Abstract NS11: Using a Template in the Electronic Medical Record to Improve Communication Between Emergency Medical Services and the Emergency Department for Acute Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Melissa Richardson ◽  
Christopher Rankin
Keyword(s):  
Emergency Medical Services ◽  
Medical Record ◽  
Point Of Care ◽  
Hospital Setting ◽  
Medical Services ◽  
Emergency Medical ◽  
Stroke Team ◽  
Get With The Guidelines ◽  
To Receive ◽  
Early Stroke

Background: In the advent of electronic medical records (EMR), emergency departments (ED) are challenged to include communication with inbound Emergency Medical Services (EMS) within the medical record. Using standardized documentation to guide and capture this critical communication may impact early activation of the stroke team and improve ‘Door to CT’ times. Starting with the “Pre-Notification” measure in Get With the Guidelines (GWTG), our team set out to improve this measure, then evaluate its impact on early stroke team activation and imaging timelines. Purpose: To utilize a standardized template in the EMR to improve the GWTG Pre-Notification measure by 30% and evaluate its impact on early stroke team activation and imaging. Methods: Initially, the team agreed that clear criteria for stroke team activation were needed. Once established, a standardized template was designed within the EMR. This included point of care glucose, neurological symptoms, cardiac rhythm, time ‘last known well’, and establishment of IV access/labs drawn. The communication nurses, designated to receive incoming EMS calls, were instructed on the use of this standardized template to guide and record communication for incoming stroke patients. Education and feedback were also provided to EMS providers so that they could anticipate required information and ensure that appropriate care occurred in the pre-hospital setting. Results: The “Pre-Notification Measure” improved from 29%-77%, early stroke team activation improved from 45% - 73%, and median ‘Door to CT’ time improved from 25 minutes - 18 minutes. (Figure). Conclusions: Using a standardized template in the EMR improves expectations of care for the ED and EMS providers. This translates into better scores for the GWTG “Pre-Notification” measure, as well early stroke team activation and imaging timelines.

The Effect of the Familiarity of a Survey Sender on Response Outcomes in a Large-Scale Survey of Emergency Medical Services Agencies

2021 ◽  
Vol 44 (3) ◽  
pp. 260-267
Author(s):  
Morgan M. Millar ◽  
Hilary A. Hewes ◽  
Andrea L. Genovesi ◽  
Michael Ely ◽  
Braden Green ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Large Scale ◽  
Nationwide Survey ◽  
Survey Response ◽  
Medical Services ◽  
Healthcare Organizations ◽  
Emergency Medical ◽  
Established Relationship ◽  
To Receive

Survey response is higher when the request comes from a familiar entity compared to an unknown sender. Little is known about how sender influences response to surveys of organizations. We assessed whether familiarity of the sender influences response outcomes in a survey of emergency medical services agencies. Emergency medical services agencies in one U.S. state were randomly assigned to receive survey emails from either a familiar or unfamiliar sender. Both deployment approaches were subsequently used nationwide, with each state selecting one of the two contact methods. Experimental results showed that requests from the familiar sender achieved higher survey response (54.3%) compared to requests from the unfamiliar sender (36.9%; OR: 2.03; 95% CI: 1.23, 3.33). Similar results were observed in the subsequent nationwide survey; in states where the familiar sender deployed the survey, 62.0% of agencies responded, compared to 51.0% when the survey was sent by the unfamiliar sender (OR: 1.57; 95% CI: 1.47, 1.67). The response difference resulted in nearly 60 additional hours of staff time needed to perform telephone follow-up to nonrespondents. When surveying healthcare organizations, surveyors should recognize that it is more challenging to obtain responses without a pre-established relationship with the organizations.

A Prehospital Database System For Emergency Medical Services

2011 ◽  
pp. 2443-2454
Author(s):  
Nada Hashmi ◽  
Mark Gaynor ◽  
Marissa Pepe ◽  
Matt Welsh ◽  
William W. Tollefsen ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Point Of Care ◽  
Efficient Solutions ◽  
Medical Services ◽  
Mobile Database ◽  
Database Application ◽  
Emergency Medical ◽  
Future Direction ◽  
Service Standards ◽  
Collection And Management

Emergency Medical Services (EMS) are not only responsible for providing prompt and efficient medical care to many different types emergencies, but also for fully documenting each and every event. Unfortunately, the vast majority of EMS events are still documented by hand. The documents are then further processed and entered manually into various billing, research, and other databases. Hence, such a process is expensive, labor intensive, and error prone. There is a dire need for more research in this area and for faster, efficient solutions. We present a solution for this problem: Prehospital Patient Care Record (PCR) for emergency medical field usage with a system called iRevive that functions as a mobile database application. iRevive is a mobile database application that is designed to facilitate the collection and management of prehospital data. It allows point-of-care data capture in an electronic format and is equipped with individual patient sensors to automatically capture vital sign data. Patient information from the field is wirelessly transmitted to a back-end server, which uses Web service standards to promote interoperability with disparate hospital information systems, various billing agencies, and a wide variety of research applications. In this chapter, we describe the current state of EMS, the iRevive application, a mini-trial deploying iRevive in real scenarios, the results, and a future direction for our solution.

