Factors impeding the effective utilisation of an electronic patient report form during handover from an ambulance to an emergency department

Altuwaijri, Eman A; Budgen, David; Maxwell, S

doi:10.1177/1460458218797984

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…Internationally, health services have identified the importance of enabling the ‘first responder’ record to be available to clinicians that will subsequently be providing care 8–11 . In the UK, the East Midlands and North East Ambulance Services have implemented electronic patient report forms which transmit information documented by the paramedics directly to the receiving hospital's electronic patient record after the patient is registered in the ED 12 . It appears there is room for improvement in Australasia.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the availability and utility of the paramedic record in the emergency department

O’Connor

Golding

2020

Emerg Medicine Australasia

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Objective Clinical handover between pre‐hospital ambulance service and the ED is important for patient safety and quality care. This study assessed the availability and utility of the paramedic record to ED clinicians in their patient assessment. Methods The document transfer in 110 handovers between ambulance service and a tertiary metropolitan hospital ED was observed. Timestamps were recorded when the electronic paramedic record was printed, when it was placed in the hospital's paper‐based patient medical record, when ED patient assessment occurred and it was noted if there was a verbal handover from paramedic to ED clinician. ED clinicians were surveyed about the availability and usefulness of the paramedic record. Results The paramedic record was printed prior to the patient being seen in only 49% of encounters and was available in the medical record at the time of initial clinical assessment in 32% of encounters. When available it was reviewed in over 90% of encounters. 87% of these reviews were reported as ‘significantly’ or ‘somewhat useful’. The paramedic record could not be located at all in 21% of encounters. In 98% of encounters the treating ED clinician would have preferred the paramedic record to have been electronic. The ED system data was corrupt in 4% of encounters. Conclusions The information in the paramedic record was found to be useful to ED clinicians when it was available. Increasing the availability of the paramedic record for ED clinical assessment may be an opportunity to improve patient safety and flow.

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Section: Discussionmentioning

confidence: 99%

Assessment of the availability and utility of the paramedic record in the emergency department

O’Connor

Golding

2020

Emerg Medicine Australasia

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“…However, the process mapping also indicated a flow of information with staff having access to certain data about patient health, collected prior to Majors entry, which could be used to address some of the bottlenecks. For instance, all patient arrivals via ambulance are accompanied by the Patient Report Form (PRF) [105,106] (or its electronic equivalent, the ePRF), which is generated by paramedics [106]. A copy of the PRF is provided to ED staff at handover [106] [Figure 2; P2].…”

Section: Use Of Precedence Information To Reduce Repeat Testsmentioning

confidence: 99%

“…For instance, all patient arrivals via ambulance are accompanied by the Patient Report Form (PRF) [105,106] (or its electronic equivalent, the ePRF), which is generated by paramedics [106]. A copy of the PRF is provided to ED staff at handover [106] [Figure 2; P2]. Additionally, the CAS card [107,108] is generated for all patients at registration and information is recorded in it along the patient flow.…”

Section: Use Of Precedence Information To Reduce Repeat Testsmentioning

confidence: 99%

Modelling Granular Process Flow Information to Reduce Bottlenecks in the Emergency Department

Amissah

Lahiri

2022

Healthcare

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Increasing demand and changing case-mix have resulted in bottlenecks and longer waiting times in emergency departments (ED). However, many process improvement efforts addressing the bottlenecks have limitations, as they lack accurate models of the real system as input accounting for operational complexities. To understand the limitation, this research modelled granular procedural information, to analyse processes in a Level-1 ED of a 1200-bed teaching hospital in the UK. Semi-structured interviews with 21 clinicians and direct observations provided the necessary information. Results identified Majors as the most crowded area, hence, a systems modelling technique, role activity diagram, was used to derive highly granular process maps illustrating care in Majors which were further validated by 6 additional clinicians. Bottlenecks observed in Majors included awaiting specialist input, tests outside the ED, awaiting transportation, bed search, and inpatient handover. Process mapping revealed opportunities for using precedence information to reduce repeat tests; informed alerting; and provisioning for operational complexity into ED processes as steps to potentially alleviate bottlenecks. Another result is that this is the first study to map care processes in Majors, the area within the ED that treats complex patients whose care journeys are susceptible to variations. Findings have implications on the development of improvement approaches for managing bottlenecks.

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“…Like other healthcare providers, paramedics need to do patient assessments and management and it is important to document what they do for the patients. EMS teams can deliver essential information to ED staff while they are enroute to the hospital, such as the status of patients, vital signs, medications, and patient treatment [12,13]. However, if this essential information is not received before arrival at the ED, the ED staff must use the paper-based patient care report (PCR), which might be difficult to read or find [14].…”

Section: Introductionmentioning

confidence: 99%

“…An electronic patient care report (ePCR) will guarantee much better accessibility of the data and assist in reducing the amount of entered duplicated patient information [16]. Moreover, in the case of a complaint, ePCR can offer evidence regarding interventions and patient outcomes in the prehospital setting [13,17].…”

Section: Introductionmentioning

confidence: 99%

Digital Future of Emergency Medical Services: Envisioning and Usability of Electronic Patient Care Report System

Haliq

Jumaan

2022

Advances in Human-Computer Interaction

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Despite the efforts of emerging technologies in the healthcare system, there is still a slower rate of acceleration in prehospital settings compared with the hospitals in digital transformation adaptation. The acknowledgment that digital transformation is significant to healthcare is reflected in planning for the future of digital healthcare. Thus, this study aimed to measure the usability of the electronic patient care report (ePCR) system among emergency medical services (EMS) staff who work in prehospital settings. A descriptive cross-sectional correlation study was used. Two hundred fifty EMS staff who are working in the prehospital setting at Saudi Red Crescent Authority in the Kingdom of Saudi Arabia were surveyed, and the response rate was 79.2% (198). An adapted tool of the Computer System Usability Questionnaire survey was used to collect data. The data were coded numerically and subjected to descriptive and inferential statistical analysis including Pearson’s correlation coefficient using the statistical software (SPSS 21). The majority of the participants rate their ePCR system as “useable” at a high level with a score of 3.41 (SD = 1.021). The overall mean of the ePCR system’s three subscales: system usefulness, information quality, interface quality, and overall satisfaction were 3.39 (SD = 1.152), 3.30 (SD = 1.052), 3.57 (SD = 1.064), and 3.37 (SD = 1.239), respectively. The least liked aspect of ePCR system software was information quality 81 (40.9%). Furthermore, there was a significant correlation between the age of EMS staff and the usability of the ePCR system (r = −0.150 ∗ , P = 0.035 ). The results suggest that healthcare institutions’ policy and decision-makers pay close attention to performing standardized training for the staff on their ePCR system before going to the field to increase efficiency and productivity. Furthermore, the users in this study identified other system features that, if included, could have enhanced usability, and improved functions and capabilities of the design to meet the EMS staff’s expectations.

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Factors impeding the effective utilisation of an electronic patient report form during handover from an ambulance to an emergency department

Cited by 5 publications

References 19 publications

Assessment of the availability and utility of the paramedic record in the emergency department

Assessment of the availability and utility of the paramedic record in the emergency department

Modelling Granular Process Flow Information to Reduce Bottlenecks in the Emergency Department

Digital Future of Emergency Medical Services: Envisioning and Usability of Electronic Patient Care Report System

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