NYS PCR Shortage

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46Young

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Maybe they need to step into the future and go ePCR?
 
reaper said:
Maybe they need to step into the future and go ePCR?
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ePCR's would greatly extend out of service times at the hospital, and multiple refusals at an MVA would be impractical having to do them one at a time, rather than have your partner help as is with paper PCR's.

In NYC the units aren't inservice after dropping off at the hosp. until the PCR is completed, not like in other areas where a unit could do 4 or 5 jobs in a row having not completed any PCR's.
 
How would ePCRs extend your service time at the hospital? I would think it would be quicker to type a report than hand write it.
 
Kinda thinking the same thing. Multiple refusals are not a problem either. Just takes the state to step up and take the plunge.
 
Aidey said:
How would ePCRs extend your service time at the hospital? I would think it would be quicker to type a report than hand write it.
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I do EPCRs. They take longer to do than paperwork. They must load up, require thing to be filled out which are not relevant, battery dies at inopportune times and as mentioned, with multiple patients and 1 tablet, 1 person does everything.
 
Aidey said:
How would ePCRs extend your service time at the hospital? I would think it would be quicker to type a report than hand write it.
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I've worked EMS in NYC using the FDNY PCR's, and I've done IFT with the NYS PCR's. You can usually knock one out in 5-10 minutes unless you're doing an arrest or something complicated. Charleston County EMS (not user friendly) and Fairfax County FRD (user friendly) both have ePCR's, the Toughbook. The CCEMS could be done in around 20-30 mins if you're good. Fairfax, maybe 15-20 unless it's a simple ALS.

There are a plethora of drop down menus, you need to select many different fields where it's much easier to write in the same fields on the same piece of paper. It's also fun when you try to finalize the report and the book shows you all the sections you haven't completed. You also need to select each intervention, V/S, assessment or whatever, each with it's own page, and enter the time. You then need to jive those times with your onscene, arrival at hosp, pt contact, etc. It's cumbersome at best.
 
reaper said:
Kinda thinking the same thing. Multiple refusals are not a problem either. Just takes the state to step up and take the plunge.
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If I'm working with paper PCR's, and I have an MVA with 4 refusals, my partner and I can split the work both onscene for the refusal, and later with documentation. With the ePCR, there's no such option. Each pt must be done one at a time, since there's only one tablet. That also leaves me with four reports to do instead of two.
 
I've used both, and even with the annoying menus you have to fill out that aren't relevant it is still much faster to do an ePRC for me.

Our ePRCs use drop down boxes so when filling them out all I have to do is hit the first or second letter of the word I want and then the tab button. Once I learned the short cuts I am able to fill out everything but the narrative in about 5 minutes, unless it is a complicated call with more than 6-8 interventions. Every call has at least 5 or so unless it is a refusal.
 
No one I know here can knock one out in less than 15 minutes unless it's a routine BLS. I've often done routine ALS written PCR's in 5-10 minutes consistently. There's still the problem of securing multiple refusals onscene with only one tablet.

Additionally, with the ePCR's capacity to fax reports to the hospital, agencies will be tempted to require units to respond from the hospital before completing the report, since they can run it and complete multiple reports later during downtime and fax them. No more "one call at a time". I can run forever, provided I'm only dealing with one pt/report at a time (with the exception of loading up two pts on a BS Allstateitis MVA).

We did this in Charleston, and it's absolutely miserable. You're pulling up to the ED, and the next call is on the screen. You quickly drop off the pt, get the blank tablet signed, and then go off to the next call. Repeat maybe four or five times. It's no fun playing catch up at 0230 completing 4-5 reports when you should be sleeping, having run consistently for 18 hours or so. It's even better when the 0700 shift change comes, and you're staying late to complete the PCR's, since they can be synced to the station computer. Not for OT, but on your own time. It's even better still when you're doing this on the back end of a forced 48 hour shift. I'd rather eat a bullet than go back to that.
 
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46Young said:
It's even better when the 0700 shift change comes, and you're staying late to complete the PCR's, since they can be synced to the station computer. Not for OT, but on your own time.
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I'm willing to bet that there's a labor law violation in there somewhere.
 
JPINFV said:
I'm willing to bet that there's a labor law violation in there somewhere.
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They've likely commited several, from my personal observations. That places drives off most that are marketable and know they can do better elsewhere. The ones that stay do as they're told, or are otherwise "persuaded" to leave by various methods.

Their attitude is that you had plenty of time during your shift to complete the PCR's. Work harder and you won't need to stay late. They know they can do this because it's ultimately the responsibility of the tech to complete all reports. No one with any sense will go home without completing all runs.
 
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46Young said:
They've likely commited several, from my personal observations. That places drives off most that are marketable and know they can do better elsewhere. The ones that stay do as they're told, or are otherwise "persuaded" to leave by various methods.

Their attitude is that you had plenty of time during your shift to complete the PCR's. Work harder and you won't need to stay late. They know they can do this because it's ultimately the responsibility of the tech to complete all reports. No one with any sense will go home without completing all runs.
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My slogan is "Off the clock, off I go" The minute I clock out I am done working and ready to leave. Occasionally ill hang around to talk with off going coworkers but if they want me to work, ill clock back in. But then I do not go back in service until all my report is done and the stretcher has been cleaned and re-dressed.
 
NYS had a PCR shortage in the past as well...although this one today is due to the state cutting the printing budget for these....just as long as our part-time legislature gets their raise. Either way, the PCR shortages of the past have been resolved after the fact - some think this too will be resolved soon. Regardless of the outcome, our agency is looking at going the electronic PCR route due to this. From what I've used at other agencies (emsCharts, ePCR), it does take a bit longer, but the computer savvy ones have a much easier time with it, provided the system used cooperates.
 
Sasha said:
My slogan is "Off the clock, off I go" The minute I clock out I am done working and ready to leave. Occasionally ill hang around to talk with off going coworkers but if they want me to work, ill clock back in. But then I do not go back in service until all my report is done and the stretcher has been cleaned and re-dressed.
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There are plenty of unwritten rules they get away with, stuff that's difficult for the employee to document. If you just up and leave, you may win the battle, but you'll ultimately lose the war with them.
 
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