25th November 2010 Presenter: Sara Jones Clinical Director Welsh Ambulance Services NHS Trust

Reducing Harm and Measuring Effectiveness MORTALITY TARGETS Reducing Harm and Measuring Effectiveness Utilise Patient Safety Prompt Tool -Percutaneous Infusion -Pre Hospital Thrombolysis Improve: -Peak Expiratory Flow -Pain scores -O2 administration -Target vehicle cleanliness -Spread structured handover via SBAR -Turnaround at A&E -Domestic abuse handover Manage Acute Coronary Syndrome Improve Infection Control Improve Clinical Communication Interventions Leadership Medicines Management -Warfarin awareness -Green bag Campaign -Spread access to Naloxone -Walkrounds -Patient Stories Reducing Falls in Intermediate Care -Falls Pathways Progress and challenges– Ambulance Patient Safety Prompt Tool – 1st Ambulance service in the world. Top 3 areas for potential harm identified, awareness raising undertaken for each intervention. 450 patient records monitored per month, reductions in numbers of events of potential harm demonstrated. Data collection suspended in August 2010 due to sustainability issues. SBAR is now a component of Paramedic CPD training and SBAR prompt cards have been developed and frame clinician to clinician handovers. Walkrounds remain ongoing throughout Wales and to date all identified issues have been resolved locally. A Patient Story opens every Trust Board meeting. Medicines Management initiatives have continued: Pilot study for Warfarin awareness campaign - information guide was met favourably by patients, with 60% identifying the information sheet had increased their existing knowledge. Positive feedback also received from health professionals who have expressed an interest in piloting this within primary care settings. Welsh Ambulance Services NHS Trust

Next Steps Review Trigger Tool data collection strategy, encourage local ownership/spread Further spread of SBAR across all teams Provide service improvement skills for teams Define measures for each new collaborative Continue maintenance of Walkrounds and Patient Stories Welsh Ambulance Services NHS Trust