Joanne Coster | The University of Sheffield (original) (raw)

Papers by Joanne Coster

Health Expectations, 2017

This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Emergency Medicine Journal, 2017

Background UK prehospital services receive poor information about what happens to patients beyond... more Background UK prehospital services receive poor information about what happens to patients beyond the prehospital phase of care; this limits the opportunity to assess patient outcomes following non-conveyance. We aimed to identify what happens to patients after prehospital discharge, as part of two studies 1) to develop better ways of measuring prehospital quality and performance (Prehospital Outcomes for Evidence Based Evaluation, (PhOEBE)) and 2) to assess Variation in Ambulance Non-conveyance decisions (VAN). Method We developed a patient level dataset, linking ambulance call and clinical data to subsequent ED, hospital and mortality data. Data for 6 months of 2013 was provided by one ambulance service and linked to national datasets using NHS Digital’s data-linking service. We identified a sub-group of non-conveyed patients and identified recontacts (EMS, ED, hospital admission or death) within 3 days of the call. We traced 24% (2514/10634) of hear and treat calls and 84% (42,796/50894) of see and treat calls. Results Within our sample, 20.6% of see and treat calls had a recontact within 3 days, 6.3% (2694/42.796) were admitted to hospital and 0.3% (129/42796) died. Poor hear and treat linkage rates limited data reliability, therefore we conducted a sensitivity analysis using traced calls only and traced plus non-traced calls as the denominator. We found that hear and treat hospital admissions within 3 days range from 2.5%–10.5% and deaths within 3 days range from 0.06%–0.24% We developed a new indicator to monitor the quality and safety of non-transport decisions “Proportion of calls left at home which result in hospital admission or death within 3 days”. Conclusions We linked multiple data sources to identify what happens to patients following prehospital care and identified low rates of hospital admission and death following non-conveyance. We developed a new non-conveyance indicator to assess safety and monitor non-conveyance rates over time.

Care of the Critically Ill

BMJ quality & safety, 2013

Case note review remains a prime means of retrospectively assessing quality of care. This study e... more Case note review remains a prime means of retrospectively assessing quality of care. This study examines a new implicit judgement method, combining structured reviewer comments with quality of care scores, to assess care of people who die in hospital. Using 1566 case notes from 20 English hospitals, 40 physicians each reviewed 30-40 case notes, writing structured judgement-based comments on care provided within three phases of care, and on care overall, and scoring quality of care from 1 (unsatisfactory) to 6 (very best care). Quality of care comments on 119 people who died (7.6% of the cohort) were analysed independently by two researchers to investigate how well reviewers provided structured short judgement notes on quality of care, together with appropriate care scores. Consistency between explanatory textual data and related scores was explored, using overall care score to group cases. Physician reviewers made informative, clinical judgement-based comments across all phases of c...

Safety Science, 2007

Medication errors are an important problem for the UK National Health Service (NHS). The aim of t... more Medication errors are an important problem for the UK National Health Service (NHS). The aim of this study was to implement a novel quantitative modelling method to predict rates of preventable adverse drug events (ADEs) and identify interventions with the greatest potential for ...

Journal of Health Services Research & Policy, 2008

Objectives: The aim of this study is to estimate the potential costs and benefits of three key in... more Objectives: The aim of this study is to estimate the potential costs and benefits of three key interventions (computerized physician order entry [CPOE], additional ward pharmacists and bar coding) to help prioritize research to reduce medication errors.

Journal of Epidemiology & Community Health, 2013

Emergency Medicine Journal, 2012

Background The emergency care practitioner (ECP) role in the UK health service involves paramedic... more Background The emergency care practitioner (ECP) role in the UK health service involves paramedic and nurse practitioners with advanced training to assess and treat minor illness and injury. Available evidence suggests that the introduction of this role has been advantageous in terms of managing an increased demand for emergency care, but there is little evidence regarding the quality and safety implications of ECP schemes. Objectives The objectives were to compare the quality and safety of care provided by ECPs with non-ECP (eg, paramedic, nurse practitioner) care across three different types of emergency care settings: static services (emergency department, walk-in-centre, minor injury unit); ambulance/care home services (mobile); primary care out of hours services. Methods A retrospective patient case note review was conducted to compare the quality and safety of care provided by ECPs and non-ECPs across matched sites in three types of emergency care settings. Retrospective assessment of care provided was conducted by experienced clinicians. The study was part of a larger trial evaluating ECP schemes (http://www.controlledtrials.com/ISRCTN22085282). Results Care provided by ECPs was rated significantly higher than that of non-ECPs across some aspects of care. The differences detected, although statistically significant, are small and may not reflect clinical significance. On other aspects of care, ECPs were rated as equal to their non-ECP counterparts. Conclusions As a minimum, care provided should meet the standards of existing service models and the findings from the study suggest that this is true of ECPs regardless of the service they are operational in.

