Interview Study of Patients and Practitioners for Developing PROVE (IS-PROVE)

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Project title Patient Reported Outcomes for Vascular Emergencies (PROVE): Interview Study of Patients and Practitioners for Developing PROVE (IS-PROVE)
Funding body  The Health Foundation
Total funding Part of Ambulance Services Cardiovascular Quality Initiative (ASCQI) £475,000
Team 
  • Professor Niroshan Siriwardena, Professor of Primary and Prehospital Healthcare,  Community and Health Research Unit, Lincoln
  • Dr Zowie Davy, Senior Lecturer in Community Health, Community and Health Research Unit, University of Lincoln
  • Miss Fiona Togher, Research Assistant, Community and Health Research Unit, University of Lincoln.
Overarching aim The aim of this qualitative interview study was to explore the experiences of patients and practitioners relating to emergency care for stroke or heart attack in the pre-hospital setting.
Objectives  More specifically the objectives were to develop an understanding about what aspects of care and outcomes of care are important and would make a difference to patients accessing the emergency services for stroke or heart attack.We anticipated that the data collected from the interviews/focus groups would be used to generate preliminary items for the development of Patient Reported Outcome Measure (PROM) and Patient Reported Experience Measure (PREM) questionnaires.
Methods Qualitative semi-structured interviews and focus groups.
Outcomes  Patients’ experiences of prehospital care for stroke and AMI were improved by:

  • good communication
  • professionalism
  • attention to treatment
  • high quality transition between the prehospital and secondary care interface.

Although patients welcomed a speedy response, this was not always necessary for them to report a high quality experience. In contrast, clinicians were concerned about the priority placed on response times as opposed to effective treatment and efficient transportation.
Outputs Togher F, Davy Z, and Siriwardena A.N. Patients and ambulance service clinicians experiences of prehospital care for acute myocardial infarction and stroke: a qualitative study. Emergency Medicine Journal online first 2012.Togher F, Davy Z, and Siriwardena A. N. (2012) Using qualitative methods for generating patient reported outcome and patient reported experience measures for prehospital emergency care of Stroke and Heart Attack: In: 41st Annual Meeting of the SAPC, 2-4th October 2012, SECC, Glasgow.Togher F, Davy Z, and Siriwardena A. N (2012) The importance of qualitative methods for generating patient reported outcome and patient reported experience measures for prehospital emergency care of Stroke. In: International Forum on Quality and Safety in HealthCare, 17-20th April 2012, Les Palais desCongres de Paris, France.
Impact  This study has provided a strong foundation for future research  focusing on the development of a standardised PREM that can be routinely used by ambulance services across the country to benchmark current standards, to help identify improvement areas and to monitor progress with patient experience.

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