Development and pilot of clinical performance indicators for English ambulance services

摘要

Introduction: There is a compelling need to developudclinical performance indicators for ambulance services inudorder to move from indicators based primarily onudresponse times and in light of the changing clinicaluddemands on services. We report on progress on theudnational pilot of clinical performance indicators for English ambulance services.udMethod: Clinical performance indicators were developedudin five clinical areas: acute myocardial infarction, cardiacudarrest, stroke (including transient ischaemic attack),udasthma and hypoglycaemia. These were determined onudthe basis of common acute conditions presenting toudambulance services and in line with a previouslyudpublished framework. Indicators were piloted byudambulance services in England and results wereudpresented in tables and graphically using funnelud(statistical process control) plots.udResults: Progress for developing, agreeing and piloting ofudindicators has been rapid, from initial agreement in Mayud2007 to completion of the pilot phase by the end ofudMarch 2008. The results of benchmarking of indicatorsudare shown. The pilot has informed services in decidingudthe focus of their improvement programme inud2008 and 2009 and indicators have been adopted forudnational performance assessment of standards ofudprehospital care.udConclusion: The pilot will provide the basis for furtheruddevelopment of clinical indicators, benchmarking ofudperformance and implementation of specific evidencebasedudinterventions to improve care in areas identifiedudfor improvement. A national performance improvementudregistry will enable evaluation and sharing of effectiveudimprovement methods as well as increasing stakeholderudand public access to information on the quality of careudprovided by ambulance services.