Development and pilot of clinical performance indicators for English ambulance services

Introduction: There is a compelling need to develop clinical performance indicators for ambulance services in order to move from indicators based primarily on response times and in light of the changing clinical demands on services. We report on progress on the national pilot of clinical performance indicators for English ambulance services. Method: Clinical performance indicators were developed in five clinical areas: acute myocardial infarction, cardiac arrest, stroke (including transient ischaemic attack), asthma and hypoglycaemia. These were determined on the basis of common acute conditions presenting to ambulance services and in line with a previously published framework. Indicators were piloted by ambulance services in England and results were presented in tables and graphically using funnel (statistical process control) plots. Results: Progress for developing, agreeing and piloting of indicators has been rapid, from initial agreement in May 2007 to completion of the pilot phase by the end of March 2008. The results of benchmarking of indicators are shown. The pilot has informed services in deciding the focus of their improvement programme in 2008 and 2009 and indicators have been adopted for national performance assessment of standards of prehospital care. Conclusion: The pilot will provide the basis for further development of clinical indicators, benchmarking of performance and implementation of specific evidencebased interventions to improve care in areas identified for improvement. A national performance improvement registry will enable evaluation and sharing of effective improvement methods as well as increasing stakeholder and public access to information on the quality of care provided by ambulance services

Investigation Interoperability Problems in Pharmacy Automation: A Case Study in Saudi Arabia

The aim of this case study is to investigate the nature of interoperability problems in hospital systems automation. One of the advanced healthcare providers in Saudi Arabia is the host of the study. The interaction between the pharmacy system and automated medication dispensing cabinets is the focus of the case system. The research method is a detailed case study where multiple data collection methods are used. The modelling of the processes of inpatient pharmacy systems is presented using Business Process Model Notation. The data collected is analysed to study the different interoperability problems. This paper presents a framework that classifies health informatics interoperability implementation problems into technical, semantic, organisational levels. The detailed study of the interoperability problems in this case illustrates the challenges to the adoption of health information system automation which could help other healthcare organisations in their system automation projects

Raising the game: nurturing research and development in the newly reconfigured ambulance services in the United Kingdom – opportunities for research for better health in prehospital settings

Ambulance services will need a new and robust structure to support the growing prehospital research agenda for the short and medium term. This structure will need to inform and be informed by effective knowledge management and dissemination and will need to ensure that research helps lead to high quality, safe (no needless harm), effective (evidence-based), patient centred (no feelings of helplessness and in accordance with patients reasonable expressed wishes), timely (no needless delay), efficient (no waste and with realistic outcomes) and equitable (fair to all patients) ambulance services which are integrated with and aligned to the wider health system. This paper recommends a structure which supports local as well as national research activity and research capacity development. In order to foster a research culture and research activity within a robust research governance framework a National Research Steering Group with representation from each ambulance service is advocated

Curriculum renewal for interprofessional education in health

In this preface we comment on four matters that we think bode well for the future of interprofessional education in Australia. First, there is a growing articulation, nationally and globally, as to the importance of interprofessional education and its contribution to the development of interprofessional and collaborative health practices. These practices are increasingly recognised as central to delivering effective, efficient, safe and sustainable health services. Second, there is a rapidly growing interest and institutional engagement with interprofessional education as part of pre-registration health professional education. This has changed substantially in recent years. Whilst beyond the scope of our current studies, the need for similar developments in continuing professional development (CPD) for health professionals was a consistent topic in our stakeholder consultations. Third, we observe what might be termed a threshold effect occurring in the area of interprofessional education. Projects that address matters relating to IPE are now far more numerous, visible and discussed in terms of their aggregate outcomes. The impact of this momentum is visible across the higher education sector. Finally, we believe that effective collaboration is a critical mediating process through which the rich resources of disciplinary knowledge and capability are joined to add value to existing health service provision. We trust the conceptual and practical contributions and resources presented and discussed in this report contribute to these developments.Office of Learning and Teaching Australi

Broadening Responsibilities: Consideration Of The Potential To Broaden The Role Of Uniformed Fire Service Employees

