Transcript Matched Data and Pre-Hospital Risk Management

Matched Data and PreHospital Risk Management
Sophie Clark
The London Ambulance Service
Patient Journey Through LAS
Hear and Treat (4%)
Data Collected on the
Telephone
See and Treat (30%)
Data Collected by the
Clinician on Scene
Clinician gives
data to hospital...
No data available....
Risks of Limited Outcome Data
•
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•
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No integration between
services
No method of
corroborating the
accuracy of LAS findings
No understanding of the
outcomes of conveyed
patients or the care
provided at A&E
Paramedics denied
lessons about identifying
and caring for the acutely
unwell
No method to track
patients in high risk
groups, such as patients
who die in A&E.
Lack of data = Unknown (unmitigated) Risks
Cardiac Arrest Outcomes
Patient Outcome Project
=
Responding Appropriately
43% of patients that are
discharged from A&E are
getting a response within 8
minutes.
But 29% of patients who die
in A&E do not get a response
within 8 minutes.
11% of patients that will die in
A&E are waiting over 30
minutes for an ambulance.
Non-urgent patients are over
triaged to the detriment of
acutely unwell patients.
Responding Appropriately
To reduce the risk of
acutely unwell
patients waiting for an
ambulance.
Neck
Alcohol
Sepsis
T2DM Muscle
Inj
Other Overdose NOF
PD
Respiratory
Vertigo
Wound
Disorder
Face
Contusion
/Bruise
Head
Nervous
System
Disorder
C-Spine
Sprain
Leg
Wound
Mixed
PE
Renal
Failure
Dementia
Colic
SVT
Asthma
Constipation
Left Before
Being Seen
ACS
Urinary
Tract
Calculus
UTI
PulOedema
Palpitations
Urine
Retention
Osteoarthritis
Arrhythmia
Other
BronchoPneumonia
Headache
♯
Humerus
Minor
Head
Injury
Grand Mal
Epilepsy
Minor
Head
Inj
Reflux
GI
Bleed
Pneumonia
Homeless
Bowel
Admittance
Rate
Leg
Bruise
Lower
Back
Pain
Thorax
Inj
CCF
Gastritis
Vasovagal
Syncope
Other Bone
Abdo Pain –
Joint
No Cause
Disorder
Infectious
Stable
Angina
Trop
Negative
COPD
Constochondritis
Depression
Gastro-
Postural
Hypotension
Epistaxis
Wound
Face
Chest Pain
LRTI
URTI
Pseudo-Obstruction
seizure
Alcohol
Intoxication
TIA
Viral
Gastroenteritis
Allergy
Alcohol
Dependence
Alcohol
Withdraw
Migraine
Knee
Sprain
Sciatica
Pancreatitis
Catheter
Problem
Stroke
Shoulder enteritis
BP
BPR
Dislocation
Alcoholic
Infection
Labyrinthitis
ACS
Ankle
Multiple Gastritis
Headache
Bruise
Electrolyte
Sprain
Falls
Foot
Lumbar
Disorder
♯
DVT
Sprain
Shoulder
Epilepsy
Tonsillitis
Anaemia
Schizophrenia
Arm
Wound
Arthritis
Results
Only
AF
Hypo
No
Coma
Cellulitis
Acute
Confusion
Neck
Alcohol
Sepsis
T2DM Muscle
Inj
Other Overdose NOF
PD
Respiratory
Vertigo
Wound
Disorder
Face
Contusion
/Bruise
Head
Nervous
System
Disorder
C-Spine
Sprain
Leg
Wound
Mixed
PE
Renal
Failure
Dementia
Colic
SVT
Asthma
Constipation
Left Before
Being Seen
ACS
Urinary
Tract
Calculus
UTI
PulOedema
Palpitations
Urine
Retention
Osteoarthritis
Arrhythmia
Other
BronchoPneumonia
Headache
♯
Humerus
Minor
Head
Injury
Grand Mal
Epilepsy
Minor
Head
Inj
Reflux
GI
Bleed
Pneumonia
Homeless
Bowel
Admittance
Rate
Leg
Bruise
Lower
Back
Pain
Thorax
Inj
CCF
Gastritis
Vasovagal
Syncope
Other Bone
Abdo Pain –
Joint
No Cause
Disorder
Infectious
Stable
Angina
Trop
Negative
COPD
Constochondritis
Depression
Gastro-
Postural
Hypotension
Epistaxis
Wound
Face
Chest Pain
LRTI
URTI
Pseudo-Obstruction
seizure
Alcohol
Intoxication
TIA
Viral
Gastroenteritis
Allergy
Alcohol
Dependence
Alcohol
Withdraw
Migraine
Knee
Sprain
Sciatica
Pancreatitis
Catheter
Problem
Stroke
Shoulder enteritis
BP
BPR
Dislocation
Alcoholic
Infection
Labyrinthitis
ACS
Ankle
Multiple Gastritis
Headache
Bruise
Electrolyte
Sprain
Falls
Foot
Lumbar
Disorder
♯
DVT
Sprain
Shoulder
Epilepsy
Tonsillitis
Anaemia
Schizophrenia
Arm
Wound
Arthritis
Results
Only
AF
Hypo
No
Coma
Cellulitis
Acute
Confusion
Alcohol
Intoxication
Sepsis
Left Before
Being Seen
Closed Fracture
Neck of Femur
Call
Category
Telephone
Chief
Complaint
LAS
Response
time
Conclusion
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Linked data is not routine
practice in LAS
•
This leads to a potential lack of
integration and unmitigated
risks.
•
Linked data can aid
understanding and quantifying
the risks.
•
Linked data can help safe
decision-making at telephone
triage and on scene.
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Defining a safe service?
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This is only the start…..
Questions?
Thank you for listening