for instance studies not specifying which pain scales when these had been used or using survival as an outcome without specifying a time period. Engaging with Patients and NHS managers to develop a Patient Reported Experience Measure (PREM) for use in UK ambulance services Initial search identified 6,067 records 979 duplicates removed 5,088 records remained 5,088 abstracts analysed 4,831 records screened out 257 full-text articles analysed for eligibility 81 articles screened out 176 studies included 5 studies from hand-searches 181 studies included overall Funding: This presentation presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research (PGfAR) scheme (Grant Reference Number RP-PG-0609-10195). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health Contact details: [email protected] University of Lincoln, Community of Health Research Unit (CaHRU), School of Health and Social Care, Tel: +44 (0)1522837731 PhD research: Fiona Togher Supervision team: Professor Niroshan Siriwardena and Dr Karen Windle How am I engaging with the public? Theoretical framework of patient-centred care: • Which aspects of their care are patients interested in measuring? • How do they think the questionnaire should look? Presenting research ideas to Patient and Public involvement (PPI) groups: • Healthy Ageing PPI group at the University of Lincoln • Prehospital Outcomes for Evidence Based Evaluation PPI group at the University of Sheffield Presenting research ideas for discussion at key national NHS groups: • National Ambulance Service Patient Experience group • National Ambulance Service Research steering group References: http://research-methodology.net/wp-content/uploads/2012/05/questionnaire1.jpg http://www.open.edu/openlearn/body-mind/health/nursing/the-importance-person-centred- approaches-nursing-care Darzi, A. (2008) High quality care for all: NHS next stage review final report. London: Department of Health. Why am I doing this research? Darzi (2008) stated in his NHS next stage review report that: “…if quality is to be at the heart of everything we do, it must be understood from the perspective of patients”. The NHS needs to develop and improve strategies for empowering patients to provide feedback about their experiences. Patient Reported Experience Measures (PREMs) are self- completion questionnaires designed to develop an understanding of what patients’ perceived actually happened during their health care episode. Research has predominantly focused on the development of measures for use in primary (GP surgeries) and acute care (hospital) settings. My research is focused on the development of a PREM for NHS ambulance services. How am I doing this research? 1. By developing a detailed understanding of the literature around PREM development and their use in health care. 2. Undertaking a secondary analysis of interview data (n=44) exploring patients’ experiences of their care. 3. Designing, refining and modifying the PREM based on engagement with patients, stakeholders and the public. Who should I be engaging with? • Ambulance service patients: share ideas and plans, ask for opinions and views about what should be included in the PREM, show them draft versions of the measure and listen to their feedback. • NHS staff: involve key stakeholders (i.e. patient experience managers) in what I am doing by including them in the research and keeping them in the loop with progress. Could your research impact on the lives of those outside your discipline knowledge? Yes - the purpose of developing this measure is to improve the experience of patients accessing emergency ambulance service care. This could be achieved by: • Measuring differences in patient experience between and within ambulance services and identifying improvement priorities. • Using the PREM data to provide feedback and inform further education for ambulance service clinicians resulting in improved patient outcomes.
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Transcript of Authors and affiliation Research, University of Sheffield, 3 East Midlands Ambulance Service Study...
Authors and affiliationResearch, University of Sheffield, 3East Midlands Ambulance Service
Study flow
Conclusion
In addition to measures relating to survival, length of stay and place of discharge, we identified 144 additional outcome measures. Few studies included patient reported or cost outcomes. By identifying a wide range of outcome measures this review will inform further research looking at the feasibility of using a wider range of outcome measures and developing new outcome measures in pre-hospital research and quality improvement.
AimWe aimed to review the international evidence base to describe the range and scope of outcome measures for prehospital performance and quality. This will seek to inform discussion about what measures might be relevant for a wider pre-hospital population.
Introduction
Ambulance service performance measurement has previously focused on response times and survival. We conducted a systematic review of the international literature on quality measures and outcomes relating to pre-hospital ambulance service care, aiming to identify a broad range of outcome measures to provide a more meaningful assessment of ambulance service care.
