Kaduce Michael, Fernandez Antonio, Bourn Scott, Calhoun Dustin, Williams Jefferson, DeLuca Mallory, Abraham Heidi, Uhl Kevin, Bregenzer Brian, Larmon Baxter, Crowe Remle P, Treichel Alison, Brent Myers J
Falck Health Institute, Orange, California.
ESO, Austin, Texas.
West J Emerg Med. 2024 Nov;25(6):949-957. doi: 10.5811/westjem.21175.
Our primary objective evaluated the perception of emergency medical service (EMS) providers' review of automated hospital outcome data. Secondarily, we assessed participation in outcome review as a means of microlearning to obtain continuing education (CE).
From October-December 2023, three high-volume EMS systems participated in a three-part intervention with results evaluated using a mixed-methods approach. First, EMS providers (emergency medical technicians and paramedics) were invited, via their electronic health record (EHR), to complete a presurvey evaluating their perceptions of reviewing outcomes. Then, EMS providers were notified about the opportunity to earn CE via a microlearning intervention, offering Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE)-approved CE hours for completion of outcome reviews and associated learning modules. Finally, EMS providers were invited to complete a post-survey mirroring the pre-survey. Qualitative analyses identified themes among open-ended responses. Quantitative analyses examined perceptions between pre- and post- surveys.
Of 843 providers contacted, 217 responded to the pre-survey (25.7%). The most endorsed rationale for reviewing outcomes included improving clinical knowledge (95%), improving patient care (94%), and knowing whether care made a difference (93%). Nearly all (91%) reported being more likely to review outcomes if CE were awarded. Among the 67 who completed the open-ended items, the three dominant themes included enhance personal confidence and competence (43%); acquire personal knowledge (39%); and operations (21%). Of 211 providers who participated in the intervention, 56 (27%) were awarded CE. A total of 152 providers responded to the post-survey, and the percentage who agreed that reviewing outcomes improves job satisfaction rose from 89% to 95% between pre- and post-surveys ( = 0.05).
EMS providers supported the personal and professional development and patient care improvement of reviewing patients' outcomes with associated CE. Further study is warranted to evaluate the generalizability of these findings and the best user experience.
我们的主要目标是评估紧急医疗服务(EMS)提供者对自动生成的医院结局数据审查的看法。其次,我们评估了参与结局审查作为一种微学习方式以获得继续教育(CE)的情况。
2023年10月至12月,三个高流量的EMS系统参与了一项分为三个部分的干预措施,并使用混合方法评估结果。首先,通过电子健康记录(EHR)邀请EMS提供者(急救医疗技术员和护理人员)完成一项预调查,评估他们对审查结局的看法。然后,通知EMS提供者有机会通过微学习干预获得CE,为完成结局审查及相关学习模块提供经院前继续教育认证委员会(CAPCE)批准的CE学时。最后,邀请EMS提供者完成一项与预调查类似的后调查。定性分析确定开放式回答中的主题。定量分析检查预调查和后调查之间的看法。
在联系的843名提供者中,217人回复了预调查(25.7%)。审查结局最被认可的理由包括提高临床知识(95%)、改善患者护理(94%)以及了解护理是否有效果(93%)。几乎所有(91%)报告称如果授予CE,他们更有可能审查结局。在完成开放式问题的67人中,三个主要主题包括增强个人信心和能力(43%);获取个人知识(39%);以及运营(21%)。在参与干预的211名提供者中,56人(27%)获得了CE。共有152名提供者回复了后调查,在预调查和后调查之间,同意审查结局能提高工作满意度的百分比从89%上升到了95%(P = 0.05)。
EMS提供者支持通过相关CE审查患者结局对个人和专业发展以及改善患者护理的作用。有必要进一步研究以评估这些发现的普遍性以及最佳用户体验。