Abstract WP27: Beyond The Call: EMS Feedback And Education Improving Stroke Care
| Autor: | Nili E Steiner, Sean Stokes, Caroline Jack, Sonia Figueroa, Laurie B Paletz |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Stroke. 54 |
| ISSN: | 1524-4628 0039-2499 |
| Popis: | Background and Purpose: Emergency Medical Services (EMS) providers are an integral part of the chain of acute stroke care, stroke patient survival and improving patient outcomes. It is imperative that EMS providers have tools to make accurate critical, time-sensitive decisions. This information impacts care patients receive in the Emergency Department (ED). This collaborative quality improvement project was created to provide feedback to paramedics with the goal of continued rapid, high-quality care for stroke patients in the ED. The purpose of this project is to determine if improved assessment, documentation and information gathering in the prehospital setting decreases door-to-thrombolytic times (DTN). Methods: Collaboration with the Beverly Hills Fire Department (BHFD) educators was initiated in July of 2021. We created a feedback form which included EMS documentation elements for the paramedics to obtain. These forms were completed by BHFD educators and our team. We performed ED chart reviews to extract data correlating items such as last known well time (LKWT), witness contact information and other pertinent data. We then provided a summary of the patient’s hospital course. Forms were returned to BHFD educators who distributed them to the paramedics for feedback purposes. Data was collected and analyzed for 12 data points over three quarters (Q3 and Q4 of 2021 and Q1 of 2022). Results: Data points analyzed showed sustained improvement. Three data elements demonstrated significant improvement: documentation of LKWT (67% Q3 2021, 89% Q4 2021, 100% Q1 2022), witness contact information collected (11% Q3 2021, 46% Q4, 83% Q1 2022) and over triage reduction (80% Q3 2021, 53% Q4 2021, 50% Q1 2022). Retrospective chart review revealed that patients delivered to our ED by BHFD treated with thrombolytics during Q3 and Q4 202 and Q1 2022 had a median DTN time of 32.6 minutes. This is outstanding and well within the national stroke DTN benchmark. Conclusion: We found that feedback to the paramedics improves documentation and assessment skills. Having information we need upon the patient’s arrival to the ED expedites and improves the quality of care we provide to our patients. We will continue to track this data with hopes of including other EMS providers in our network. |
| Databáze: | OpenAIRE |
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