scholarly journals Variation in the delivery of telephone advice by emergency medical services: a qualitative study in three services

2019 ◽  
Vol 28 (7) ◽  
pp. 556-563
Author(s):  
Rachel O'Hara ◽  
Lindsey Bishop-Edwards ◽  
Emma Knowles ◽  
Alicia O'Cathain
Keyword(s):  
Qualitative Study ◽  
Emergency Medical Services ◽  
Participant Observation ◽  
Geographical Location ◽  
Medical Services ◽  
Alternative Response ◽  
Response Options ◽  
Emergency Medical ◽  
Telephone Advice ◽  
On The Road

BackgroundAn emergency ambulance is not always the appropriate response for emergency medical service patients. Telephone advice aims to resolve low acuity calls over the phone, without sending an ambulance. In England, variation in rates of telephone advice and patient recontact between services raises concerns about inequities in care. To understand this variation, this study aimed to explore operational factors influencing the provision of telephone advice.MethodsThis is a multimethod qualitative study in three emergency medical services in England with different rates of telephone advice and recontact. Non-participant observation (120 hours) involved 20 call handlers and 27 clinicians (eg, paramedics). Interviews were conducted with call handlers, clinicians and clinician managers (n=20).ResultsServices varied in their views of the role of telephone advice, selection of their workforce, tasks clinicians were expected and permitted to do, and access to non-ambulance responses. Telephone advice was viewed either as an acceptable approach to managing demand or a way of managing risk. The workforce could be selected for their expertise or their inability to work ‘on-the-road’. Some services permitted proactive identification of calls for a lower priority response and provided access to a wider range of response options. The findings aligned with telephone advice rates for each service, particularly explaining why one service had lower rates.ConclusionSome of the variation observed can be explained by operational differences between services and some of it by access to alternative response options in the wider urgent and emergency care system. The findings indicate scope for greater consistency in the delivery of telephone advice to ensure the widest range of options to meet the needs of different populations, regardless of geographical location.

Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study

2016 ◽  
Vol 32 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Seth A. Brown ◽  
Theresa C. Hayden ◽  
Kimberly A. Randell ◽  
Lara Rappaport ◽  
Michelle D. Stevenson ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Emergency Medical Services ◽  
Prehospital Care ◽  
Educational Interventions ◽  
Medical Services ◽  
Theory Approach ◽  
Publication Type ◽  
Pediatric Education ◽  
Emergency Medical

AbstractObjectivesPrevious studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements.MethodsPurposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data.ResultsForty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements.ConclusionFocus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care.BrownSA, HaydenTC, RandellKA, RappaportL, StevensonMD, KimIK. Improving pediatric education for Emergency Medical Services providers: a qualitative study. Prehosp Disaster Med. 2017;32(1):20–26.

scholarly journals Driving the ambulance: an essential component of emergency medical services: an integrative review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julia Becker ◽  
Karin Hugelius
Keyword(s):  
Medical Care ◽  
Emergency Medical Services ◽  
Time Pressure ◽  
Medical Condition ◽  
Potential Effect ◽  
Integrative Review ◽  
Medical Services ◽  
The Road ◽  
Emergency Medical ◽  
On The Road

Abstract Background The transport of patients from one location to another is a fundamental part of emergency medical services. However, little interest has been shown in the actual driving of the ambulance. Therefore, this review aimed to investigate how the driving of the ambulance affects the patient and the medical care provided in an emergency medical situation. Methods A systematic integrative review using both quantitative and qualitative designs based on 17 scientific papers published between 2011 and 2020 was conducted. Results Ambulance driving, both the actual speed, driving pattern, navigation, and communication between the driver and the patient, influenced both the patient’s medical condition and the possibility of providing adequate care during the transport. The driving itself had an impact on prehospital time spent on the road, safety, comfort, and medical issues. The driver’s health and ability to manage stress caused by traffic, time pressure, sirens, and disturbing moments also significantly influenced ambulance transport safety. Conclusions The driving of the ambulance had a potential effect on patient health, wellbeing, and safety. Therefore, driving should be considered an essential part of the medical care offered within emergency medical services, requiring specific skills and competence in both medicine, stress management, and risk approaches in addition to the technical skills of driving a vehicle. Further studies on the driving, environmental, and safety aspects of being transported in an ambulance are needed from a patient’s perspective.

Emergency Medical Services Provider Perspectives on Pediatric Calls: A Qualitative Study

2019 ◽  
Vol 23 (4) ◽  
pp. 501-509 ◽  
Author(s):  
Jessica N. Jeruzal ◽  
Lori L. Boland ◽  
Monica S. Frazer ◽  
Jonathan W. Kamrud ◽  
Russell N. Myers ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Provider Perspectives ◽  
Emergency Medical

scholarly journals Construction of a dynamic arrival time coverage map for emergency medical services

2018 ◽  
Vol 10 (1) ◽  
pp. 167-173 ◽  
Author(s):  
Adam Piórkowski
Keyword(s):  
Emergency Medical Services ◽  
Arrival Time ◽  
Medical Services ◽  
The Road ◽  
Emergency Medical ◽  
Long Term Trends ◽  
Static Version ◽  
On The Road ◽  
Dynamic Version

