Clinical governance is the term used to describe the process where clinical practice is regularly monitored, reviewed and changes implemented following these reviews. It encompasses a framework of activities all with the aim to improve the standards and service that any patient care organisation provides.

Mark Hellaby BSc (Hons)
RODP, ATACC MRT

The following activities are all linked to our clinical governance programme

Team member induction

All potential team members undergo an induction period where they are supernumerary and mentored. It is during this time that skills learnt in both the hospital clinical environment, during the ATACC course and on training days can be built upon for pre hospital use.

Training

All team members have to attend regular training sessions often with the help of local Fire and Rescue and Ambulance services, such training covers scene safety, casualty extrication, confined space rescue and practical fire fighting. Some members have also attended courses particularly aimed at techniques in stabilising and extrication of casualties from crashed vehicles, swift water rescue and practical use of breathing apparatus.

The majority of team members are also actively involved in teaching on the ATACC course, at the beginning of each course the faculty holds a journal club reviewing the latest research, guidelines and how they can be implemented into our course and clinical practice.

This is in addition to external courses that members attend such as the Resuscitation Councils ALS (advanced life support course), PALS (Paediatric ALS) and the MIMMS (major incident medical management and support course).

Standard Operating Procedures (SOPs)

Our Sops (click this link for list) cover our procedures for day to day running. Some of the main SOPs originated from our colleagues at HEMS, but almost all of these have now been modified to allow for differences in team configuration, transport and the geographical area we serve. The SOPs are reviewed annually or sooner if practice / equipment changes before this time.

These SOPs range from the type of personal protective equipment (PPE) that is available and when it should be worn to dealing with Major Incidents a CD-r with all the teams SOPs as well as useful phone numbers, safety information etc is issued annually to all team members. A full hard copy of our SOPs is available at Cheshire Fire HQ and MRAS HQ.

The complete list of SOPs can be viewed and once these have been approved by the ATACC committee they will appear online for reference

National Trauma forum

The aim is to set up a national trauma forum involving all the medical team major players from across the country (HEMS, MAGPAS, ATACC etc to review SOPs and with the overall aim to provide a more united, uniform and coherent presence in the UK pre hospital sector by issuing guidelines and advice.

Clinical audit

The team has its own patient report forms (prf) which have been drawn up to make the audit of calls and actions easier. Team members have access to our records for audit purposes, it is also hoped soon to do some auditing of calls logged by the ambulance service to try and demonstrate both chronological and geographic trauma hot spots as this will effect how our service evolves, times we operate and were we position ourselves throughout the region. We have also contacted the Highways Agency to see if we can access there extensive research on motorways in our region.

Peer review

All team members have access to an online group where a list of all cases attended each shift is posted and case management is discussed. The forum is also a useful platform for team pertinent discussions about equipment, shifts etc.

 ATACC Clinical Governance committee

The plan is to bring together a senior group of team members and some local A&E consultants to meet to review some random cases and any particular cases as either requested by a team member or external body (i.e. hospital or ambulance service). These meeting will be open meetings and the minutes available to all interested groups.

Incident / Occurrence Reporting

Any untoward incident or occurrence should be informed to the ATACC Medical Director/ team coordinator. 

Depending on the type / nature of the occurrence one or more of the following steps should also be undertaken 

-         Case / incident discussed on news group to make all team members aware

-         Details entered in the local MRAS occurrence bookFull MRAS Incident form completed , copy sent to our medical director