Hospital Follow-Up

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eventer22

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One of our local hospitals has a stroke follow up program for ems. Before you leave the hospital you can get the assigned "number" of the patient, then follow up online about how they turned out. Anybody else have any sort of program like this for stroke, mi, trauma, etc?
 
One if our hospitals does something similar. We all have a log on and can go in and look. I have yet to utilize this, because we do not go there very often.

If one of our main hospitals did this, it would be awesome! I'm always bugging the docs to see how my patients end up.
 
At least one hospital in the area calls to follow-up on all ED patients. EMS does not do that.
 
I haven't heard of this, but it sounds like a good way to close the loop on quality of care. Too often, I think, HIPAA is used as an excuse to avoid tracking performance.
 
I thought it was neat. Our hospitals seem to be very ems friendly. It would be cool if you could do it with any patient though.
 
mgr22 said:
I haven't heard of this, but it sounds like a good way to close the loop on quality of care. Too often, I think, HIPAA is used as an excuse to avoid tracking performance.
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That's for 2 reasons.. Half the people really don't understand HIPAA, and the others are just Lazy.

Our Closest Cardiac, Stroke and Trauma Centers are quite EMS friendly, And send out performance reviews on STEMI, Stroke Alert and Trauma Alerts to the EMS providers of course the patient is a "number" but they give the metrics oh lets say a 56 yr old male presents with new onset chest pain. STEMI confirmed by EMS. and then the time to first ECG, Door to balloon ETC. They will also provide you with a follow up of the patient. I.E. Patient received 2 coronary stents and is currently home with rehabilitation measures.
 
mgr22 said:
I haven't heard of this, but it sounds like a good way to close the loop on quality of care. Too often, I think, HIPAA is used as an excuse to avoid tracking performance.
Click to expand...

HIPPA is misunderstood by many, for sure.

But it isn't used as an excuse not to track performance. It's just that if there is no mechanism in place for relaying information back to EMS, it's very difficult for anyone inside the hospital system to provide the feedback.

If you were sitting at the station and a stranger called you out of the blue and asked for detailed information about a patient you treated recently, would you provide it? No, of course not. What if they assured you that they have a right to know under HIPPA? You probably still wouldn't, unless they could provide some proof. Well, that's the same situation that a doctor or nurse in the hospital is in when you call or walk in asking about a patient.

Unless the hospital has a strong EMS liaison program, they probably don't have those mechanisms set up. Especially if the EMS agencies haven't made a strong effort to get them set up.

unleashedfury said:
That's for 2 reasons.. Half the people really don't understand HIPAA, and the others are just Lazy.
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He he.....I remember when I was a street medic and I assumed that most people who worked in the hospital were lazy.....

Considering how busy ED and ICU staff typically are, and considering the fierce retribution that can come with even minor and unintentional HIPAA violations, I don't think it is surprising that it is hard to get feedback. It's unfortunate, but it is how it is.
 
Our hospitals have follow up programs in place for us. The two big ones do at least. Automatic feedback on STEMI patients then we can put our names down along with a patient sticker in a secured patient binder and put down what we want to know and they'll put patient paperwork in a secure folder that we can access to follow up. It's pretty sweet. Also we all have an open invitation to observe cath cases with one of our cardiology groups. Just have to call and schedule it. Most of the MDs will let us walk the entire shift with them and include us during assessments and discussions.
 
I wish our local hospitals did this. The only thing we get is anonymous reports of patient outcomes from ED arrival to discharge posted up in the EMS rooms.
 
That's cool that you have that program. I might see if there's anything I can do like that. I never did get to do er clinicals for my a, but i could ride the ambulance as much as I wanted to, which was a lot. I did find out that the first and only cardiac arrest i have worked started breathing against the vent, but there was nothing "upstairs. " they let him go a week later. Sad, but it was cool to see him come back.
 
It would be fantastic if more hospitals would implement some sort of formal follow-up, such as providing a unique identifier of a patient that isn't a name so that an ambulance company's quality control could obtain info appropriately and securely. I think we all would benefit by closing the loop. While run reviews can be beneficial, they may be cherry-picked. Sure, those are great to learn from, but it doesn't show me how I'm doing overall, or over time. If I'm doing a good job and I'm trending better or worse, I want to know that, and in what areas I'm lacking. The closer to the event, the more it's going to make an impact on me. Otherwise, how am I supposed to improve if I don't really remember that transport?
 
I'm writing a piece about QA/QI for EMS World. To those who get formal feedback from hospitals about patient outcomes -- e.g. eventer22, Anjel, unleashedfury and Robb -- could you give me the names of those hospitals? Also, feel free to add opinions about the value of that practice. I'll let you review your quotes before I use them, and I'll credit you (real or screen name) if you like. You can get back to me here, in a private message, or by email to **email removed**. Thanks!
 
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I'd love to see that. I have tried to follow up on patients but all I have ever gotten is "they are not in the system" meaning they either weren't admitted or...
 
We get patient updates through EMScharts. Sometimes they do not provide much, others we get paragraphs.
 
That is correct, there is a specific patient update sections. We also have staff from several of the hospitals that have access to flag as Q/A which can be both positive and negative. This includes our medical director who is an er doc at a local.
 
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