Evaluation of Paramedic Practitioners
Title of study
A randomised controlled trial to evaluate the effectiveness of community paramedic practitioners managing older people calling 999 with minor conditions
Funders:
The Health Care Foundation
Staff
Sue Mason, Lead Investigator
Emma Knowles, Project Manager
Clive Francis, Project Officer
Study design:
- Randomised controlled trial involving a patient survey of experiences and satisfaction with the service, compared to standard service of transportation to the ED
- Telephone interviews with key stakeholders
- Economic evaluation of the PP scheme
- Carer satisfaction with the PP scheme
Objectives:
- To examine the differences in older people’s experiences and satisfaction, and where appropriate, of carer’s experience and satisfaction with the management of acute minor conditions by Paramedic Practitioners and when compared to the existing standard service.
- To assess the clinical and cost effectiveness of community intermediate care support Paramedic Practitioners in the management of older people with acute minor conditions compared with standard management of ambulance transport to and treatment in the ED.
- To assess the effects of community intermediate care support Paramedic Practitioners on ambulance service and ED performance.
- To consider the impact of the Paramedic Practitioner initiative on the practitioners themselves and on the wider health service locally by a series of telephone interviews conducted with 1) a sample of practitioners, and 2) a sample of professionals working in health and/or at the interface between health and social care.
Outcomes:
The primary outcomes measured to evaluate the effectiveness of the paramedic practitioner scheme were identified at three levels; patient, process and service.
Patient outcomes
- Patient experiences and satisfaction with the new service
- Time from 999 call to completion of the initial care episode
- Mortality and patient health status at four weeks
- Satisfaction of carers
Process outcomes:
- Level of appropriateness of ED attendance and hospital admission measured using a validated process measure based on treatment, investigation and disposal
- Disposal of patients following initial consultation
- Economic evaluation of the new service by recording and costing all relevant resource use
Service Outcomes:
- Impact on all ED attendances, waiting times and hospital admission rates
- Impact on ambulance service response times
- Safety of the services through patient follow-up at 3 and 28 days documenting further related episodes requiring medical attention.
Outputs:
The study is nearing completion, with results expected in Autumn 2005