Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
Eur J Emerg Med. 2011 Jun;18(3):143-7. doi: 10.1097/MEJ.0b013e328341edac.
The aim of the study was to evaluate the feasibility of a newly developed computer-assisted feedback system between dispatch centre and ambulances in Stockholm, Sweden.
A computer-assisted feedback system based on a Finnish model was designed to fit the Swedish emergency medical system. Feedback codes were identified and divided into three categories; assessment of patients' primary condition when ambulance arrives at scene, no transport by the ambulance and level of priority. Two ambulances and one emergency medical communication centre (EMCC) in Stockholm participated in the study. A sample of 530 feedback codes sent through the computer-assisted feedback system was reviewed. The information on the ambulance medical records was compared with the feedback codes used and 240 assignments were further analyzed.
The used feedback codes sent from ambulance to EMCC were correct in 92% of the assignments. The most commonly used feedback code sent to the emergency medical dispatchers was 'agree with the dispatchers' assessment'. In addition, in 160 assignments there was a mismatch between emergency medical dispatchers and ambulance nurse assessments.
Our results have shown a high agreement between medical dispatchers and ambulance nurse assessment. The feasibility of the feedback codes seems to be acceptable based on the small margin of error. The computer-assisted feedback system may, when used on a daily basis, make it possible for the medical dispatchers to receive feedback in a structural way. The EMCC organization can directly evaluate any changes in the assessment protocol by structured feedback sent from the ambulance.
本研究旨在评估在瑞典斯德哥尔摩开发的调度中心与救护车之间新的计算机辅助反馈系统的可行性。
设计了一种基于芬兰模型的计算机辅助反馈系统，以适应瑞典的紧急医疗系统。反馈代码被确定并分为三类；评估救护车到达现场时患者的主要情况、不通过救护车转运和优先级。斯德哥尔摩的两辆救护车和一个紧急医疗通讯中心（EMCC）参与了这项研究。对通过计算机辅助反馈系统发送的 530 个反馈代码样本进行了回顾。将救护车病历上的信息与使用的反馈代码进行了比较，并进一步分析了 240 个分配。
从救护车发送到 EMCC 的使用反馈代码在 240 次分配中有 92%是正确的。发送给紧急医疗调度员的最常用的反馈代码是“同意调度员的评估”。此外，在 160 次分配中，紧急医疗调度员和救护车护士的评估存在不匹配。
我们的结果表明，医疗调度员和救护车护士评估之间具有高度一致性。基于较小的误差范围，反馈代码的可行性似乎是可以接受的。计算机辅助反馈系统可通过从救护车发送的结构化反馈，使医疗调度员能够以结构化的方式接收反馈。EMCC 组织可以通过从救护车发送的结构化反馈，直接评估评估协议的任何变化。