MethodWe searched a number of electronic databases including CINAHL, the Cochrane Library, EMBASE, Medline and Web of Science. The next stage involved developing a data extraction tool, which established the eligibility criteria for inclusion. We included studies if they: were research or evaluation; referred to the pre- hospital phase of care; reported outcomes; and were published in theEnglish language.
Results
Overall, 181 full-text articles were included: 83 (46%) studies from North America, 50 (28%) from Europe and 21 (12%) from the UK. A total of 176 articles were obtained after examining 257 full-text articles in detail from 5,088 abstracts screened. A further five papers were subsequently identified from references of the articles examined and studies known to the authors. There were 140 articles (77%) which contained at least one survival-related measure, 47 (34%) which included information about length of stay and 87 (48%) which identified at least one place of discharge as an outcome.
Limitations
We encountered a problem of incomplete information, for instance studies not specifying which pain scales when these had been used or using survival as an outcome without specifying a time period.
Engaging with Patients and NHS managers to develop a Patient Reported Experience Measure (PREM) for use in UK ambulance services
Initial search identified 6,067 records
979 duplicates removed
5,088 records remained
5,088 abstracts analysed
4,831 records screened out
257 full-text articles analysed for eligibility
81 articles screened out
176 studies included
5 studies from hand-searches
181 studies included overall
Funding: This presentation presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research (PGfAR) scheme (Grant Reference Number RP-PG-0609-10195). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of HealthContact details: [email protected]
University of Lincoln, Community of Health Research Unit (CaHRU), School of Health and Social Care,Tel: +44 (0)1522837731
PhD research: Fiona TogherSupervision team: Professor Niroshan Siriwardena and Dr Karen Windle
How am I engaging with the public?
Theoretical framework of patient-centred care:• Which aspects of their care are patients interested in
measuring?
• How do they think the questionnaire should look?
Presenting research ideas to Patient and Public involvement (PPI) groups: • Healthy Ageing PPI group at the University of Lincoln
• Prehospital Outcomes for Evidence Based Evaluation
PPI group at the University of Sheffield
Presenting research ideas for discussion at key national NHS groups:• National Ambulance Service Patient Experience group
• National Ambulance Service Research steering group
References: http://research-methodology.net/wp-content/uploads/2012/05/questionnaire1.jpg
http://www.open.edu/openlearn/body-mind/health/nursing/the-importance-person-centred-approaches-nursing-care
Darzi, A. (2008) High quality care for all: NHS next stage review final report. London: Department of Health.
Why am I doing this research? Darzi (2008) stated in his NHS next stage review report that:
“…if quality is to be at the heart of everything we do, it must be understood from the perspective of patients”.
The NHS needs to develop and improve strategies for empowering patients to provide feedback about their experiences.
Patient Reported Experience Measures (PREMs) are self-completion questionnaires designed to develop an understanding of what patients’ perceived actually happened during their health care episode.
Research has predominantly focused on the development of measures for use in primary (GP surgeries) and acute care (hospital) settings. My research is focused on the development of a PREM for NHS ambulance services.
How am I doing this research? 1. By developing a detailed understanding
of the literature around PREM development and their use in health care.
2. Undertaking a secondary analysis of interview data (n=44) exploring patients’ experiences of their care.
3. Designing, refining and modifying the PREM based on engagement with patients, stakeholders and the public.
Who should I be engaging with?
• Ambulance service patients: share ideas and plans, ask for opinions and views about what should be included in the PREM, show them draft versions of the measure and listen to their feedback.
• NHS staff: involve key stakeholders (i.e. patient experience managers) in what I am doing by including them in the research and keeping them in the loop with progress.
Could your research impact on the lives of those outside your discipline knowledge?
Yes - the purpose of developing this measure is to improve the experience of patients accessing emergency ambulance service care. This could be achieved by:
• Measuring differences in patient experience between and within ambulance services and identifying improvement priorities.
• Using the PREM data to provide feedback and inform further education for ambulance service clinicians resulting in improved patient outcomes.
