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Install and evaluate dementia button on ambulance electronic patient record.

A new dementia section on the electronic patient record will enable paramedics on scene record dementia so the information can be passed on to other services and improve patient care.

Read comments 4
  • Winning idea
  • 2022

Meet the team

Also:

  • Phil King - Data Analyst, South Central Ambulance Service (SCAS)
  • Helen Pocock - Senior Paramedic, SCAS
  • Chloe Lofthouse-Jones - Education Manager, SCAS
  • Patryk Jadzinski - Senior Lecturer, University of Portsmouth / Paramedic, SCAS
  • Sarah Taylor - Research Administrator, SCAS
  • Martina Brown - Research and Governance Lead, SCAS

What is the challenge your project is going to address and how does it connect to the theme?

Older people have a high usage of emergency ambulance services. Dementia is a common condition affecting older people using health services, and impacts on all aspects of their care.

South Central Ambulance Service (SCAS) in partnership with academic colleagues from the Universities of Portsmouth and Southampton and members of the public carried out an audit and a survey of ambulance clinical staff on the recording of dementia in the SCAS electronic patient record (ePR).

We found that dementia is recorded in 16 different free-text fields on the ePR, making it difficult for accurate data retrieval by other staff referring to the record. Clinicians surveyed suggested that a designated button would enable systematic recording of dementia, facilitating transfer of this key information to other services.

We propose to implement this digital change and evaluate its implementation using a re-audit of the electronic data and a further survey of clinical staff.

What does your project aim to achieve?

Project objectives:

–          To include a button that will enable ambulance staff to record if a patient has a diagnosis of dementia on the electronic patient record (ePR).

–          To perform a closed-loop audit to assess how this button has changed recording of dementia in the ePR.

–          To survey a sample of ambulance clinicians to understand use of the button and impact on patient care.

Expected benefits:

–          More complete and consistent recording of dementia will benefit patients by permitting other staff and services in the care pathway to see the diagnosis at the point of handover and make adjustments in the patients care.

–          Ambulance staff will be able to more easily locate somewhere to record dementia.

–          People with dementia have poorer outcomes in hospital – this will enable them to receive more appropriate care from the Emergency Department onwards or from other referral services e.g. social care.

How will the project be delivered?

The project team includes front-line clinical ambulance staff, experienced research paramedics, a health services researcher, a data analyst, and an education lead. We will also re-engage with our public contributors during the project. The team has worked successfully for the last 5 years to develop and deliver audit and research related to older people’s care by emergency ambulance services.

The team has already produced the background work which has led to the development of this project and is appropriately placed to carry forward this work. Impact will be measured both through indicators in the electronic data by re-auditing how often and where dementia is recorded, and will be combined with a survey of the end-users of the tool to assess benefits and identify any problems or further developments required.

The dementia button would also be reproducible in other ambulance Trusts using an electronic record, providing value for money.

How is your project going to share learning?

Ease of data recording and retrieval is especially important for emergency ambulance services, who may be the first team to assess the patient in a potentially long and complex series of transfers of care, for example to out-of-hours community or social care services, hospital emergency departments or specialist teams. The impacts of data quality can be felt by the patient right through the patient journey.

Our team has a track record of dissemination to all levels of the health economy, including the public (SCAS Patient Forum, Hampshire), nationally to patients and healthcare providers at conferences (Alzheimers society, 999EMS Research Forum), and academics via peer-reviewed journals. Our team includes a member of the National Ambulance Research Steering Group (NARSG) and we will disseminate our work to all ambulance services through this channel, and Q Community members in related services and ambulance services with electronic records e.g. South West, Northern Ireland.

How you can contribute

  • Provide feedback on our idea and suggest improvements or ways to increase impact.
  • Highlight networking opportunities with colleagues in emergency and urgent care.
  • Identify potential collaborators to promote the idea and develop other similar projects.
  • Provide strategic insight into the challenges of patient handovers between ambulance services and subsequent steps in the care pathway for older people.

Plan timeline

1 Jul 2022 Governance and contracts for work put into place
1 Aug 2022 Development of dementia button on ePR finalised
1 Sep 2022 Raising awareness amongst SCAS staff of the project
1 Oct 2022 Release of dementia button to live system
1 Nov 2022 Develop documentation for audit and survey approvals
1 Apr 2023 Begin re-audit of recording of dementia on ePR
1 May 2023 SCAS staff survey on button use and impact on care
1 Jul 2023 Project write-up and knowledge sharing
31 Oct 2023 Project final dissemination and close

Comments

  1. Interesting idea - presumably the ambulance staff are prompted to look at free text afterwards?  Given the range of dementia knowing this solely isn't going to be overly helpful

    1. Thank you so much Christopher for the comment.

      Yes, there will also be a free-text box associated with the dementia flag to enter more details. Our aim is to at least try to get these details into one place that people can refer to, but as part of the project we will evaluate how well this has worked by looking at the data and seeing if it has helped to reduce the number of places that a record of dementia might be found. We will also explore whether any further tweaks to the ePR are needed by sharing the results with clinicians and discussing what has worked and what hasn't, and taking on board further suggestions.

      I hope that answers your question but do please let us know if you have other ideas because it is really great to get feedback!

      Many thanks,

      Carole

  2. Hi,

    Have you posted this in our Ambulance QI SIG?

    I think members would be really interested in this idea.

    1. Thank you so much Darren, that is a great idea. I've asked to join the group and then will seek input!

      Best wishes,

      Carole

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