Input needed: Designing new run reports

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seanm028

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Hello everyone, I've been given the rare opportunity to design a patient care report ("run report") for a new EMS group that is (slowly) forming in my area. I was hoping to get input from the people here who have filled out God-only-knows how many run reports. What do you like? What don't you like? What would you change? Try to imagine using this yourself on a daily basis, and then tell me what changes you would suggest based off of experience.

Note: as you can tell, identifying organization names have been blacked out. That was a request by some higher-ups. Just ignore that.

Run Report
 
digital, digital, digital!!!!!

if thats not an option, go as simple as possible. more check boxes, less writing. it makes cqi easier. eliminate all redundancy. if its got a check box, it doesnt need to be stated in the narrative. if its required in the narrative, it doesnt need a check box or seperate write in.
 
1. If you are going to skimp on the narritive section, please also design a narritive continuation sheet. Some of us write. A lot. You can't use check boxes for everything and if a provider is trying to paint an accurate picture with a decent flow, it's gonna take at least some space. If you do skimp, people will find ways around it (/me has bad memories of before his old company got continuation sheets and almost every call ended up with at least part of the narritive having 2 lines of text on every line).

2. On the flip side, make it blantantly obvious what needs to be filled out Every. Single. Call. For every person who could be described as needing number one, there will be numerous providers who will only do the bare minimum. It can't be avoided and at least this way you'll be guarenteed to have a minimum data set.

3. If you semi-regularly use more than 2 crew members, have enough spaces for everyone to have their name recorded. For example, if your service regularly runs 3 people, have 3 boxes. If your company semi-regularly does CCTs that require both a RN and a RT in addition to two EMT-__, have 4 boxes.
 
First note... Mac.com doesn't like Firefox... which is a PITA... but why I still have IE on my computer :)

Is this for a QRS/First Responder group? QRS=Quick Response Service, the PA term for a non-transport BLS responder. Is there more paperwork that you fill out in quarters, or is this ALL of the report?

What are you using the form for... this looks like it is designed to be completed onscene, right? Is this on NCR (carbonless) paper so that the transporting agency and/or ED has a copy? If so.. then 1 sided is fine. If not... use the BACK of the form too. (actually my service uses the back of our NCR refusal form, for our checklist... the patient gets one copy, we get the other).

JPINFV... there seems like decent narrative space... and the option to "see supplement"... I'm cool with that.

I think you probably need more room for PMH/Meds... like 2 lines. My one employer has a list of checkboxes for PMH including diabetes, COPD, Heart Attack, etc.

look through what type of calls are common... are there questions that would be good to document?

I think the GCS is a little big, and could be made smaller.
you should probably put a checkbox on there for O2 administered, how much, and device.

Maybe a checkbox area for patient presentation (lying/sitting/standing - in/on what?)


Jon
 
KEVD18 said:
digital, digital, digital!!!!!

if thats not an option, go as simple as possible. more check boxes, less writing. it makes cqi easier. eliminate all redundancy. if its got a check box, it doesnt need to be stated in the narrative. if its required in the narrative, it doesnt need a check box or seperate write in.
Click to expand...


I hate check boxes! Unfortunately, most of the areas are never in them and as well I still have to explain more in detail. Give me a sheet with lines!.. I can chart!

R/r 911
 
i hate digital completely. not only do i never find the right thing I'm looking for in the check boxes...but printing takes too long. give me a structured form and I'll fill it out with great detail in 5 minutes.
 
Ridryder911 said:
I hate check boxes! Unfortunately, most of the areas are never in them and as well I still have to explain more in detail. Give me a sheet with lines!.. I can chart!

R/r 911
Click to expand...

OMG I couldn't have said it better Rid! I can chart and I rather it be in my words then try and guess which box to check off. LOL But that is my opinion!

MDKEMT
 
Jon said:
JPINFV... there seems like decent narrative space... and the option to "see supplement"... I'm cool with that.
Click to expand...

Dolt... I didn't even see that there was a link posted, I was just going off of what was written in the post, especially the part about check boxes.

Looking at it, I'd be able to easily feel up that narrative box on a non-emergent transport, but it's an almost moot point since a supplemental section is there. For the GCS cheat sheet section, I personally prefer it on the back of the sheet, which will open up some more space. A handy method is to have it printed upside down on the bottom of the sheet so that a provider can just fold the sheet up to read it (I have a few copies of my old company's run sheet in my clip board and I can take a few photographs to show you what I mean). The V/S section is way too large and should be able to be shrunk down quite a bit. I'll print out a copy and see what I could do to play around with it tomorrow when I have downtime in my lab.
 
