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Why Quality Improvement, Research & Audit are important to us

What is best for our patients is always at the forefront of our decision-making processes at Devon Air Ambulance. When minutes matter, the care provided at the scene en route to hospital is just as important as the speed in getting the patient to hospital.
Working collaboratively with the South Western Ambulance Service, the Enhanced and Critical Care that Devon Air Ambulance provides supplements the treatment provided by the ambulance service and requires us to have the highest standards of education, training, audit and reflection, to ensure we deliver care of the highest quality to every patient.
We are committed to providing our patients the very best care delivered safely. There are many processes that support our ability to do this, some of which are:

Clinical Governance

It is widely accepted that there are seven main pillars of high-quality Clinical Governance.
• Education and Training
• Clinical Audit
• Clinical Effectiveness including Research
• Risk Management
• Patient and Public Involvement
• Information Governance
• Staff Management
Alongside openness, we have a series of systems and processes that underpin the safe and effective delivery of patient care.

Education

All our paramedics undertake Master’s level education through our partnership with Plymouth University. Our ‘Advanced Paramedics in Critical Care’ complete a 3-year Master’s in Pre-Hospital Critical Care/Retrieval and Transfer providing them with the knowledge and skills to provide a level care well beyond that traditionally able to be provided by paramedics. Find out more information on the Masters in Pre-Hospital Critical Care/Retrieval and Transfer.

However, education is embedded into our culture. All our clinicians are supports with development time to support their professional activities and attendance on course, seminars, training events and conferences are fed back to the wider team so all can benefit from the learning.

Each month, as part of our Clinical Governance day, a Journal Club and themed education session are delivered which enables our team to keep abreast of the very latest evidence and treatment provision available.

Clinical audit

Clinical audit is a way to find out if healthcare is being provided in line with standards and informs us of how well we are doing, and where there could be improvements. We employ a full-time Patient Services auditor who supports the Clinical Committee and allows quality improvement to take place where it will be most helpful and will improve outcomes for patients. Our Clinical Audit enables us to submit data on our service to support national Ambulance Quality Indicators as well informing our in-house audit cycles and quality standards, and identifying any areas where a Quality Improvement project could lead to even higher standards of care.

Clinical Effectiveness including Research

Along side Clinical Audit, the care we deliver is reviewed by our Clinical Manager and Clinical Governance Lead doctor. Incidents we attend in challenging circumstances, or care we provided that utilised the highest level of medications or interventions we provide, are reviewed and benchmarked against our policies and procedures and, at our monthly Clinical Governance sessions, reflected upon by the whole team as an aid to learning from the experience of others.
We have a Research Paramedic whose role includes reviewing the latest medical evidence and considers the opportunities for Devon Air Ambulance to develop new treatments or enhance those we already provide. Any new area of treatment is subject to our Clinical Audit process to help ascertain its effectiveness.
We are currently participating in the Paramedic 3 trial, which looks at the most effective way to treat someone when their heart suddenly stops working out of hospital by giving drugs through a vein or into bone. Answering this question may help to improve future treatment of people who have a cardiac arrest.

Risk Management

The management of risk is a key focus area within Devon Air Ambulance as the work that we undertake, and the environment we work in, is not risk free.
Alongside managing the risks associated with flying helicopters, we have a number of staff within the organisation who assess the risk of what we undertake, consider the mitigating actions that can be taken to still enable us to undertake the actively effectively, and develop and design processes to keep patient and staff safe.

As part of the risk assessment process, staff who undertake the activity are involved in the risk review process and encourage to provide feedback on their experience or solution that could help keep everyone safe.

Our comprehensive suite of risk assessments are linked to our incident reporting system, enabling any incident report to be ‘tagged’ to a risk assessment so that when the risk is reviewed, all the reports related to the activity are instantly available to feed into the review process.

Patient and Public Involvement

Our three Patient Liaison Clinicians seek to contact our patients or their relatives after an incident that we have attended to offer support, fill in any gaps about the care we provided and, where beneficial, provide contact details for other agencies or charities who can provide ongoing support to them. Find our more about our Patient Liaison Clinicians.

Information Governance

We recognise the great trust patients place upon us by disclosing their personal and confidential information to enable us to treat them safely and effectively. Understanding their medical history, medications they take and social circumstances is an essential element of delivering high quality care. Recording this information accurately and passing it on to hospital staff so that they can continue to provide the patient with safe care is essential to provide the patient with the highest possible chance of a successful outcome.

Managing patient information is another key area of focus for Devon Air Ambulance. We only share identifiable information with agencies we hand the care of the patient to. We keep records to inform our Clinical Governance process and to comply with legislative requirements and all records are stored and transmitted encrypted. Access records is restricted to just those that need to have access to them and we use Multi Factor Authentication for all means of access.

Staff Management

Every member of our team has a defined Job Description detailing their role and responsibilities and everyone has a named Line Manager. All staff participate in a monthly 1-2-1 with their Line Manager where aspects such as their welfare, workload, personal development and maintenance of standards is discussed. All staff are encouraged to participate in our annual staff survey
Within Patient Services we have established a Joint Negotiation and Consultation Committee (JNCC) to provide all staff the opportunity to participate is areas of change or development and, because the nature of our work is not just 9-5 Monday to Friday, amongst the Patient Services Leadership team there is always a manager on call 24/7 365 days a year to support staff.