Reducing Mortality & Harm in Welsh Ambulance Services NHS Trust

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Presentation transcript:

Reducing Mortality & Harm in Welsh Ambulance Services NHS Trust Graham McLean Service Development Lead Welsh Ambulance Services NHS Trust

Welsh Ambulance Services NHS Trust Driver diagram Reducing Harm and Measuring Effectiveness Mortality & Harm Ambulance Patient Safety Prompt Tool (APSPT) Develop and Implement a Pre Hospital Early Warning Scoring System Improve: Pain scores Peak Expiratory Flow O2 administration Asepsis/Peripheral venous cannula insertion Improve rates of vehicle cleanliness audits IPC on all CPD programmes Spread structured handover via SBAR Turnaround at A&E Call taker to nurse SBAR handover Domestic abuse handover RRAILS Reducing Healthcare Associated Infections Improve Clinical Communication Interventions Leadership Acute Stroke Care FAST for rapid identification of stroke Blood pressure and blood glucose obtained to eliminate stroke mimics Introduce ROSIER PDSA with ABM East Patient Safety Executive WalkRounds Patient Stories Clinical Triage Model in Control Centres Reducing Falls in the Community Falls Pathways Referrals by Paramedics and Nurses Welsh Ambulance Services NHS Trust

Reducing Mortality & Harm in the Welsh Ambulance Services NHS Trust Driver diagram reviewed to reflect new collaborative work and maintenance areas Stroke – Aim to support patients to return to the highest quality of life following stroke. Compliance with documenting FAST test on patient care records improved from 35 to 52% To further improve the rates of FAST compliance and transfer patients directly to a stroke team within 60 minutes. Introduce FAST test via telephone assessment at initial point of contact (999) To introduce the use of ROSIER test for stroke patients in the pre-hospital setting (PDSA planned with ABMU East) Welsh Ambulance Services NHS Trust

FAST Compliance – Patient Care Records where condition code relates to Stroke/TIA and FAST test documented Welsh Ambulance Services NHS Trust

Clinical Triage Model Welsh Ambulance Services NHS Trust New clinical triage model introduced into Ambulance Control centres where calls that are neither life threatening nor urgent are transferred for a nurse telephone assessment which is commenced within 10 minutes. Provides a high quality clinical service which meets patients clinical needs. Model continually monitored and evolving through review and lessons learnt. Nurses triaging average 62% of callers to a more clinically appropriate outcome. Improved patient safety by nurse assessment identifying patient requires more urgent intervention than initial prioritisation suggests 14627 ambulance journeys were saved from 1 April 2010 to 31 March 2011 due to new model in ambulance control rooms Welsh Ambulance Services NHS Trust

Clinical Triage Model Welsh Ambulance Services NHS Trust