EMAS - A&E 5A study published in Implementation Science, ‘The effect of a national quality improvement collaborative on prehospital care for acute myocardial infarction and stroke in England’ has demonstrated how a national multi-organisational quality improvement collaborative in ambulance services led to dramatic improvements in care for heart attack and stroke. The study was conducted by a team from the Lincoln Institute of Health including members of the Community and Health Research Unit (CaHRU) working with East Midlands Ambulance Service NHS Trust (EMAS) and other ambulance services in England.

EMAS - PTS 7The key features of the collaborative, termed the ‘Ambulance Services Cardiovascular Quality Initiative’ which led to improvement in care bundles for heart attack and stroke were clear goals, provision of information about performance, and healthcare systems strengthened by using education, provider prompts and checklists, individualised feedback and sharing information across multiple networks. The care bundle for heart attack (aspirin, glyceryl trinitrate [GTN] pain assessment and analgesia) improved from 43 to 79% and for stroke (face-arm-speech test, blood pressure and blood glucose recording) from 83 to 96%.

VLUU L110, M110  / Samsung L110, M110The authors included Niro Siriwardena (co-lead), Zowie Davy and Fiona Togher from CaHRU; Debbie Shaw, Nadya Essam (project manager) and Anne Spaight (co-lead) from EMAS with Michael Dewey (independent statistician) representing a wider ASCQI team drawn from other ambulance services. The study used mixed methods including an interrupted time series design and multiple case study methods.