Reliability and Validity of Retrospective Peer Review of the Quality of Care in Emergency Medical Services

Abstract Background Quality indicators (QI) for physician staffed emergency medical services (P-EMS) are necessary to improve service quality. Mortality can be considered the ultimate outcome QI. The process quality of care in P-EMS can be described by 15 response-specific QIs developed for these services. The most critical patients in P-EMS are presumably found among patients who die within 30 days after the P-EMS response. Securing high quality care for these patients should be a prioritized task in P-EMS quality improvement. Thus, the first aim of this study was to describe the 30-days survival in Nordic P-EMS as an expression of the outcome quality of care. The second aim was to describe the process quality of care as assessed by the 15 QIs, for patients who die within 30 days after the P-EMS response. Methods In this prospective observational study, P-EMSs in Finland, Sweden, Denmark, and Norway registered 30-days survival and scored the 15 QIs for their patients. The QI performance for patients who died within 30 days after the P-EMS response was assessed using established benchmarks for the applied QIs. Further, mean QI performance for the 30-days survivors and the 30-days non-survivors were compared using Chi-Square test for categorical variables and Mann-Whitney U test for continuous variables. Results We recorded 2808 responses in the study period. 30-days survival varied significantly between the four participating countries; from 89.0 to 76.1%. When assessing the quality of care for patients who die within 30 days after the P-EMS response, five out of 15 QIs met the established benchmarks. For nine out of 15 QIs, there was significant difference in mean scores between the 30 days survivors and non-survivors. Conclusion In this study we have described 30-days survival as an outcome QI for P-EMS, and found significant differences between four Nordic countries. For patients who died within 30 days, the majority of the 15 QIs developed for P-EMS did not meet the benchmarks, indicating room for quality improvement. Finally, we found significant differences in QI performance between 30-days survivors and 30-days non-survivors which also might represent quality improvement opportunities.

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Information Quality of the Emergency Medical Services 115 Report Form Among Traffic Injured in Mashhad Social Welfare Hospitals

International Electronic Journal of Medicine ◽

10.31661/iejm108.1 ◽

2019 ◽

Author(s):

Mahdi Dehnavi

Keyword(s):

Social Welfare ◽

Emergency Medical Services ◽

Information Quality ◽

Medical Services ◽

Emergency Medical

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The effect of quality circles on job satisfaction and quality of work-life of staff in emergency medical services

International Emergency Nursing ◽

10.1016/j.ienj.2012.10.002 ◽

2013 ◽

Vol 21 (4) ◽

pp. 264-270 ◽

Cited By ~ 15

Author(s):

Reza Hosseinabadi ◽

Arezou Karampourian ◽

Shoorangiz Beiranvand ◽

Yadollah Pournia

Keyword(s):

Job Satisfaction ◽

Emergency Medical Services ◽

Work Life ◽

Quality Of Work Life ◽

Medical Services ◽

Quality Circles ◽

Quality Of Work ◽

Emergency Medical

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Effect of Acute Exposure to Altitude on the Quality of Chest Compression‐Only Cardiopulmonary Resuscitation in Helicopter Emergency Medical Services Personnel: A Randomized, Controlled, Single‐Blind Crossover Trial

Journal of the American Heart Association ◽

10.1161/jaha.121.021090 ◽

2021 ◽

Author(s):

Anna Vögele ◽

Michiel Jan van Veelen ◽

Tomas Dal Cappello ◽

Marika Falla ◽

Giada Nicoletto ◽

...

