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dc.contributor.authorO'Hara, Rachel
dc.contributor.authorJohnson, Maxine
dc.contributor.authorHirst, Enid
dc.contributor.authorWeyman, Andrew
dc.contributor.authorShaw, Deborah
dc.contributor.authorMortimer, Peter
dc.contributor.authorNewman, Chris
dc.contributor.authorStorey, Matthew
dc.contributor.authorTurner, Janette
dc.contributor.authorMason, Suzanne
dc.contributor.authorQuinn, Tom
dc.contributor.authorShewan, Jane
dc.contributor.authorSiriwardena, Aloysius Niroshan
dc.date.accessioned2019-11-13T13:35:37Z
dc.date.available2019-11-13T13:35:37Z
dc.date.issued2015-05
dc.identifier.citationO’Hara, R. et al, 2015. Decision making and safety in ambulance service transitions. Emergency Medicine Journal : EMJ, 32 (5), e2.en_US
dc.identifier.issn1472-0205
dc.identifier.issn1472-0213
dc.identifier.doi10.1136/emermed-2015-204880.4
dc.identifier.urihttp://hdl.handle.net/20.500.12417/449
dc.description.abstractIntroduction Decisions made by ambulance staff are often timecritical and based on limited information. Wrong decisions could have serious consequences for patients but little is known about areas of risk associated with decisions about patient care. We aimed to examine system in fluences on decision making in the ambulance service setting focusing on paramedic roles. Method An exploratory mixed methods qualitative study was conducted in three Ambulance Service Trusts. A document search and 16 interviews were conducted to understand service delivery in each Trust, how they link with other services and potential influences on decisions about patient care. Researchers observed ambulance crews on 34 shifts and 10 paramedics completed ‘digital diaries’ to report challenges for decision making or patient safety. Three focus groups with staff (N=21) and three with service users (N=23) were held to explore their views on decision making and patient safety. Data were charted to produce a typology of decisions then coded and thematically analysed to identify in fluences on those decisions. Findings Nine types of decision were identi fied, ranging from specialist emergency pathways to non-conveyance. In fluences on these decisions included communication with Control Room staff; patient assessment, decision support and alternative options to ED conveyance. Seven main issues in fluencing patient safety in decision making were identi fied: meeting demand; performance and priorities; access to care options; risk aversion; education, training and professional development for crews; communication and feedback to crews; resources and safety culture. Conclusions A range of decisions are made by ambulance staff in complex, time bound changing conditions. Training and development and access to alternative options to ED conveyance were identi fied as particularly important issues. https://emj.bmj.com/content/emermed/32/5/e2.1.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-2015-204880.4
dc.language.isoenen_US
dc.subjectEmergency Medical Servicesen_US
dc.subjectCommunicationen_US
dc.subjectDecision Makingen_US
dc.subjectPatient Careen_US
dc.subjectAssessment Skillsen_US
dc.titleDecision making and safety in ambulance service transitionsen_US
dc.typeConference Paper/Proceeding/Abstract
dc.source.journaltitleEmergency Medicine Journal : EMJen_US
dcterms.dateAccepted2019-09-19
rioxxterms.versionNAen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2019-09-19
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2015-05
html.description.abstractIntroduction Decisions made by ambulance staff are often timecritical and based on limited information. Wrong decisions could have serious consequences for patients but little is known about areas of risk associated with decisions about patient care. We aimed to examine system in fluences on decision making in the ambulance service setting focusing on paramedic roles. Method An exploratory mixed methods qualitative study was conducted in three Ambulance Service Trusts. A document search and 16 interviews were conducted to understand service delivery in each Trust, how they link with other services and potential influences on decisions about patient care. Researchers observed ambulance crews on 34 shifts and 10 paramedics completed ‘digital diaries’ to report challenges for decision making or patient safety. Three focus groups with staff (N=21) and three with service users (N=23) were held to explore their views on decision making and patient safety. Data were charted to produce a typology of decisions then coded and thematically analysed to identify in fluences on those decisions. Findings Nine types of decision were identi fied, ranging from specialist emergency pathways to non-conveyance. In fluences on these decisions included communication with Control Room staff; patient assessment, decision support and alternative options to ED conveyance. Seven main issues in fluencing patient safety in decision making were identi fied: meeting demand; performance and priorities; access to care options; risk aversion; education, training and professional development for crews; communication and feedback to crews; resources and safety culture. Conclusions A range of decisions are made by ambulance staff in complex, time bound changing conditions. Training and development and access to alternative options to ED conveyance were identi fied as particularly important issues. https://emj.bmj.com/content/emermed/32/5/e2.1.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-2015-204880.4en_US


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