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

2. 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

3. 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

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

5. 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

6. Clinical Triage Model
Welsh Ambulance Services NHS Trust