If you had access to all of your agencies info, what research would you do?

[climberslacker]

Hey guys,

Just took over a position that gives me access to all of my agencies PCRs as well as our data base of info from those PCRs. We are a Collegiate BLS First-Response agency and I was hoping to maybe do some research using the information I have access to. Is there anything worth doing or are we too small for anything useful to be gleaned?

Maybe I could do something supporting alternate transport decisions, as we are in a very, very lucky place where we have the option to refer patients (and offer them non-ambulance rides) to either an urgent care, a walk-in clinic, or the hospital. Thoughts on how I can go about it?

 

[Ewok Jerky]

first I would find out what your most common chief complaint is and see if you can't prevent some events through campus-wide patient education.

 

[DesertMedic66]

first I would find out what your most common chief complaint is and see if you can't prevent some events through campus-wide patient education.

I'm gonna take a stab and say their most common C/C is Alcohol related...

 

[climberslacker]

I'm gonna take a stab and say their most common C/C is Alcohol related...

DING DING DING

Yup, it's alcohol and alcohol prevention is obviously a large priority.

I'm thinking about maybe doing something showing that an EMS system that does more than just transport to the ER (referrals to other places) can work, and showing a small college system as an unlikely example of the future of EMS?

Or is that too presumptive and fraught with error?

I have a ton of data, at this point it is figuring our how to leverage it in a way that can become a published article (that's the goal, at least).

 

[RedAirplane]

approximately how big is your college?

 

[climberslacker]

Probably somewhere in the 3000 range including all faculty and staff, maybe a little more.

Approx. 300 calls a year. Mostly calls you would expect from a predominately early-20s patient population. Every once in a while we'll get a call for a professor, staff member or what have you.

 

[mgr22]

Do you have access to hospital diagnoses?

 

[climberslacker]

Do you have access to hospital diagnoses?

It depends, what do you have in mind? We only transport to one hospital so it would be pretty straightforward. In order to do that I would need to set it up as an actual research project through the school with a faculty advisor--no big deal because that's the end goal anyways.

 

[mgr22]

It depends, what do you have in mind? We only transport to one hospital so it would be pretty straightforward. In order to do that I would need to set it up as an actual research project through the school with a faculty advisor--no big deal because that's the end goal anyways.

It would be interesting to see how your responders' prehospital impressions compare to the ED's diagnoses. For example, one of your people starts a neb treatment on a suspected asthmatic, but the hospital says the pt was in APE. If you were to accumulate all of those kinds of matches and mismatches, you'd learn something about the quality of care your agency is delivering.

Besides hospital data, you'd also need your people to specify their prehospital impressions on their PCRs.

 

[RebelAngel]

I would take a QA/QI approach and look at what kind of calls we were getting and if we needed to tweak our training programs, continuing education, or equipment to better suit. I would look for response times, good and bad documentation practices, and ensuring that the correct equipment was being utilized in the proper ways according to protocols.

 

[Meursault]

It would be interesting to see how your responders' prehospital impressions compare to the ED's diagnoses. For example, one of your people starts a neb treatment on a suspected asthmatic, but the hospital says the pt was in APE. If you were to accumulate all of those kinds of matches and mismatches, you'd learn something about the quality of care your agency is delivering.

Besides hospital data, you'd also need your people to specify their prehospital impressions on their PCRs.

Ideally, you'd want to talk to your transporting/911 service, too, and see how diagnoses change and information gets lost across the three transitions of care. If you ask around in your alumni network, you might find someone who can help facilitate this. That said, you might well meet resistance from both entities for legal and cultural reasons.
This is a pretty ambitious project and doesn't lend itself well to a 3-4 year complete organizational turnover. It might be useful just to reach out to your 911 service and ED for informal feedback first, then see how they feel about the research project.

DING DING DING
I'm thinking about maybe doing something showing that an EMS system that does more than just transport to the ER (referrals to other places) can work, and showing a small college system as an unlikely example of the future of EMS?

There's a reason they call it a "special population waiver". Unless the future of EMS involves turning the country into small homogeneous clusters of young people with few chronic conditions, good insurance, and parents to pay for things.

I have a ton of data, at this point it is figuring our how to leverage it in a way that can become a published article (that's the goal, at least).

Gunner.