Keyword(s):

Emergency Medical Services ◽

Chest Compression ◽

Acute Exposure ◽

Medical Services ◽

Compression Depth ◽

Helicopter Emergency Medical Services ◽

Emergency Medical ◽

Emergency Medical Services Personnel ◽

Cpr Quality

Background Helicopter emergency medical services personnel operating in mountainous terrain are frequently exposed to rapid ascents and provide cardiopulmonary resuscitation (CPR) in the field. The aim of the present trial was to investigate the quality of chest compression only (CCO)‐CPR after acute exposure to altitude under repeatable and standardized conditions. Methods and Results Forty‐eight helicopter emergency medical services personnel were divided into 12 groups of 4 participants; each group was assigned to perform 5 minutes of CCO‐CPR on manikins at 2 of 3 altitudes in a randomized controlled single‐blind crossover design (200, 3000, and 5000 m) in a hypobaric chamber. Physiological parameters were continuously monitored; participants rated their performance and effort on visual analog scales. Generalized estimating equations were performed for variables of CPR quality (depth, rate, recoil, and effective chest compressions) and effects of time, altitude, carryover, altitude sequence, sex, qualification, weight, preacclimatization, and interactions were analyzed. Our trial showed a time‐dependent decrease in chest compression depth ( P =0.036) after 20 minutes at altitude; chest compression depth was below the recommended minimum of 50 mm after 60 to 90 seconds (49 [95% CI, 46–52] mm) of CCO‐CPR. Conclusions This trial showed a time‐dependent decrease in CCO‐CPR quality provided by helicopter emergency medical services personnel during acute exposure to altitude, which was not perceived by the providers. Our findings suggest a reevaluation of the CPR guidelines for providers practicing at altitudes of 3000 m and higher. Mechanical CPR devices could be of help in overcoming CCO‐CPR quality decrease in helicopter emergency medical services missions. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04138446.

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Job Stressors and Job Satisfaction in a Major Metropolitan Public EMS Service

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00027692 ◽

1999 ◽

Vol 14 (4) ◽

pp. 32-35 ◽

Cited By ~ 8

Author(s):

J. Shelby Bowron ◽

Knox H. Todd

Keyword(s):

Job Satisfaction ◽

Career Choice ◽

Emergency Medical Services ◽

Life Support ◽

Advanced Life Support ◽

Emergency Medical Technicians ◽

Medical Services ◽

Job Stressors ◽

Emergency Medical

AbstractIntroduction:Behavioral and social science research suggests that job satisfaction and job performance are positively correlated. It is important that Emergency Medical Services managers identify predictors of job satisfaction in order to maximize job performance among prehospital personnel.Purpose:Identify job stressors that predict the level of job satisfaction among prehospital personnel.Methods:The study was conducted with in a large, urban Emergency Medical Services (Emergency Medical Services) service performing approximately 60,000 Advanced Life Support (Advanced Life Support) responses annually. Using focus groups and informal interviews, potential predictors of global job satisfaction were identified. These factors included: interactions with hospital nurses and physicians; on-line communications; dispatching; training provided by the ambulance service; relationship with supervisors and; standing orders as presently employed by the ambulance service. These factors were incorporated into a 21 item questionnaire including one item measuring global job satisfaction, 14 items measuring potential predictors of satisfaction, and seven questions exploring demographic information such as age, gender, race, years of experience, and years with the company. The survey was administered to all paramedics and Emergency Medical Technicians (Emergency Medical Technicians s) Results of the survey were analyzed using univariate and multivariate techniques to identify predictors of global job satisfaction.Results:Ninety paramedics and Emergency Medical Technicians participated in the study, a response rate of 57.3%. Job satisfaction was cited as extremely satisfying by 11%, very satisfying by 29%, satisfying by 45%, and not satisfying by 15% of respondents. On univariate analysis, only the quality of training, quality of physician interaction, and career choice were associated with global job satisfaction. On multivariate analysis, only career choice (p = 0.005) and quality of physician interaction (p = 0.05) were predictive of global job satisfactionConclusion:Quality of career choice and interactions with physicians are predictive of global job satisfaction within this urban emergency medical service (Emergency Medical Technicians). Future studies should examine specific characteristics of the physician-paramedic interface that influence job satisfaction and attempt to generalize these results to other settings.

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