Abstract
Introduction:To determine emergency physician (EP) opinions of prehospital patient care reports (PCRs) and whether such reports are available at the time of emergency department (ED) medical decision-making.Methods:Prospective, cross-sectional, electronic web-based survey of EPs regarding preferences and availability of prehospital PCRs at the time of ED medical decision-making.Results:We sent the survey to 1,932 EPs via 4 American College of Emergency Physicians (ACEP) email lists. As a result, 228 (11.8%) of email list members from 31 states and the District of Columbia completed the survey. Most respondents preferred electronic prehospital PCRs as opposed to handwritten prehospital PCRs (52.2% [95% confidence interval (CI): 49.1, 55.3] vs. 17.1% [95%CI: 11.7, 22.5]). The remaining respondents (30.5% [95%CI: 26.0, 35.0]) had no preference or had seen only one type of PCR. Of the respondents, 45.6% [95%CI: 42.1, 48.7] stated PCRs were “very important” while 43.0% [95% CI: 39.3, 46.7] rated PCRs as “important” in their ED practice. Most respondents (79.6% [95%CI: 76.5, 82.7]) reported electronic prehospital PCRs were available ≤50% of the time for medical decision-making while 20.4% [95%CI: 9.2, 31.6] reported that electronic prehospital PCRs were available > 50% of the time (P=0.00). A majority of participants (77.6% [95%CI: 74.5, 80.7]) reported that handwritten prehospital PCRs were available ≥ 50% while 22.4% [95%CI: 11.8, 33.0] of the time for medical decision-making (P=0.00).Conclusion:EPs in this study felt that prehospital PCRs were important to their ED practice and preferred electronic prehospital PCRs over handwritten PCRs. However, most electronic prehospital PCRs were unavailable at the time of ED medical decision-making. Although handwritten prehospital PCRs were more readily available, legibility and accuracy were reported concerns. This study suggest that strategies should be devised to improve the overall accuracy of PCRs and assure that electronic prehospital PCRs are delivered to the receiving ED in time for consideration in ED medical decision-making.
Highlights
To determine emergency physician (EP) opinions of prehospital patient care reports (PCRs) and whether such reports are available at the time of emergency department (ED) medical decision-making
EPs in this study felt that prehospital PCRs were important to their ED practice and preferred electronic prehospital PCRs over handwritten PCRs
Most electronic prehospital PCRs were unavailable at the time of ED medical decision-making
Summary
The prehospital patient care report (PCR) is an essential tool for communicating pertinent prehospital patient and demographic data to hospital-based healthcare providers. The appearance of the patient prior to hospital arrival, and the prehospital treatment provided, can help speed and guide subsequent emergency department (ED) care.[1,2] Because of this, the accuracy and timeliness of the prehospital PCR is important. The prehospital PCR plays an important role in research, quality improvement, and protocol development.[4] Recently, there have been attempts to link prehospital and hospital datasets to better study the impact of prehospital care on patient morbidity and mortality.[5,6] The need for standardized datasets, uniform and reliable data transmission, integrated information systems, and provision of feedback to prehospital providers was a recommendation in the Emergency
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