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Is your agency concerned with gathering insurances/guaranteer info?
 
Be sure to check with your State EMS Agency as well. Most states require either to use a State Form or to comply with required filters. Not only state but Federal as well. Alike was described, one also has to comply with insurance payers request or filters.

R/r 911
 
Wow, thanks everyone for the responses! I've already started to reform everything in my head to change things.


To answer some questions:

-Unfortunately, digital is not (currently) an option. I'll work on it.

-We are QRS... not transport. A third-party company will do all the transporting.

-This is on a 3-part NCR form. Top copy is ours, the 2nd and 3rd go to the transporting agency (1 for them, 1 for the hospital).

-On the back of the 1st page, there's the refusal form (upside down). On the back of the third page, there's a list of situations that require ALS activation, followed by a list for the clinical findings section. This list contains all the conditions that must be met (ex. Neck: No venous distention, trachea is midline, etc.) in order to check the box next to that body part. A checked box means "unremarkable". So basically, if a patient meets all of the conditions in a particular section, you can save yourself all the writing and just check "unremarkable".

-We are an all volunteer organization, and we are funded by grants, donations, and standby fees. We do not charge patients for our services and therefore do not need insurance info. Unless it turns out that there's a state/federal requirement to do so, in which case we'll add a section somewhere.
 
Be warned with check boxes and narratives that the two need to match data or your whole form is suspect. If your staff is not real good, top notch, particular with their narratives and you end up with a box checked and different info in the narrative, you can be in trouble.
 
where I used to work... my paperwork didn't require home address or social security number... but I'd get them anyway for the transporting co and PD, because they needed them.

Perhaps you should talk with the transporting agency and ensure what THEY need.. because it might be helpful for you to gather info for them.
 
Okay, I've made some adjustments after meeting with our medical control physicians and I've changed the form a bit.

Please leave me input - I don't want to order 500 of these and then realize they're inefficient.

Here's the link again.
 
The form looks good.
Some thoughts:
1) ASU is a member of NCEMSF (National Collegiate EMS Foundation). They have a section on their website with other college EMS' PCRs online-- as a resource. Check out http://www.ncemsf.org/resources/pcr/ In general NCEMSF is an excellent resource for things like this. If you havent already, check out some of their articles.

2) I think the vitals section is still too large. Shrinking it vertically is all you need to do. You prob dont need all the check boxes for pupils-- a space for people to write in the condition should be enough.

3) The clinical findings section could/should be larger. Perhaps you should come up with a formula for your narratives (for consistency and thoroughness) and attach it to the clipboard (see below).

4) I suggest you turn page 3 into a laminated thing on your clipboard. I dont think you need it on every PCR. Include other important information on the sheet. Do your members really need that much detail on when to call for ALS? If you are a BLS service with all Basics (I assume you are, based on the BGL section), they should know when to call for BLS v ALS. Maybe include common EMS acronyms for assesment on there as well (categorized based on clinical findings).

I have other nitpickey questions and comments, but I'll hold off on them.

Good Luck,

Dan
 
I cannot download it; but I HIGHLY recommend that you include all NEMSIS criteria as all States will require such information within the next year.

R/r 911
 
Jon said:
First note... Mac.com doesn't like Firefox... which is a PITA... but why I still have IE on my computer :)
Click to expand...

I use Mac.com and Firefox 3 every day. Works perfectly fine. If it doesn't work then use Safari.
 
Ridryder911 said:
I cannot download it; but I HIGHLY recommend that you include all NEMSIS criteria as all States will require such information within the next year.

R/r 911
Click to expand...

See if this link is better. The link to download is at the bottom right, after all the ads.

As for NEMSIS, I will look into that. Their dictionary is over 400 pages long, so it may take me a while to come into compliance, but just by glancing at it I think I've already covered most of their data points.
 
Other things you should consider adding to the PCR
1. pt. affiliation to university (student/staff/faculty/visitor/vendor)?
2. pt. campus residence, home address, phone number, SSN, etc.
3. Workers comp related?
4. Dispatched to: (reported condition)
5. Section for O2 admin (n/c? nrm? Rate?)
6. Section for BLS drug admin (rate, route, time, dosage, etc.)
7. Pt. disposition (refused, transported BLS, transported ALS, transported to health center, release to PD, pt not found, etc.)
8. Section for EMT signature (at the bottom)
9. Contact info for the corps- address, phone number, etc.
10. Section for parent info if patient is under 18
11. Med Control contact?
 
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