338548
Accuracy of Communication between pre-hospital and hospital staff in Cuenca, Ecuador
In 2012, Ecuador invested in a national emergency communication system, ECU911. However, EMS-hospital communication has been suboptimal. This student capstone project, in cooperation with two Ecuadorian medical schools, aimed to identify if a structured method was used to communicate critical patient data and what barriers existed for accurate communication between prehospital and hospital staff in Cuenca, Ecuador.
Methods
A survey administered to prehospital, ECU911, and hospital staff at the region’s main public hospital assessed demographics, knowledge and practice of standardized prehospital communication. Results were entered into an electronic database and analyzed using SPSS for response patterns indicating possible areas of weakness in the present system.
Results/Outcomes
A total of 188 prehospital providers, 19 ECU911 staff members, 2 hospital triage clerks, and 26 emergency physicians were surveyed. We found 63% of prehospital staff use the standardized MIVT communication tool. However, disparities in communication between prehospital and hospital providers exist, such as: 73% of prehospital staff reported giving all MIVT data; however, hospital staff reported receiving all data points at a rate of 12%. The barriers to MIVT use included lack of training and inability to obtain expected data. Communication challenges included incomplete data, inconsistent training between agencies, and interference from lack of direct field-hospital communication.
Conclusions
Accurate communication of patient data between prehospital and hospital staff is essential. Implementation of an evidence-based EMS training program, direct EMS-hospital communication, and standardized protocols regarding dispositional decision-making for pre-hospital trauma patients should be investigated as possible solutions to the communication disparities identified.
Learning Areas:
Administer health education strategies, interventions and programsCommunication and informatics
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines
Learning Objectives:
DEFINE the challenges to trauma care in limited resource and global setting
IDENTIFY important elements in prehospital communication regarding critical patients
ANALYZE barriers to effective prehospital care in limited resource settings
COMPARE challenges faced by emergency providers in low- versus high-income settings
Keyword(s): Emergency Medical Services, Communication
Qualified on the content I am responsible for because: I gained an understanding of the theory and practice of EMS-hospital communication as an EMT-IV for several years. This background informed my observations and data analysis of the prehospital trauma system in Cuenca, Ecuador. Further, as a senior medical student pursuing Emergency Medicine and performing this investigation under the direct supervision of multiple seasoned trauma surgeons and public health researchers, one can be confident that my work has been performed with utmost care and competence.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.