25 April 2017
Alex shares some details of his plan to improve care for trauma patients who are hurt on evenings and weekends, when they are more likely to die.
The final week before our Easter break brings a service improvement plan presentation for our module, Professional Role of the Paramedic. For a while I struggled to find an idea for a project to write. Many things came to mind, including electronic patient record-keeping and educational first aid courses for the public. However, I have settled on a topic involving the trauma network and delivering enhanced pre-hospital care to major trauma patients.
In 2010, the National Audit Office produced a review of current trauma care services. It stated:
“There is an unacceptable variation, which often means if you were to have an accident on an evening or weekend, in many areas you are more likely to receive worse quality of care and more likely to die.” (Morse, 2010).
The aim of my Service Improvement Plan is to integrate specialist practitioners, in order to give a tailored and appropriate response to critically injured or unwell patients. This entails the redesign of the Mercedes sprinter ambulances to give 360-degree trolley bed access in the saloon of the vehicle, which has been proven to improve patient care and safety (RCA, 2014). After all, many journals and publications teach the ability to establish 360-degree patient access for cardiac arrests and seriously injured patients, so why do we not have this availability on-board the vehicles we use for the shifts?
Alongside this model, an Advanced Paramedic Practitioner (APP) and Emeritus HEMS Paramedic operating Friday through to Sunday would staff these specialist vehicles. My thought process for the three-day operation is to run similarly to the JRU model (Joint Response Unit), which operates Thursday through to Saturday and is a huge success.
As well as this, I have collected data from London’s Air Ambulance to find that the busiest hours and days, in a 12-month period, fall on weekends. Six of these specialist vehicles could operate in the LAS at HART East, HART West, and the three APP hubs. This equates to roughly £1.25 million for the purchase of the vehicles alone. An extended idea for the product is for the vehicles to be used during the week for hospital transfers or frontline demand. My idea will be presented in a summative PowerPoint presentation, as well as a 2,000-word piece of writing.
My cohort of second year student paramedics are soon to start our hospital placements, at the end of April for most of us. I have been placed on a range of wards including maternity, Acute Medical Unit and critical care. It will be very interesting to see healthcare from beyond the doors of A&E. The staff I have emailed about the placement have all be very welcoming; it's put my nerves to rest. We will be able to practise some of our clinical skills under supervision too, so I am hoping to boost my cannulation competency for one thing!
Morse, A,. 2010. Major trauma care in England [online]. Available at https://www.nao.org.uk/report/major-trauma-care-in-england/. Accessed 12 March 2017.
Royal College of Art, 2014. RCA Leads Way in Multidisciplinary User-Centred Design Solutions for Patient Safety [online]. Available at https://www.rca.ac.uk/news-and-events/news/rca-leads-way-design-solutions-patient-safety/. Accessed 4 April 2017.
Alex studies Paramedic Science at ARU. You can find out more about this and other degree courses at one of our Open Days.