BMC Health Services Research, 2007

Background: Care pathways can be complex, often involving multiple care providers and as such are... more Background: Care pathways can be complex, often involving multiple care providers and as such are recognised as containing multiple opportunities for error. Prospective hazard analysis methods may be useful for evaluating care provided across primary and secondary care pathway boundaries. These methods take into account the views of users (staff and patients) when determining where potential hazards may lie. The aim of this study is to evaluate the feasibility of prospective hazard analysis methods when assessing quality and safety in care pathways that lie across primary and secondary care boundaries.

Quality & Safety in Health Care, 2006

Aim: To explore the factor structure, reliability, and potential usefulness of a patient safety c... more Aim: To explore the factor structure, reliability, and potential usefulness of a patient safety climate questionnaire in UK health care. Setting: Four acute hospital trusts and nine primary care trusts in England. Methods: The questionnaire used was the 27 item Teamwork and Safety Climate Survey. Thirty three healthcare staff commented on the wording and relevance. The questionnaire was then sent to 3650 staff within the 13 NHS trusts, seeking to achieve at least 600 responses as the basis for the factor analysis. 1307 questionnaires were returned (36% response). Factor analyses and reliability analyses were carried out on 897 responses from staff involved in direct patient care, to explore how consistently the questions measured the underlying constructs of safety climate and teamwork. Results: Some questionnaire items related to multiple factors or did not relate strongly to any factor. Five items were discarded. Two teamwork factors were derived from the remaining 11 teamwork items and three safety climate factors were derived from the remaining 11 safety items. Internal consistency reliabilities were satisfactory to good (Cronbach's alpha >0.69 for all five factors).

Study objective: In 2005, England implemented a controversial target limiting patient stays in th... more Study objective: In 2005, England implemented a controversial target limiting patient stays in the emergency department (ED) to 4 hours. We determine the effect of the "4-hour target" on quality of care and resource use.

To address concerns about prolonged emergency department (ED) stays from crowding, England mandat... more To address concerns about prolonged emergency department (ED) stays from crowding, England mandated that the maximum length of ED stay for 98% of patients be no greater than 4 hours. We evaluate the effect of the mandated ED care intervals in England.

Journal of advanced nursing, 2012

This paper is a report of the synthesis of evidence on the appropriateness of, and compliance wit... more This paper is a report of the synthesis of evidence on the appropriateness of, and compliance with, telephone triage decisions. Telephone triage plays an important role in managing demand for health care. Important questions are whether triage decisions are appropriate and patients comply with them. CINAHL, Cochrane Clinical Trials Database, Medline, Embase, Web of Science, and Psyc Info were searched between 1980-June 2010. Rapid Evidence Synthesis. The principles of rapid evidence assessment were followed. We identified 54 relevant papers: 26 papers reported appropriateness of triage decision, 26 papers reported compliance with triage decision, and 2 papers reported both. Nurses triaged calls in most of the studies (n=49). Triage decisions rated as appropriate varied between 44-98% and compliance ranged from 56-98%. Variation could not be explained by type of service or method of assessing appropriateness. However, inconsistent definitions of appropriateness may explain some varia...

Ambulance service performance measurement has previously focused on response times and survival. ... more Ambulance service performance measurement has previously focused on response times and survival. We conducted a systematic review of the international literature on quality measures and outcomes relating to pre-hospital ambulance service care, aiming to identify a broad range of outcome measures to provide a more meaningful assessment of ambulance service care. We searched a number of electronic databases including CINAHL, the Cochrane Library, EMBASE, Medline, and Web of Science. For inclusion, studies had to report either research or evaluation conducted in a pre-hospital setting, published in the English language from 1982 to 2011, and reporting either outcome measures or specific outcome instruments. Overall, 181 full-text articles were included: 83 (46%) studies from North America, 50 (28%) from Europe and 21 (12%) from the UK. A total of 176 articles were obtained after examining 257 full-text articles in detail from 5,088 abstracts screened. A further five papers were subsequently identified from references of the articles examined and studies known to the authors. There were 140 articles (77%) which contained at least one survival-related measure, 47 (34%) which included information about length of stay and 87 (48%) which identified at least one place of discharge as an outcome. We encountered the problem of incomplete information, for instance studies not specifying which pain scales when these had been used or using survival without a specific time period. In addition to measures relating to survival, length of stay and place of discharge, we identified 247 additional outcome measures. Few studies included patient reported or cost outcomes. By identifying a wide range of outcome measures this review will inform further research looking at the feasibility of using a wider range of outcome measures and developing new outcome measures in prehospital research and quality improvement.

How to obtain copies of this and other HTA programme reports An electronic version of this title,... more How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).

Annals of Emergency Medicine, 2012