Abstract This article presents a design of coverage maps for emergency journeys made by emergency medical services. The system was designed for the Malopolskie Voivodeship Office in Cracow, Poland. The proposed solution displays maps of the ambulance coverage of areas and ambulance’s potential journey times. There are two versions of the map: static and dynamic. The static version is used to appropriately allocate ambulances to cover an area with the ability to reach locations in less than 15 or 20 minutes; the dynamic version allows monitoring of ambulance fleets under normal conditions or in the event of a crisis. The article also presents the results of archival data related to the movement of ambulances on the roads of Malopolskie Voivodship. Particular attention was paid to the relation between the speed of vehicles and the traffic on the road, the day of the week or month, and long-term trends. The collected observations made it possible to assume a general model of ambulance movement in the voivodeship to calculate arrival time coverage maps.

scholarly journals Barriers to utilization of pre-hospital emergency medical services among residents in Libreville, Gabon: A qualitative study

2013 ◽  
Vol 3 (4) ◽  
pp. 172-177 ◽  
Author(s):  
Nichole Bosson ◽  
Michael A. Redlener ◽  
George L. Foltin ◽  
Maria C. Raven ◽  
Mark P Foran ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Hospital Emergency ◽  
Emergency Medical

scholarly journals “Dying due to poverty and lack of easy transport”: A qualitative study on access and availability of pre-hospital emergency medical services in Kampala, Uganda

2019 ◽  
Author(s):  
Amber Mehmood ◽  
Shirin Wadhwaniya ◽  
Esther Bayiga Zziwa ◽  
Olive C Kobusingye
Keyword(s):  
Qualitative Study ◽  
Emergency Medical Services ◽  
Emergency Care ◽  
Poor Quality ◽  
Medical Services ◽  
Community Members ◽  
Hospital Emergency ◽  
Care Services ◽  
Emergency Medical

Abstract Background Emergency care services in low-and middle-income countries (LMICs) have traditionally received less attention in the dominant culture favouring vertical health programs. The unmet needs of pre-hospital and hospital-based emergency services are high but the barriers to accessing safe and quality emergency medical services (EMS) remain largely unaddressed. Few studies in Sub-Saharan Africa have qualitatively investigated barriers to EMS use, and quality of pre-hospital services from the providers and community perspective. We conducted a qualitative study to describe the patient-centred approach to emergency care in Kampala, Uganda, with specific attention to access to EMS.Methods The data collection was comprised of Key Informant Interviews (KII) and Focus Group Discussions (FGDs) with the community members. KII participants were selected using maximum purposive sampling based on expert knowledge of emergency care systems, and service delivery. FGDs were conducted to understand perceptions and experiences towards access to pre-hospital care, and to explore barriers to utilization of EMS. The respondents of ten KII and seven FGDs included pre-hospital EMS (PEMS) administrators, policy makers, police, health workers and community members. We conducted a directed content analysis to identify key themes and triangulate findings across different informant groups.Results Key themes emerged across interviews and discussions concerning: (1) lack of funds, (2) lack of standards, (3) need for upfront payments for emergency transport and care, 4) corruption, 5) poor quality pre-hospital emergency service, 6) poor quality hospital emergency care, and 7) delay in seeking treatment.Conclusions Patient-centred emergency care should be an integral part of comprehensive health care services. As Uganda and other LMICs continue to strive for universal health coverage, it is critical to prioritize and integrate emergency care within health systems owing to its cross-cutting nature. Community perceptions around access and quality of PEMS should be addressed in national policies covering affordable and safe EMS.

The State of Leadership Education in Emergency Medical Services: A Multi-national Qualitative Study

2014 ◽  
Vol 29 (5) ◽  
pp. 478-483 ◽  
Author(s):  
William Joseph Leggio
Keyword(s):  
Qualitative Study ◽  
Emergency Medical Services ◽  
Education And Training ◽  
The State ◽  
Leadership Education ◽  
Medical Services ◽  
Publication Type ◽  
Emergency Medical ◽  
Medical Education And Training ◽  
And Training

AbstractObjectiveThis study investigated how leadership is learned in Emergency Medical Services (EMS) from a multi-national perspective by interviewing EMS providers from multiple nations working in Riyadh, Kingdom of Saudi Arabia.MethodsA phenomenological, qualitative methodology was developed and 19 EMS providers from multiple nations were interviewed in June 2013. Interview questions focused on how participants learned EMS leadership as an EMS student and throughout their careers as providers. Data were analyzed to identify themes, patterns, and codes to be used for final analysis to describe findings.ResultsEmergency Medical Services leadership is primarily learned from informal mentoring and on-the-job training in less than supportive environments. Participants described learning EMS leadership during their EMS education. A triangulation of EMS educational resources yielded limited results beyond being a leader of patient care. The only course that yielded results from triangulation was EMS Management. The need to develop EMS leadership courses was supported by the findings. Findings also supported the need to include leadership education as part of continuing medical education and training.ConclusionEmergency Medical Services leadership education that prepares students for the complexities of the profession is needed. Likewise, the need for EMS leadership education and training to be part of continuing education is supported. Both are viewed as a way to advance the EMS profession. A need for further research on the topic of EMS leadership is recognized, and supported, with a call for action on suggested topics identified within the study.LeggioWJJr. The state of leadership education in Emergency Medical Services: a multi-national qualitative study. Prehosp Disaster Med. 2014;29(5):1-6.

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