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Using a Quality Framework to Explore Air Ambulance Patients’ Journey Outcomes in Central Queensland, Australia

Published online by Cambridge University Press:  11 November 2022

Kristin H. Edwards Open the ORCID record for Kristin H. Edwards [Opens in a new window] ,
Richard C. Franklin Open the ORCID record for Richard C. Franklin [Opens in a new window] ,
Rhondda Jones ,
Petra M. Kuhnert  and
Sankalp Khanna
Kristin H. Edwards*
Affiliation:
James Cook University, College of Public Health, Medical, and Veterinary Sciences, Townsville, Queensland, Australia
Richard C. Franklin
Affiliation:
James Cook University, College of Public Health, Medical, and Veterinary Sciences, Townsville, Queensland, Australia
Rhondda Jones
Affiliation:
James Cook University, College of Public Health, Medical, and Veterinary Sciences, Townsville, Queensland, Australia
Petra M. Kuhnert
Affiliation:
The Commonwealth Scientific and Industrial Research Organization (CSIRO) Data61, Darwin, Northern Territory, Australia
Sankalp Khanna
Affiliation:
CSIRO, Australian e-Health Research Centre, Brisbane, Queensland, Australia
*
Correspondence: Kristin Edwards James Cook University College of Public Health, Medical, and Veterinary Sciences 1 James Cook Drive Townsville, Queensland, Australia E-mail: kristinedwards2016@gmail.com
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Abstract

Introduction:

In Australia, aeromedical retrieval provides a vital link for rural communities with limited health services to definitive care in urban centers. Yet, there are few studies of aeromedical patient experiences and outcomes, or clear measures of the service quality provided to these patients.

Study Objective:

This study explores whether a previously developed quality framework could usefully be applied to existing air ambulance patient journeys (ie, the sequences of care that span multiple settings; prehospital and hospital-based pre-flight, flight transport, after-flight hospital in-patient, and disposition). The study aimed to use linked data from aeromedical, emergency department (ED), and hospital sources, and from death registries, to document and analyze patient journeys.

Methods:

A previously developed air ambulance quality framework was used to place patient, prehospital, and in-hospital service outcomes in relevant quality domains identified from the Institutes of Medicine (IOM) and Dr. Donabedian models. To understand the aeromedical patients’ journeys, data from all relevant data sources were linked by unique patient identifiers and the outcomes of the resulting analyses were applied to the air ambulance quality framework.

Results:

Overall, air ambulance referral pathways could be classified into three categories: Intraregional (those retrievals which stayed within the region), Out of Region, and Into Region. Patient journeys and service outcomes varied markedly between referral pathways. Prehospital and in-hospital service variables and patient outcomes showed that the framework could be used to explore air ambulance service quality.

Conclusion:

The air ambulance quality framework can usefully be applied to air ambulance patient experiences and outcomes using linked data analysis. The framework can help guide prehospital and in-hospital performance reporting. With variations between regional referral pathways, this knowledge will aid with planning within the local service. The study successfully linked data from aeromedical, ED, in-hospital, and death sources and explored the aeromedical patients’ journeys.

Keywords

air ambulancehealth care qualitymortalitypatient outcome assessmentprehospital emergency care
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 38 , Issue 1 , February 2023 , pp. 57 - 64
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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