What is this report about? This report, commissioned by the National Joint Council for Local Authority Fire and Rescue Services (NJC), aims to identify what impact, if any, firefighters can have on the delivery of emergency medical response and wider community health interventions in the UK. What are the overall conclusions? Appropriately trained and equipped firefighters co-responding1 to targeted, specific time critical medical events, such as cardiac arrest, can improve patient survival rates. The data also indicate that there is support from fire service staff – and a potential need from members of the public, particularly the elderly, isolated or vulnerable – to expand ‘wider work’. This includes winter warmth assessments, Safe and Well checks, community defibrillator training and client referrals when staff believe someone may have dementia, are vulnerable or even, for example, have substance dependencies such as an alcohol addiction. However, there is currently insufficient data to estimate the net benefit of this work

Committed to Safety: Ten Case Studies on Reducing Harm to Patients

Presents case studies of healthcare organizations, clinical teams, and learning collaborations to illustrate successful innovations for improving patient safety nationwide. Includes actions taken, results achieved, lessons learned, and recommendations

A Systematic Review of the Selected Evidences on the Effectiveness of Inter-professional Education (IPE) in Developing Interprofessional Learning Environment

Purpose: This systematic review aimed to provide available evidence in determining for the effectiveness of IPE as a modality in developing interprofessional learning environment for healthcare students.Methods: The computerized searches from 2009-2015 in ten electronic databases were performed. Two independent reviewers were consulted to assess the eligibility, level of evidences and methodological quality in each study. Result: nine out of ten studies were retrieved. These studies include (a) two RCT studies; scored eight and seven out of eight, (b) Three quasi-experimental pretestposttest design; scored seven, six, and six out of eight, (c) Three controlled before and after study; scored six, six, five and five out of eight, and (d) one controlled longitudinal; scored six out of eight respectively.Conclusion: Based on the systematic review, evidence showed that IPE was effective in building strong interprofessional learning environment. On the other hand, the authors recommend considering conduct of similar systematic review grounded on IPE with larger sample size within the health allied discipline

Reclaiming human machine nature

Extending and modifying his domain of life by artifact production is one of the main characteristics of humankind. From the first hominid, who used a wood stick or a stone for extending his upper limbs and augmenting his gesture strength, to current systems engineers who used technologies for augmenting human cognition, perception and action, extending human body capabilities remains a big issue. From more than fifty years cybernetics, computer and cognitive sciences have imposed only one reductionist model of human machine systems: cognitive systems. Inspired by philosophy, behaviorist psychology and the information treatment metaphor, the cognitive system paradigm requires a function view and a functional analysis in human systems design process. According that design approach, human have been reduced to his metaphysical and functional properties in a new dualism. Human body requirements have been left to physical ergonomics or "physiology". With multidisciplinary convergence, the issues of "human-machine" systems and "human artifacts" evolve. The loss of biological and social boundaries between human organisms and interactive and informational physical artifact questions the current engineering methods and ergonomic design of cognitive systems. New developpment of human machine systems for intensive care, human space activities or bio-engineering sytems requires grounding human systems design on a renewed epistemological framework for future human systems model and evidence based "bio-engineering". In that context, reclaiming human factors, augmented human and human machine nature is a necessityComment: Published in HCI International 2014, Heraklion : Greece (2014

Ontology-Based Modeling for Newborn Behavior Simulation during Cardiopulmonary Resuscitation

This chapter concerns the formulation of a methodology and its implementation to elaborate a training simulator for medical staff who may be confronted with the critical situations of newborn resuscitation. The simulator reproduces the different cardiopulmonary pathological behaviors of newborns, the working environment of resuscitation rooms, and the monitoring and control environment of the learners by a teacher. Conceptual models of newborn behaviors combined with the cardiopulmonary resuscitation gestures have been developed. The methodological process is jointly using cognitive approaches with formal modeling and simulation. Cognitive approaches are mobilized to elaborate application ontologies to be the bases for the development of the conceptual models and the specification of the simulator. Ontologies have been developed on the bases of a corpus of academic documents, return on experience documents, and practitioner interviews, by means of the knowledge-oriented design (KOD) method. A discrete event formalism has been used to formalize the conceptual models of the newborn behaviors. As a result, a simulator has been built to train medical practitioners to face situations, which are reported to potentially cause errors, and thus improve the safety of the resuscitation gestures