Allowing nondisclosure in surveys with suicide content: Characteristics of nondisclosure in a national survey of emergency services personnel.

AbstractPurpose:Emergency services personnel are highly vulnerable to acute and cumulative critical incident stress (CIS) that can manifest as anger, guilt, depression, and impaired decision-making, and, in certain instances, job loss. Interventions designed to identify such distress and restore psychological functioning becomes imperative.Methods:A statewide debriefing team was formed in 1988 through a collaborative effort between an academic department of emergency medicine and a social work department of a teaching hospital, and a metropolitan area fire department and ambulance service. Using an existing CIS debriefing model, 84 pre-screened, mental health professionals and emergency services personnel were provided with 16 hours of training and were grouped into regional teams.Debriefing requests are received through a central number answered by a communicator in a 24-hour communications center located within the emergency department. Debriefings are conducted 48–72 hours after the event for specific types of incidents. Follow-up telephone calls are made by the debriefing team leader two to three weeks following a debriefing. The teams rely on donations to pay for travel and meals.Results:One hundred sixty-eight debriefings were conducted during the first four years. Rural agencies accounted for 116 (69%) requests. During this period, 1,514 individuals were debriefed: 744 (49%) firefighters, 460 (30%) EMTs, and 310 (21%) police officers, dispatchers, and other responders. Deaths of children, extraordinary events, and incidents involving victims known to the responders (35%, 14%, and 14% respectively) were the most common reasons for requesting debriefings. Feedback was received from 48 (28%) of the agencies that requested the debriefing. All of those who responded felt that the debriefing had a beneficial effect on its personnel. Specific individuals identified by agency representatives as having the greatest difficulty were observed to be returned to their pre-incident state.Conclusion:CIS debriefings are judged as beneficial. A statewide response team is an effective way to provide these services at no cost to agencies.

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TEACHING THE TEACHERS—WHAT EDUCATION AND TRAINING NEEDS ARISE AMONG TEACHERS THROUGH THE USE OF SIMULATION IN THE EDUCATION OF EMS PERSONNEL IN THE GERMAN HEALTH CARE SYSTEM

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2015-000044.3 ◽

2015 ◽

Vol 1 (1) ◽

pp. 41.3-41

Author(s):

Michael Wessels ◽

Manuel Geuen

Keyword(s):

Patient Safety ◽

Emergency Services ◽

Teaching Method ◽

Medical Personnel ◽

Further Education ◽

Teaching Staff ◽

Transfer Of Knowledge ◽

Performance Skills ◽

Intensive Training ◽

Emergency Services Personnel

Background & PurposeThe professional qualifications of paramedics in the emergency services are not uniform at the federal level across Germany. Federalism leads to a considerable heterogeneity of regional regulations and curricula for training at the state-approved emergency services School. This results in an uneven transfer of knowledge of action skills, scientific findings as well as inconsistent application of appropriate teaching methods. Finally, this culminates in an inconsistent qualification of EMS personnel.To illustrate the needs of teachers in simulation in training and continuing education of EMS personnel.MethodsBased on a systematic literature review and expert interviews on training and further education of non-medical personnel in emergency care simulation was analysed as a teaching method from an educational perspective. For a standardized carrying out of the interviews a unified interview guide was used. The statements of the experts were analysed with the software MAXQDA.ResultsThrough simulation, in conjunction with debriefings an outstanding benefit for the direct learning from mistakes is made possible, both in the whole group as well as in the setting of reality (train where you work). This supports a long-needed culture of errors in emergency service as well as improving patient safety in emergency response. This requires intensive training of the teaching staff in pedagogy and technology. Further research needs were identified for potential fields of application of simulation in the training of EMS personnel.ConclusionsSimulation provides for the training of emergency services personnel, particularly in view of the new profession of emergency paramedics (Notfallsanitäter) and their advanced performance skills extensive opportunities. With the help of simulation abilities and skills as well as inter-professional teamwork can be taught and improved individualized. In fact, simulation contributes to improving patient safety and guideline- based care of emergency patients.

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What are emergency ambulance services doing to meet the needs of people who call frequently? A national survey of current practice in the United Kingdom

BMC Emergency Medicine ◽

10.1186/s12873-019-0297-3 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Helen A. Snooks ◽

Ashrafunnesa Khanom ◽

Robert Cole ◽

Adrian Edwards ◽

Bethan Mair Edwards ◽

...

Keyword(s):

Case Management ◽

National Survey ◽

Current Practice ◽

Emergency Services ◽

Response Times ◽

Models Of Care ◽

Call Centre ◽

Complex Needs ◽

Team Meetings ◽

Emergency Ambulance

Abstract Background Emergency ambulance services are integral to providing a service for those with unplanned urgent and life-threatening health conditions. However, high use of the service by a small minority of patients is a concern. Our objectives were to describe: service-wide and local policies or pathways for people classified as Frequent Caller; call volume; and results of any audit or evaluation. Method We conducted a national survey of current practice in ambulance services in relation to the management of people who call the emergency ambulance service frequently using a structured questionnaire for completion by email and telephone interview. We analysed responses using a descriptive and thematic approach. Results Twelve of 13 UK ambulance services responded. Most services used nationally agreed definitions for ‘Frequent Caller’, with 600–900 people meeting this classification each month. Service-wide policies were in place, with local variations. Models of care varied from within-service care where calls are flagged in the call centre; contact made with callers; and their General Practitioner (GP) with an aim of discouraging further calls, to case management through cross-service, multi-disciplinary team meetings aiming to resolve callers’ needs. Although data were available related to volume of calls and number of callers meeting the threshold for definition as Frequent Caller, no formal audits or evaluations were reported. Conclusions Ambulance services are under pressure to meet challenging response times for high acuity patients. Tensions are apparent in the provision of care to patients who have complex needs and call frequently. Multi-disciplinary case management approaches may help to provide appropriate care, and reduce demand on emergency services. However, there is currently inadequate evidence to inform commissioning, policy or practice development.

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Experimental Document Design: Guidebook Organization and Index Formats

Proceedings of the Human Factors Society Annual Meeting ◽

10.1177/1071181380024001125 ◽

1980 ◽

Vol 24 (1) ◽

pp. 480-483

Author(s):

Bruce W. Hamill

Keyword(s):

Experimental Data ◽

Emergency Services ◽

Document Design ◽

Error Analyses ◽

Emergency Services Personnel

An experiment was conducted to determine the best way to format a guidebook to be used by emergency services personnel. Converging results of time and error analyses of the experimental data favor particular formats for numerical and alphabetical indices and a particular organization for sections of the guidebook.

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