Prehospital Research

1993 ◽  
Vol 8 (S1) ◽  
pp. S5-S10 ◽  
Author(s):  
Donald M. Yealy
Keyword(s):  
Emergency Medical Services ◽  
Knowledge Base ◽  
Research Design ◽  
Prehospital Care ◽  
Hospital Setting ◽  
Medical Services ◽  
Professional Advancement ◽  
Emergency Medical ◽  
Potential Benefits ◽  
Basic Features

Prehospital care experienced a “honeymoon” from the early 1970s until recently. Treatments usually were extrapolated directly from the hospital setting, even though the prehospital environment is markedly different. That honeymoon is over and emergency medical services (EMS) providers must prove what is beneficial. Additionally, academic prehospital care physicians interested in professional advancement, must show the same ability as do the more traditional medical academicians to expand the knowledge base of their chosen field.This manuscript will highlight the basic features and identify the potential benefits and pitfalls of prehospital research. This chapter is not a cookbook for EMS research, nor will it obviate the need for accessing other sources on research design. Other manuscripts within this series will focus on more specific topics; yet, it will be obvious that many of the points made here will be re-emphasized in the following papers. That simply is a reflection of the importance of these commonly overlooked perils and pitfalls.

A Prehospital Database System for Emergency Medical Services

2009 ◽  
pp. 1344-1356
Author(s):  
Nada Hashmi ◽  
Mark Gaynor ◽  
Marissa Pepe ◽  
Matt Welsh ◽  
William W. Tollefsen ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Point Of Care ◽  
Efficient Solutions ◽  
Medical Services ◽  
Mobile Database ◽  
Database Application ◽  
Emergency Medical ◽  
Future Direction ◽  
Service Standards ◽  
Collection And Management

Emergency Medical Services (EMS) are not only responsible for providing prompt and efficient medical care to many different types emergencies, but also for fully documenting each and every event. Unfortunately, the vast majority of EMS events are still documented by hand. The documents are then further processed and entered manually into various billing, research, and other databases. Hence, such a process is expensive, labor intensive, and error prone. There is a dire need for more research in this area and for faster, efficient solutions. We present a solution for this problem: Prehospital Patient Care Record (PCR) for emergency medical field usage with a system called iRevive that functions as a mobile database application. iRevive is a mobile database application that is designed to facilitate the collection and management of prehospital data. It allows point-of-care data capture in an electronic format and is equipped with individual patient sensors to automatically capture vital sign data. Patient information from the field is wirelessly transmitted to a back-end server, which uses Web service standards to promote interoperability with disparate hospital information systems, various billing agencies, and a wide variety of research applications. In this chapter, we describe the current state of EMS, the iRevive application, a mini-trial deploying iRevive in real scenarios, the results, and a future direction for our solution.

A Prehospital Database System for Emergency Medical Services

2011 ◽  
pp. 205-219
Author(s):  
Nada Hashmi ◽  
Mark Gaynor ◽  
Marissa Pepe ◽  
Matt Welsh ◽  
William W. Tollefsen ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Point Of Care ◽  
Efficient Solutions ◽  
Medical Services ◽  
Mobile Database ◽  
Current State ◽  
Emergency Medical ◽  
Future Direction ◽  
Service Standards ◽  
Collection And Management

Emergency Medical Services (EMS) are not only responsible for providing prompt and efficient medical care to many different types emergencies, but also for fully documenting each and every event. Unfortunately, the vast majority of EMS events are still documented by hand. The documents are then further processed and entered manually into various billing, research, and other databases. Hence, such a process is expensive, labor intensive, and error prone. There is a dire need for more research in this area and for faster, efficient solutions. We present a solution for this problem: Prehospital Patient Care Record (PCR) for emergency medical field usage with a system called iRevive that functions as a mobile database application. iRevive is a mobile database applicationthat is designed to facilitate the collection and management of prehospital data. It allows point-of-care data capture in an electronic format and is equipped with individual patient sensors to automatically capture vital sign data. Patient information from the field is wirelessly transmitted to a back-end server, which uses Web service standards to promote interoperability with disparate hospital information systems, various billing agencies, and a wide variety of research applications. In this chapter, we describe the current state of EMS, the iRevive application, a mini-trial deploying iRevive in real scenarios, the results, and a future direction for our solution.

