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Explore the progress in national audits for ambulance services, focusing on thrombolysis, cardiac arrest, and pain management. Learn about clinical performance indicators, benchmarking, and future directions. Engage with key partners and stay updated on international developments.
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JRCALC Conference 200410th November 2004. Royal College of Physicians Mark Cooke BMedSci(Hons) MScNational Clinical Effectiveness Manager Ambulance Service Association
Move towards National Audit • 2002/4 ~ 1st 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 ~ 1st ever national audit of ‘OoH 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
Clinical Performance Indicators • Documented clinical care provided • JRCALC v3 • 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 Management2005/2006 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