International
Journal
of
Hea th Care Qua ity Assurance Quality improvement and paramedic care: what does the literature reveal for pre-hospital emergency care in Australia? RusseU Linwood
Queensland Department of Emergency Services, Brisbane, Australia Gary Day
School of Public Health, Queensland University of Technology, Kelvin Grove, Australia Gerrard FitzGerald
Faculty of Health, Queensland University of Technology, Kelvin Grove, Australia Brian Oldenburg
Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Australia
~'t..·. Publishing 1967·2007
International Journal of Health Care Quality Assurance. Vol. 20 No. 5. 2007.
© Emerald Group Publishing Limited. 0952-6862
This joumal
Mission stat~m~nt The International Journal of Health Care Quality Assurance provides a forum forthe international exchange ofthearetical and practical aspects of quality assurance and management in health care and helps to develop knowledge about quality assurance and its implementation
in health
Is also available
online
www.emeraldlnslghtcom/ljhcqa.htm Table of contents www.emeraldlnsightcom/0952-6862.htm Online Journal content available at www.emeraldlnslght.com
c.are organizations.
at:
Joumallnformatlon
worldwide
EDITOR Dr Keith
Hurst
Senior Lecturer, Leeds University Health and Public Health Research Institute, 71-75 Clarendon Road, Leeds E-mail:
[email protected]
Sciences
LS2 9Pl, UK
Kay Downey-Ennis Director of Quality & Education, Daughters Charity ofSt Vincent de Paul, Central Management Office, St Vincent's Centre, Navan Road, Dublin 7,Ireland E-mail:
[email protected] CENTRE SECTION EDITOR Jo lamb-White LambWhite
Partnership
Ltd, Bow Cottage,
Shaftesbury,
Dorset
SP7 9NE, UK
PUBLISHER Vicky Wllliams
ISSN 0952.6862
©
2007
Emerald
Group
(r:>
)
41'
-INVESTORIN PEOPLE
Regional offices:
CO-EDITOR
Ludwell,
60/62 Toiler Lane, Bradford Em~rald Group Publishing BD8 9BY,United Kingdom limited Tel +44 (0) 1274 777700 Fax +44 (0) 1274 785200 E-mail/oumatsoomoraldinslghLcom
Publishing
limited
For North America Emerald, 875 Massachusetts Avenue, 7th Floor, Cambridge, MA02139, USA Tel Toll free +1 888 622 0075; Fax +1617 354 6875 E-mail amerlcaoemeraldinslghLcom For Japan Emerald, 3-22-7 Oowada, Ichikawa-shl, Chlba, 272-0025, Japan Tel +81 47 393 7322; FaH81 47 393 7323 E-mail japano~oraldlnslghLcom For India Emerald, 135, 1St Vardhman Diamond Plaza, DeshBandhu Gupta Road, New Delhl-110055, India Tel +9111-42838038; Fax +9111-42838038 E-mail indlaOemeraldinslghLcom For Asia Pacific Emerald, 7-2, 7th Floor, Menara KLH,Bandar Puchong Jaya, 47100 Puchong, Selangor, Malaysia Tel +60 3 8076 6009; Fax +60 3 8076 6007 E-mailasiapaclficoemoraldinslghLcom For China Emerald, 7th Xueyuan Road, Haldlan District, Room 508, Hongyu Building 100083, Bei)ing, China Tet +86 10 8230 6438 E-mail chlnaOomoraldinslghLcom Customer helpdesk: Tel +44 (0) 1274785278; Fax+44 (0) 1274785201; E-mail supportC/)emoraldlnslghLcom Web www.emeraldinslghLcomfcustomerchartor Orders, subscription and missing claims enquiries: E-mail subscrlptlonsf!)emeraldlnsighLcom Tet +44 (0) 1274 777700; Fax+44 (0) 1274785201
a~ QUWTY
~
~
026
c.tiftale
IIWDber _...JJIIMt __
Awarded in recognition
of
Emerald's production department's adherence to quality systems and processes when preparing scholarty joumals for print
Int~matlonal Journal of Health Care Quality Assuranc~ is Indexed and abstracted in: ASSIA: Appll~ Social Scl~nc~slndex & Abstracts British Nursing Index Cab~I\'s Directory of PubllshlngOpportunltl~ In Managem~nt & Marketing Emerald Reviews (fonmerly Anbar) Health Service Abstracts Hospital and Health Administration Index MEDlINE PNA Reseanth Scopus
Missing Issue claims will be fulfiiled If claimed within six months of date of despatch. Maximum of one claim per Issue. Reprints service: Tet +44 (0) 1274785135 E-mail reprlntsoomeraldinslght.com Web www.emeraldlnslghLcom/reprlnts Penmlsslons service: Tel +44 (0) 1274 785300 E-mail ponmlsslonsOemeraldinslghLcom Web www.omeraldinslght.comfpenmlsslons No part of this journal may be reproduced, stored In a retrieval system, transmitted in any form or by any means electronic, mechanica~ photocopying, recording orotherwlst without either the priorwrftten permission of the publiSher or a licence permitting restricted copying Issued In the UKbyThe Copyright licensing Agency
and in the USAbyTheCopyrightClearanceCenter.Noresponsibility Is accepted for the accuracy of Information contained In the text. iUustratlons
or advertisements.
The opinions
expressed
In the
articles are not necessarily those of the Editor orthe publisher.
Emerald Is a trading Publishing Umlted
name of Emerald
PrInted by Printhaus Group Ltd, Stlrocco Close, Moulton Park. Northampton NN36HE
Group
•
www.emeraIdinsight.coml0952-6862.htm The current issue and full text archive of this journal is available at
Quality improvement and paramedic care
Pre-hospital emergency care in Australia
What does the literature reveal for pre-hospital emergency care in Australia? Russell Linwood Queensland Department of Emergency Seroices, Brisbane, Australia
405 Received 19 April 2006 Revised 17 August 2006 Accepted 1 September 2006
Gary Day School of Public Health, Queensland University of Technology, Kelvin Grove, Australia
Gerrard FitzGerald Faculty of Health, Queensland University of Technology, Kelvin Grove, Australia, and
Brian Oldenburg Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, Australia
Abstract Purpose - The purpose of this article to review the literature relating to improving paramedic care in an Australian context Desigo/methodology/approach - The paper presents changes and challenges that have occurred in the ambulance services in tenns of improving care and measuring performance, exploring the literature on quality improvement initiatives and their application to pre-hospital care. Findings - While hospitals and health services have moved well down the quality improvement pathway, the application of these processes to pre-hospital care has been a relatively recent phenomenon. Ambulance services have taken a variety of approaches to measuring and improving pre-hospital care. This article questions the transferability of lessons learned in hospitals to ambulance services. Arguably, the quality improvement approach is dependent upon health control and funding models and where ambulance is categorised in terms of health or emergency services. Originalitylvalue - The quality improvement approach by Australian paramedics and ambulance services is in its infancy. This article provides insights into the quality improvement approach taken by ambulance staff in Australia compared to other countries, as well as highlighting useful information on the future direction and research into the area. Keywords
Ambulance services, Quality improvement, Emergency treatment, Paramedics, Australia
Paper type Literature review
Introduction
Health care quality has been brought into sharp community focus through spectacular system failures as evidenced by the recent Bundaberg Hospital (Davies, 2005), Campden and Campbelltown Hospitals and Bristol Royal Infirmary Inquiries (Faunce and Bolsin, 2(04), just to name a few. Unfortunately, these adverse incidents devalue
int.
