Patient Follow-Ups

awildstein

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I was wondering how other organizations manage patient follow-ups/case review. The volunteer organization I am part of does not have any formal case review meetings; however, crew chiefs can put in a request to the hospital for the patient's charts. I feel such information is very useful in order to improve as a provider and is also a very tangible way to learn more about the calls we do and the ailments our patients suffer from.

Does your organization allow you to follow-up with patients? Do you have a regular meeting to review calls? Your thoughts?
 

MrBrown

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Yes we have a very strong system of clinical review and audit; the Regional Medical Advisers review PRFs for patients who are not transported (ambulance transport not required), status 1 or 2 (critical or serious primary problem) and a random selection of others (moderate or minor primary problem). Any cases referred to the Clinical Management Group for review are also trended and analysed.

We are free (and encouraged) to speak with Clinical Standards Officers, regional Clinical Standards Manager, Operations Team Leader or Team Manager about any aspect of the clinical or operational role of Ambulance Officer that we wish to.

About 5 or 6 times a year the CMG publish "Clinical Matters" which is our internal clinical publication as well as updating our Clinical Procedures (guidelines) every two years, the next release of the guidelines will be in September this year.
 

Epi-do

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Our medical director comes out to us once a month and does an audit and review on runs he has selected for various reasons - good example/bad example of documentation, unusual run that was handled correctly, pt with unexpected outcome, fits into a "type" that he thinks we are having issues with and need to review. He also does a lecture on a topic of his choosing.

Along with that, if we have any runs that we are curious about, we send an email to our officer that gets forwarded through our chain of command until it reaches the medical director. If the patient went to his hospital, he gets back to us pretty quickly. If the patient went to a different hospital, he still gets back to us as soon as he can get any info on the patient's outcome. Also, all ALS runs are reviewed by the medical director. He occasionally will send one back to the medic with comments/questions to be addressed. If there is a big enough issue, you find yourself in his office.
 
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DesertMedic66

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Our medical director comes out to us once a month and does an audit and review on runs he has selected for various reasons - good example/bad example of documentation, unusual run that was handled correctly, pt with unexpected outcome, fits into a "type" that he thinks we are having issues with and need to review. He also does a lecture on a topic of his choosing.

Along with that, if we have any runs that we are curious about, we send an email to our officer that gets forwarded through our chain of command until it reaches the medical director. If the patient went to his hospital, he gets back to us pretty quickly. If the patient went to a different hospital, he still gets back to us as soon as he can get any info on the patient's outcome. Also, all ALS runs are reviewed by the medical director. He occasionally will send one back to the medic with comments/questions to be addressed. If there is a big enough issue, you find yourself in his office.

I would love to be able to have that. I've never met my medical director. I don't even know his/her name or what hospital he/she works at and no clue on how to get in contact with him/her.

If we want a follow up on a patient we have to go down to the hospital and request information about the patient. Our patient follow ups is if we come back to the hospital dropping off another patient. We will ask the nurses what was wrong etc.
 

medicdan

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For the volunteer service I work for, I meet with the medical director every week, and she reviews all PCRs, as well as follows up with all patients (either in outpatient clinic or ED/Hospital), and keeps me updated, which I communicate to the crew chief responsible.
At the paid service I work for, I don't think the medical director knows we have basics, or for that matter, care anything about BLS. The only reason I know his name is because I go to ALS M&M rounds, and ask questions.
 

LucidResq

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During ride-alongs I'd see little forms in the EMS lounges. If you wanted follow-up info on a patient you could fill one out. I assume then someone would get back to you. I think most hospitals here have a liaison or contact person that works for the hospital that can help you find out what happened to a patient.

Up in dispatch we'll call sometimes, mostly for cardiac arrests. When you spend 5-15 minutes talking to someone's hysterical family member or talking them thru CPR, you can get almost as invested in their outcome as someone on the street. Staff will at least tell us whether or not they made it.

Our fire department also conducts regular formal incident reviews. For example we had two interesting pediatric cors the other day (one suspicious, one kiddo with a congenital heart condition and very far out in the boonies). They get everyone together, including the 911 calltaker, dispatcher, the folks from the private ambulance, even hospital staff if possible I believe. They pull the 911 & radio tapes, run reports, hospital charts, etc and do a big debriefing.

That is in addition to the other stuff they do that doesn't involve us.
 

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