Abstract 206: Pre-notification by Emergency Medical Services is Associated with More Timely Evaluation and Treatment of Acute Ischemic Stroke

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Cheryl Lin ◽  
Eric D Peterson ◽  
Eric E Smith ◽  
Jeffrey L Saver ◽  
Li Liang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Stroke Patients ◽  
Emergency Medical ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tissue Plasminogen ◽  
Get With The Guidelines

Background: The benefits of intravenous tissue-plasminogen activator (tPA) in acute ischemic stroke are time-dependent. Emergency medical services (EMS) pre-notification of stroke arrivals may provide a means of reducing evaluation and treatment times. In this study we used data from the nationwide Get With The Guidelines Stroke (GWTG-Stroke) program to determine the effect of EMS pre-notification on acute ischemic stroke processes of care. Methods: Acute ischemic stroke patients transported by EMS to 1585 GWTG-Stroke hospitals from April 2003 to March 2011 were studied. The association between EMS pre-notification and door-to-imaging (DTI) times, door-to-needle (DTN) times, onset-to-needle times (OTN), and tPA treatment rates were analyzed using multivariable GEE regression analyses. Results: Of 371,988 EMS transported acute ischemic stroke patients, EMS pre-notification occurred in 249,197 (67.0%). Patients with pre-notification had shorter door-to-imaging times, shorter onset-to-needle times, and were more likely to be treated with tPA when eligible ( Table ). EMS pre-notification was independently associated with increased odds of DTI ≤25 minutes (adjusted OR 1.53, 95% CI 1.44–1.63, p<0.0001), DTN times ≤60 minutes (aOR 1.20, 95% CI 1.10–1.31, p<0.0001), OTN times (aOR 1.17, 95% CI 1.09–1.25, p<0.0001), and tPA use within 3 hours among eligible patients arriving by 2 hours (aOR 1.64, 95% CI 1.50–1.79, p<0.0001), without significant increases in complications of thrombolytic therapy. Conclusion: EMS pre-notification is independently associated with more rapid patient imaging and increased timeliness in IV tPA administration. These results support the need for initiatives targeted at increasing EMS pre-notification rates as a mechanism from improving quality of care and outcomes in acute ischemic stroke.

scholarly journals The Danish prehospital emergency healthcare system and research possibilities

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Tim Alex Lindskou ◽  
Søren Mikkelsen ◽  
Erika Frischknecht Christensen ◽  
Poul Anders Hansen ◽  
Gitte Jørgensen ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Medical Service ◽  
Medical Record ◽  
Healthcare System ◽  
Emergency Care ◽  
Medical Service ◽  
Medical Services ◽  
Emergency Medical Service System ◽  
Emergency Medical ◽  
Medical Healthcare

Abstract The emergency medical healthcare system outside hospital varies greatly across the globe - even within the western world. Within the last ten years, the demand for emergency medical service systems has increased, and the Danish emergency medical service system has undergone major changes. Therefore, we aimed to provide an updated description of the current Danish prehospital medical healthcare system. Since 2007, Denmark has been divided into five regions each responsible for health services, including the prehospital services. Each region may contract their own ambulance service providers. The Danish emergency medical services in general include ambulances, rapid response vehicles, mobile emergency care units and helicopter emergency medical services. All calls to the national emergency number, 1-1-2, are answered by the police, or the Copenhagen fire brigade, and since 2011 forwarded to an Emergency Medical Coordination Centre when the call relates to medical issues. At the Emergency Medical Coordination Centre, healthcare personnel assess the situation guided by the Danish Index for Emergency Care and determine the level of urgency of the situation, while technical personnel dispatch the appropriate medical emergency vehicles. In Denmark, all healthcare services, including emergency medical services are publicly funded and free of charge. In addition to emergency calls, other medical services are available for less urgent health problems around the clock. Prehospital personnel have since 2015 utilized a nationwide electronic prehospital medical record. The use of this prehospital medical record combined with Denmark’s extensive registries, linkable by the unique civil registration number, enables new and unique possibilities to do high quality prehospital research, with complete patient follow-up.

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