School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.
Yorkshire Ambulance Service Research Institute, Yorkshire Ambulance Service NHS Trust, Wakefield, WF2 0XQ, UK.
BMC Emerg Med. 2024 Sep 13;24(1):165. doi: 10.1186/s12873-024-01082-y.
Providing feedback to healthcare professionals and organisations on performance or patient outcomes may improve care quality and professional development, particularly in Emergency Medical Services (EMS) where professionals make autonomous, complex decisions and current feedback provision is limited. This study aimed to determine the content and outcomes of feedback in EMS by measuring feedback prevalence, identifying predictors of receiving feedback, categorising feedback outcomes and determining predictors of feedback efficacy.
An observational mixed-methods study was used. EMS professionals delivering face-to-face patient care in the United Kingdom's National Health Service completed a baseline survey and diary entries between March-August 2022. Diary entries were event-contingent and collected when a participant identified they had received feedback. Self-reported data were collected on feedback frequency, environment, characteristics and outcomes. Feedback environment was measured using the Feedback Environment Scale. Feedback outcomes were categorised using hierarchical cluster analysis. Multilevel logistic regression was used to assess which variables predicted feedback receipt and efficacy. Qualitative data were analysed using content analysis.
299 participants completed baseline surveys and 105 submitted 538 diary entries. 215 (71.9%) participants had received feedback in the last 30 days, with patient outcome feedback the most frequent (n = 149, 42.8%). Feedback format was predominantly verbal (n = 157, 73.0%) and informal (n = 189, 80.4%). Significant predictors for receiving feedback were a paramedic role (aOR 3.04 [1.14, 8.00]), a workplace with a positive feedback-seeking culture (aOR 1.07 [1.04, 1.10]) and white ethnicity (aOR 5.68 [1.01, 29.73]). Feedback outcomes included: personal wellbeing (closure, confidence and job satisfaction), professional development (clinical practice and knowledge) and service outcomes (patient care and patient safety). Feedback-seeking behaviour and higher scores on the Feedback Environment Scale were statistically significant predictors of feedback efficacy. Solicited feedback improved wellbeing (aOR 3.35 [1.68, 6.60]) and professional development (aOR 2.58 [1.10, 5.56]) more than unsolicited feedback.
Feedback for EMS professionals was perceived to improve personal wellbeing, professional development and service outcomes. EMS workplaces need to develop a culture that encourages feedback-seeking to strengthen the impact of feedback for EMS professionals on clinical decision-making and staff wellbeing.
为医疗保健专业人员和组织提供有关绩效或患者结果的反馈，可能会提高护理质量和专业发展水平，尤其是在急诊医疗服务（EMS）中，因为专业人员做出自主、复杂的决策，而当前的反馈提供有限。本研究旨在通过测量反馈的普遍性、确定接受反馈的预测因素、对反馈结果进行分类以及确定反馈效果的预测因素，来确定 EMS 中的反馈内容和结果。
本研究采用观察性混合方法研究。在英国国民保健服务中提供面对面患者护理的 EMS 专业人员在 2022 年 3 月至 8 月之间完成了基线调查和日记条目。日记条目是根据事件的发生而收集的，当参与者确定他们收到了反馈时就会进行记录。自我报告的数据包括反馈的频率、环境、特征和结果。使用反馈环境量表测量反馈环境。使用层次聚类分析对反馈结果进行分类。多水平逻辑回归用于评估哪些变量可以预测反馈的接受和效果。使用内容分析法对定性数据进行分析。
299 名参与者完成了基线调查，105 名参与者提交了 538 份日记条目。在过去 30 天内，215 名（71.9%）参与者收到了反馈，其中患者结果反馈最常见（n=149，42.8%）。反馈形式主要是口头（n=157，73.0%）和非正式（n=189，80.4%）。接受反馈的显著预测因素包括：护理人员角色（优势比 3.04[1.14，8.00]）、具有积极寻求反馈文化的工作场所（优势比 1.07[1.04，1.10]）和白种人种族（优势比 5.68[1.01，29.73]）。反馈结果包括：个人幸福感（解决问题、自信和工作满意度）、专业发展（临床实践和知识）和服务成果（患者护理和患者安全）。寻求反馈的行为和反馈环境量表的更高分数是反馈效果的统计学显著预测因素。征求的反馈比非征求的反馈更能提高幸福感（优势比 3.35[1.68，6.60]）和专业发展（优势比 2.58[1.10，5.56]）。
EMS 专业人员认为反馈可以提高个人幸福感、专业发展和服务成果。EMS 工作场所需要培养一种鼓励寻求反馈的文化，以增强反馈对 EMS 专业人员临床决策和员工幸福感的影响。
