A Dissertation Proposal Example on Whether the EMAS Initiative Can Be Implemented in North Wales Ambulance Service

Date:  2021-04-05 15:12:35
8 pages  (1926 words)
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Background to the problem

Falls-related calls make up about 20% of calls received by the EMAS; approximately 90,000 calls per year. The EMAS initiative has been replicated in the East Midlands in Nottinghamshire and Derbyshire.

In an attempt to reduce the demand on hospitals due to falls, the EMAS in the Northamptonshire area has developed the Crisis Response Falls Team (CRFT). The CRFT comprises specialist ambulance crews and social care support team to cover a population of 700,000 people.

As well as the usual staff, the ambulance crews include also emergency care assistants who are trained in diagnosis and lifting techniques related to falls. The emergency team of 7 people uses two bariatric ambulances and specialist lifting equipment so people of any size can be helped.

Problem Statement

A feasibility study to ascertain whether the EMAS (East Midlands Ambulance Service) NHS Trust initiative can be implemented in North Wales Ambulance Service (NWAS)?

Objectives of the study

The study seeks to explore if the East Midlands Ambulance Service initiative could be implemented in North Wales Ambulance Service.

3.0 Area of Study

A Dissertation Proposal on Reducing demand on hospitals and the potential adverse outcomes associated with hospital admission for patients and psychological impacts due to falls

3.1 Data and Methodology

The research method was chosen and best suited to this paper is feasibility study uses PIECES (Performance, Information, Economy, Control, Efficiency, Services) framework (Wetherbe, 1995). It comprises the use of qualitative and quantitative research analyses.

In describing this feasibility study, and achieve the dissertation aim and objectives, an operational feasibility approach was employed. Bentley and Whitten (2007) propose operational feasibility, seeks to measure how well a proposed project resolves the identified task or problem and focuses on the degree to which identified plans fit within the existing organizational environment and processes. Also, (Eriksson & Lindgarde, 1991)advocate this approach is people-orientated and focuses on social issues such as workforce, organizational conflicts, and policies; helping to identify and structure problems and determine the likely success of proposed solutions. This further justifies the appropriateness of selecting this methodology to guide the feasibility study.

To objectively guide the process, as proposed by Hochhauser (1986), the operational feasibility tool devised by Wetherbe (1994) was utilized. This defines potential operational problems, which should be considered when testing feasibility, using the acronym PIECES, which relate to specific areas of study.

Feasibility Study Using PIECES Framework


A significant proportion of EMAS income was dedicated to quality improvement and modernisation goals. Commission for quality and innovation (CQUIN) scheme saw the corporation agreeing to deliver the following schemes:

Paramedic Pathfinder: is an electronic tool that was developed to allow ambulance scene to access health service that is most suitable to the patient.

Risk trigger tool: This tool recorded whether significant observations had been made and documented by the officials. The device was soon found redundant. Therefore, a new tool was soon developed that showed a 95% match indicating harm.

Mental Health Steering Group: As the name suggests this is a particular group devised in assistance to those with mental illnesses. This will also improve partnerships with Mental Health Car initiative

Dementia: this is a progressive decline in cognitive function due to damage or disease in the brain. Dementia assessment tool. This has made the group members assess whether a patient is suffering from Dementia. This group is a continuation of Mental Health Steering Group.

Clinical Assessment Test (CAT): This sector takes a more precise attention to the patients' needs and uses an electronic file recording system, while those not reported to be in a critical situation and directed to a more specific care unit.

General Practitioner in CAT: a general practitioner is available at peak times when the health professionals in that field are not available.

High Volume Service Users: This is a unit specialized in doing research and collecting data of those calling the emergency number. Determining the location, type of call and the number of times the patient called.

There are several departments in the EMAS, of which are focused on the improvement of performance of the emergency team. Improving the quality of service offered for patients need. NWAS has a high level of income and supporting management that can implement the projects at this moment done by EMAS.


The Risk Trigger Tool is used to input patients' data and stores the data in electronic form until the time of need, until when problems concerning the patient are discovered, and after that, the tool is required to show similarity in the problem's regarding the patient. This tool is accurate. Showing accuracy levels of about 95%. As reasonable as it may seem. It may give false information at times. The tool can be overloaded. This means it can contain information to a certain extent. Limited entries are allowed in the device.

