Since the formal inception of paramedicine as a profession in its own right, marked by professional registration in 2000, quality management, control, assurance and improvement have been a priority, with the first standards of proficiency for paramedics being published by the Health and Care Professions Council in 2003.
In fact, there are currently seven distinct points to adhere to listed the under the section dedicated to a paramedic's ability to assure the quality of their practice (12.1–12.7) within the current standards. These points have to do with engaging in evidence-based practice, evaluating practice systematically and participating in quality assurance programmes where appropriate as well as audit, which plays a central role. This includes understanding the role of audit in quality control and assurance, and the use of appropriate outcome measures, as well as maintaining an effective audit trail and working towards continual improvement. In addition, the standards note the importance of gathering qualitative and quantitative data to determine and evaluate service user response; evaluating and revising interventions using recognised outcome measures to align with service user needs; and the need to monitor and evaluate the quality of practice, contributing to data generation for quality assurance and improvement.
However, despite the significance of adhering to standards and controlling, assuring and improving quality, the variety and unpredictable nature of prehospital settings make it even more challenging to achieve standardisation of conditions and processes than it is in hospital environments.
The current issue of the Journal of Paramedic Practice is dedicated to these themes, starting with an article by Enrico Dippenaar on p. 94 covering triage system performance measurement, making improvements aligned with the needs of patients, and the roles of reliability, validity and conscious decision-making. Following this, on p. 100, Heaney et al explore the use of a ‘portable laboratory’, consisting of point-of-care testing equipment for triage to reduce unnecessary admission to hospital, with encouraging results. Lastly, in addition to overarching practice evaluation and innovation, the role of the paramedics themselves and the impact of effective feedback provision on clinical performance cannot be overlooked, and a literature review by Eaton-Williams et al investigates on p. 109 how small but important improvements can be made.
In the same vein, we have received a reader letter this month accompanied by a short but valuable case study illustrating how cardiac arrest from accidental hypothermia can be effectively managed with the right awareness, knowledge and training—and how anything less should not be accepted.
Also, in the current issue, our new Clinical Examination Series continues with an overview of the cranial nerves VII–XII, on pages that we encourage you to cut out of the journal for your reference and use for application to practice.
What can you do to raise the bar within your own practice?