National Action Group Data and Measurement Mark Hamilton Improvement Advisor, Active and Independent Living Richard Combe Senior Information Analyst & Information Governance Officer, Scottish Ambulance Service
Scottish Ambulance Service Falls and Frailty Pathways National Action Group Collaborative Learning Session 25 th November 2016 #ActionOnFalls
Data & Measurement Goal Setting AIM GOALS • • To improve the experience Reduce unnecessary conveyance to ED and outcomes of people • Increase the number of non- the SAS respond to conveyed people referred to following a fall and / or community services with frailty, by the SAS providing: providing access to the – (a) immediate care and support, as an alternative to most appropriate support ED attendance and care at the time of the – (b) planned intervention to response. support recovery following a falls and reduce the risk of further falls.
Data & Measurement Goal Setting AIM GOALS • • To improve the experience Reduce unnecessary conveyance to ED and outcomes of people • Increase the number of non- the SAS respond to conveyed people referred to following a fall and / or community services with frailty, by the SAS providing: providing access to the – (a) immediate care and support, as an alternative to most appropriate support ED attendance and care at the time of the – (b) planned intervention to response. support recovery following a falls and reduce the risk of further falls.
So What Do We Measure? • Number of Falls • Conveyance Rate • Referrals to Community Teams • By Age Group? • By Location? • By Type? • By Time of Day?
Edinburgh City Health & Social Care Falls Analysis Framework - Pilot Project 999 Initiation ACC 111 Crew Call Triage Decision NHS 24 Dispatched Abandoned CATS team Not Decision to Attendance Advice Only dispatched Conveyed Convey Intermediate Prof to prof Discharged Treatment Primary Action Care Admitted discussion Only from A&E Contacted Referred to No Safe Assessed by Intermediate Home or IC Medical Surgical Safe Home Care Involvement Outcome Assessed at Assessment Assessed at Assessment Home refused Home refused
Edinburgh City Health & Social Care SAS Conveyance Rates for >65s September 2016 Potential factor Finding • Time of day • less likely OOHs • Day of week • more likely Sunday,Monday • Age • >65s Rates similar to <65s • >75s Rates similar to >65s • Classification of fall • 15% uninjured • 35% minor injuries, of which 66% conveyed • 50% condition considered dangerous >90% conveyed
National Measurement Framework • Two sessions undertaken to date • Representation: – 2 x H&SCPs (urban & rural) – Scottish Ambulance Service – Active and Independent Living Improvement Programme – Health Improvement Scotland • Considered: – Edinburgh City Pilot Project findings – Availability – Feasibility – Frequency – Use of data for improvement
Falls by Age & Day of Week
Falls by Age & Hour of Day
Seasonality
>65 Falls & Conveyance by Day of Week
>65 Falls & Conveyance by Hour of Day
How it will work During the lifetime of the National Action Group… • SAS provides Monthly reports to NAG team. • Partnerships Report Community Service Data to NAG team. • NAG team collates and disseminates to all Partnerships. • Each Partnership Reviews / Compares their Data with comparable partnership areas.
How it will work Scottish Ambulance Service will provide: • Each Month by Age group: – Number of Falls – Conveyance Rate – Referrals to Community Teams • Each 6 months – Localised 12 month view – By Hour, Day of week, Type, Location and Month
How it will work Each Partnership will provide: • Each Month by Age group: – Number of Referrals that Community Teams receive from the SAS for falls / frailty patients. – Number of level 2 Multi-factorial Falls Assessments completed on these patients. – [Optional] Response rate profile, • i.e. number of attendances on Same day, Next day, within 48 hours or within 5 days.
National Measurement Framework Monthly – Total overall flow for most recent month • Number of Falls by Age Group • Conveyance Rate by Age Group • Referrals to Community Teams (by Age Group?) • Number of level 2 multifactorial assessments undertaken Biannually (6 monthly) – Localised 12 month view • Hour of Day, Day of Week, Seasonality • Type of fall • Location
Thank you [Image removed]
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