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Regional Activity

Each regional group will report their current clinical effectiveness activity on these pages.

Scotland
Last updated 23/10/00

The Scottish Ambulance Service has its own website at http://www.scottishambulance.com

Clinical Performance: A Pilot Study
Thi spilot study originated within the National Audit Office's Value-For-Money Study of the Scottish Ambulance Service. A small part of the study has the aim of examining the issue: 'within existing resources, what scope is there to improve quality and increase the clinical effectiveness of patient care?'. The study is a case-note audit intended to support this aim.

All emergency and urgent records from Command and Control Systems covering Scotland were sampled for a one-week period covering 26/11/97 to 03/12/97. Patient Report Forms for the same period were cross-referenced and analysed by experienced Operational Officers. This involved 10,033 patient-journeys, made up of 5,540 emergency and 4,491 urgetn (or short-term planned) patient-journeys.
Characteristics of the incidents, times, patients, injuries and treatments were taken for inclusion into a purpose built database. An external company was commissioned to produce a total of 86 tables from 560 database queries. Dr Fiona Gailey, NAO, and Robin Lawrenson, SAS directed the process toward the report, with the latter being responsible for the production of the report and the text within.
It is intended the report will form a basis for discussion aimed at improving clinical efficiency, especially in those areas within, both internally and with Service stakeholders.


The following article is a summary of the CERBERUS clinical audit newsletter
and is taken from - RESPONSE – Scottish Ambulance Service Vol 9 No.2 Summer 2000

Cerberus
by Robin Lawrenson – National Clinical Audit Manager

GUARDING CLINICAL PRACTICE STANDARDS
This is the first column of what is to be a regular feature written by clinical audit and clinical effectiveness staff. The aim is to keep everyone informed of the movement in this ever-growing field. Attempts will be made to inform, raise comment without bias and create a forum for open debate. The title Cerberus loosely speaking stands for Clinical Effectiveness, Research-Based Evidential Report and Update Sheet. Cerberus was a mythical three-headed watchdog who guarded the gates of Hades to prevent the bad guys escaping. Appropriately each of the three heads will have a title, namely ‘Structure’, ‘Process’ and ‘Outcome’ to guard against unproven clinical practice. It is intended to publish results and progress from varying elements of clinical audit and effectiveness work from within the Service. Comments are welcomed for publication.

Fife Pain Study
This work was created to ascertain if effective pain management is being achieved, regardless of source. The study not only looked at analgesic but all aspects of treatment which may effect pain.
From last summer all A&E patients were given a pain score when the crew arrived and again upon reaching hospital.
The pain was scored on the following scale:-
0 – no pain - 1 – discomfort - 2 – minor pain - 3 – pain causing distress - 4 – extreme pain

Karen Stuart, Cowdenbeath Ambulance Paramedic, with help from Fife crews and local managers, collected, collated and entered 5000 records on to database which is now being analysed by IT specialists. This work will go a long way in helping create guidelines for treating pain. Results will be given when available.

Glasgow Asthma Study
This was a small study to test effectiveness of treatment regimes against new guidelines by Scottish Intercollegiate Guidelines Network (SIGN). Leading Ambulance Paramedic, Chad Blacklaw, collected data from 50 asthma patients treated by Glasgow crews over two months.
Data was analysed and a draft report prepared. Preliminary findings appear to support the adoption of new guidelines based on the work of SIGN.

Change in the issue of Glucagon
Reminder – Glucagon is to be discontinued and replaced by Glucagen, no operational differences but easily recognisable by orange container.

Annual Report
Scottish Ambulance Service have published their Clinical Audit – Annual Report covering the period April 1999 – March 2000.

Further details on all of the above can be obtained from Robin Lawrenson – Scottish Ambulance Service, Maitland Street, Glasgow. G4 0HX. Tel.No. 0141 3536001. Fax. 0141 3536359.