The tool can be corrupted since it is vulnerable to attackers. Like hackers and virus which are computer related malware. As much of good use as it can be it has its limitations. This tool can be assimilated by NWAS, but it is not highly efficient.


The implementation of projects stated above, require funding by state or internally by the East Midlands Ambulance Services. One choosing on what to spend money on, they have to make a choice and opportunity cost. The opportunity cost is the best-forgone alternative. This is where they have to make a decision the best cost effective good to spend their money on. This study is useful as it gives an organization a framework on what to choose. Budgeting on how much to spend is also done at this particular time. The choice of spending should be wise, enabling the organization to spend just the right amounts.


A project developed must be kept in right quantities of control, but with little control data is not efficiently edited and stored. Data is also vulnerable to outside attackers when the control system is not as enough as it should. Private data is breached, and the guidelines set are consistently being violated. The part of projects to be implemented need to be a secret and kept confidential to avoid someone else's hands from falling to the project. In this setting, decision errors are quite frequent. However, when there is too much control in place, the implementation of the project is delayed. Control can be inconvenient since employees and customers feel like machines when there are lengthy protocols.


Time is wasted in many ways. People and machines waste time in data copying generation. The purpose of a project needs to be precise and accurate, utilizing the least number of resources.


A system may be agreed upon and implemented but then in the testing, if it is usable many flaws may arise that need rectification. Flexibility is a good thing that a system need to have for adoption to future unexpected or anticipated changes. NWAS may implement the initiative of EMAS, but if the system is inflexible, it may not be of much significance. Of which sooner or later they will need to abandon it.

Literature Review

Reviewing the literature in this particular field would help me come up with a clear outlook of my study. It will not only enhance by ability to identify the gap in the study but also help me identify areas that need further research. A feasibility study is the analysis of the possibility of implementing an idea. This is meant to answer the question "should we carry on?" It can also be termed as the evaluation process, where one tries to figure out which is the best way forward. But before the feasibility study, it is necessary to perform a pre-feasibility study. This is done to allow for time-saving and also saving cost. If a project is too expensive to implement or it is to take much time than is available it would be wise to look for the best alternative (Sharpless et al., 2014). This is the period of finding the strength and weaknesses of a particular project. This is the point where one needs to be skeptical, questioning every decision and reason. In the systematic following of the feasibility process, the EMAS NHS Trust initiative can be implemented.

Gathering adequate information will be done at this particular point. Evaluating the best possibility and the best alternative. Eliminating the threats and identifying the opportunities overlying. It would be senseless to perform a feasibility study of a project that has been previously executed.

Seniors are people that need care in society. Although they are vulnerable to fall. Which is not caused by unconsciousness or any chronic illness. This causes serious injuries. Considering that their growth limit is almost up. Hence more time is taken in the healing process. Nurses and carers are useful in ensuring their safety and welfare. Repeated falls create fear to the senior citizens as well as the loved ones.

Reducing Demand on Hospital

Technology has brought a new way of living. The health sector is one of the many areas that have benefited from this. Telecommunication devices and tools are vital in delivering healthcare service in a distant place. Also, it is important in obtain feedback from the patient through remote monitoring and personalized self-management (Khelifi, et al. 2013). Telehealthcare is appropriate in synchronizing the data regarding cost-benefit analysis as well as the risk.


Several reviews have been conducted. Reviews are spanning a decade. The reviews have been via direct interactions with patients and going through records of past treatment. The reviewer used Critical Appraise Skill Programme (CASP). This research will focus on the findings where it is probably expected that there will be no significant, notable difference between telehealthcare and the standard well-known usual healthcare according to CITATION Bra91 \l 1033 (Brauer, 1991). Many of the reviews noted short-term feasibility, which usually was some fewer than 12 months having less than 20 members. On reviews of many reports indicated the effects of telehealthcare being the tremendous reduction in some hospitalizations. Patients with long-term conditions benefited more from teleheal...

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