Decision-Making and Safety in Emergency Care Transitions

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Project Title Decision-Making and Safety in Emergency Care Transitions
Funding body National Institute for Health Research, Service Delivery and Organisation (NIHR SDO)
Total funding £168,690
Team 
  • Dr Rachel O’Hara, University of Sheffield (Principal Investigator)
  • Janette Turner, School of Health & Related Research (ScHARR), University of Sheffield
  • Enid Hirst, Public & Patient Representative
  • Professor Suzanne Mason, School of Health & Related Research (ScHARR), University of Sheffield
  • Professor Niroshan Siriwardena, School of Health & Social Care, University of Lincoln
  • Professor Tom Quinn, Health & Medical Strategy, University of Surrey
  • Jane Shewan, Yorkshire Ambulance Service (YAS)
  • Dr Andrew Weyman, University of Bath
  • Dr Maxine Johnson, School of Health & Related Research (ScHARR), University of Sheffield
  • Sue Wilson, Project Administrator, School of Health & Related Research (ScHARR), University of Sheffield.
Overarching aim To identify areas of high risk regarding decision-making about service user options.
Objectives 
  • To map the emergency care system in a sample of Ambulance Services
  • To conduct an ethnographic investigation of factors influencing decision making by ambulance service staff
  • To feed back study findings to participating ambulance services and stakeholders.
Methods
  • An organisational case study approach using a range of qualitative methods to explore influences on safe decision-making during key emergency care transitions
  • Interviews with key members of staff at participating Ambulance Services
  • Ethnographic methods (observation, interviews, diaries) involving operational Ambulance Service staff
  • Separate focus groups with operational Ambulance Service staff and service users
  • Feedback workshops.
Outcomes  The publication date reporting  outcomes was February 2014.
Outputs
  • The final research report synthesised findings across the three phases of the study to identify significant threats to the delivery of safe care, potential strategies to improve safety, and areas where further research is needed
  • Presentations at appropriate national and international conferences  targeted practitioner and academic audiences in the areas of health services research and emergency medicine, e.g., SDO and HSRN conference
  • Publication of study findings in peer reviewed journals, practitioner publications and appropriate health magazines or website links for users and patients.

Research papers

O’Hara R, Johnson M, Siriwardena AN, Weyman A, Turner J, Shaw D, Mortimer P, Newman C, Hirst E, Storey M, Mason S, Quinn T, Shewan J (2015) A qualitative study of systemic influences on paramedic decision making: care transitions and patient safety. Journal of Health Services Research & Policy, 20 (S1): 45-53.

O’Hara R, Johnson M, Hirst E, Weyman A, Shaw D, Mortimer P, Newman C, Storey M, Turner J, Mason S, Quinn T, Shewan J, Siriwardena AN (2014) A qualitative study of decision-making and safety in ambulance service transitions. Health Services Delivery Research, 2 (56): 0-146

Conference abstracts

Impact  The findings of the study are of direct relevance to emergency care services in identifying potential influences on decision making and the delivery of safe care. The findings also identified strategies for quality improvement.

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