Measuring Patient Outcomes: Clinical Quality Indicators
From April 2011, Ambulance Trusts began to assess their performance in a new way.
The Category B, 19-minute response time target for ambulances (serious but not immediately life-threatening) was replaced with a set of 11 new Clinical Quality Indicators, the aim being to improve the quality and safety of care by focusing on those groups of patients with the greatest clinical need – rather than according to the categorisation of call alone.
Ambulance Services are still required to respond to 75% of all category A (immediately life-threatening) patients within 8 minutes and, where needed, to provide transport to these calls within 19 minutes.
The Clinical Quality Indicators were designed with the aim of promoting a culture of continuous improvement involving clinicians, managers and commissioners.
The list of 11 ambulance indicators is as follows:
- Outcome from acute ST-elevation myocardial infarction (STEMI)
- Outcome from cardiac arrest – return of spontaneous circulation
- Outcome from cardiac arrest – survival to discharge
- Outcome following stroke for ambulance patients
- Proportion of calls closed with telephone advice or managed without transport to A and E (where clinically appropriate)
- Re-contact rate following discharge of care (i.e. closure with telephone advice or following treatment at the scene)
- Call abandonment rate
- Time to answer calls
- Service Experience
- Category ‘A’ 8 minute response time
- Time to treatment by an ambulance-dispatched health professional
In addition, Ambulance Trusts continue to be monitored against the 19 minute transportation standard for Category A calls.
These 11 Clinical Quality Indicators form the basis of a national tool for measuring the effectiveness of the NHS Ambulance Service as a whole, called National Clinical Dashboards.