A School Report

This is in essence an ambulance blog. Yes I know, I often drift off into policing, politics, random thoughts and health care in general but so what! It's my blog and I'll do what I want when I want. I don't have the time to manage two blogs so therefore I don't have a personal one. Because of that, when an opportunity presents itself I will share where I can my proud parent moments and where possible tie it in to the blog!

"4 year male, been a very good boy at school"

My son came home from school yesterday with a 'mini report' to let me know how he was doing in this current school term. Obviously, being only 4 years old it isn't in depth and is simply an exercise of highlighting the correct statement in a list to show how he performed in a particular area. It doesn't discuss aptitude to learning or progress etc. but concentrates on the things that matter for a kid in reception. The things that make him a good little boy. He tries hard, his attendance is good, he's always on time, he does his homework, reads at home and is always well behaved. That is what any parent loves to see! It did get me thinking though about how were are judged as ambulance staff though. 

Frustratingly, we arn't judged on things that I think matter. We get generic print outs based solely on statistics and percentages of targets met and paperwork compliance. We periodically get given our Clinical Performance Indicators (CPI) which tells you how good you paperwork is. Every Patient Report Form (PRF) we do is scanned and audited. Once checked your PRF is then given a percentage of compliance based on various boxes you have or haven't ticket. You loose marks for petty things like not putting a patients ethnicity down, for not writing the postcode from where you were activated and for not writing in one of the ridiculous amount of times down. Origin of call time, dispatch time, time of mobilisation, arrive at RVP, arrive at scene, arrive with patient, time of first set of OBs, time of second set of OBs, time you left scene, time you put in a blue call, arrival at hospital, clinical handover, patient handover, green mobile time, left hospital time and finally time of the next call! That is 16 times you have to write down and all so that the  targets can be monitored. That list doesn't even include the times for drugs given, time of cannulation, intubation, shocks given, ROLE and ROSC etc. Miss one off and you get marked down. If you write a drug you gave down but don't also write the acronym for that drug, you are marked down. The list is endless. 

Once you have your paperwork compliance score you are given a staff report of your times in each category, each with their own target. You average time for each target is highlighted in a different colour to show where you stand in terms of what is expected. Green means 'keep it up', amber means 'work to be done' and red means that 'you are a disgrace and should much more target focused!' The targets by which we are judged are as follows:

1. A8 - % of Cat A calls reached within 8 minutes of call origin time.
2. Mobilisation - Time in seconds from which you are dispatched to when the ambulance wheels are moving.
3. Running - Your average time in minutes to get to a job.
4. At scene - The average amount of time you spend on scene with a patient. (I'm always in the amber or red!)
5. At hospital - The amount of time you spend at hospital after a job. 
6. Handover TG- The amount of time elapsed from patient handover to greening up for the next job. (Strict target of less than 15 minutes)
7. Job cycle - The total time that a job takes from call start to greening up again.
8. VOR - Amount of time in % your vehicle is off the road.

Once you have your paperwork compliance percentage and your times you can be judged! This is what we are scored by and in all honesty I think it is total crap. It doesn't in any way show how you interact with other staff and how well you treat your patients. It doesn't show if you are well presented, courteous and respectful or any of the other things that I think are much more important than times and numbers. What should happen, just like reception kids, is we should get a 'Mini-Report' showing how good we are, just like this:

Do you agree?! As light hearted as this is, what more do you actually want when you call 999? Surely you want a professional looking, caring and considerate person standing at your door with a smile on their face, who will try their best for you or your family and treat them with clinical excellence. If everyone did that then you would have a 'world class ambulance service'. Sadly if that person arrived at your door but took too long to mobilise, took over 8 minutes to arrive, spent too long with you, forgot to tick a few boxes, didn't write down the time they mobilised, forgot to say what ethnicity you were and then spent more than 15 minutes at hospital then they'd probably be 'let go'! Times and Targets, that's the name of the game!