A case study framework for design and evaluation of a national project to improve prehospital care of myocardial infarction and stroke
Essam, Nadya Davy, Zowie Shaw, Deborah Spaight, Anne Siriwardena, Aloysius
Essam, Nadya
Davy, Zowie
Shaw, Deborah
Spaight, Anne
Siriwardena, Aloysius
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Abstract
Background Cardiovascular disease (CVD) affects 1.8% of the
population annually, 0.9% with stroke and 0.8% with coronary
heart disease. People suffering from CVD often present acutely to
ambulance services with symptoms of acute myocardial infarction
or stroke. Early and effective treatment prevents death, improves
long term health and reduces future disability.
Objective Our aim is to develop a rational approach for informing
the design and evaluation of a national project for improving
prehospital care of myocardial infarction and stroke: the Ambulance
Services Cardiovascular Quality Initiative (ASCQI), the first
national improvement project for prehospital care.
Methods We will use a case study methodology initially utilising an
evaluation logic model to define inputs (in terms of resources for
planning, implementation and evaluation), outputs (in terms of
intended changes in healthcare processes) and longer-term
outcomes (in terms of health and wider benefits or harms),
whether intended or incidental and in the short, medium or long
term.
Results We will present an evaluation logic model for the project.
This will be expanded to show the analytical techniques which we
will use to explain how and why the project achieves its outcomes.
This includes times series analyses, pattern matching, cross case
syntheses and explanation building to inform an explanatory logic
model. We will discuss how this model will be useful in determining
the data that will need to be collected during the course of the
project to inform the detailed explanation of how and why the
project delivered its outcomes.
Conclusion The case study approach will enable us to evaluate the
impact of this collaborative project in constituent ambulance services as well as the initiative as a whole. It will enable us to show
whether and to what extent the project has had an impact, but also
how and why this has happened.
https://emj.bmj.com/content/emermed/28/11/e2.7.full.pdf
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
http://dx.doi.org/10.1136/emermed-2011-200645.15