School of Medicine and Health Sciences Poster Presentations

Title

A Videographic Assessment of the Quality of EMS to ED Handoff Communication during Pediatric Resuscitations

Document Type

Poster

Keywords

Emergency medical services; handoff communication; pediatric resuscitation

Publication Date

Spring 2017

Abstract

Background: The National Association of EMS Physicians emphasizes the importance of high quality communication between emergency medical services (EMS) providers and emergency department (ED) staff for providing safe, effective care. The quality of handoff communication from EMS to ED teams for critically ill pediatric patients needs further exploration.

Objective: This study assessed the quality of handoff communication during pediatric resuscitations.

Methods/Design: This study was conducted at a level 1 pediatric trauma center. We retrospectively reviewed video recordings of pediatric patients who required critical care (“resuscitations”) in the ED between 1/1/2014 and 2/2/2016. All events that had video recordings with EMS to ED provider handoff communication were included. Handoff quality parameters included critical patient information (chief complaint, age, medical history, vital signs, weight, exam findings, pre-hospital interventions) and inefficient communication patterns (ED staff interruptions, ED attending questions to repeat previously communicated information, and ED staff questions on information not communicated by EMS). Times involving the handoff process were also collected [handoff time= arrival to ED bed; report time=complete EMS report]. Our institutional review board approved this study.

Results/Discussion: 68 resuscitations were reviewed; 25% were cardiac arrests. 78% arrived by ground transport; 22% by helicopter. The median handoff and report times were 50 seconds [IQR 30,74] and 108 seconds [IQR 62,252] respectively. EMS handoff included: chief complaint (88%), interventions (81%), exam (63%), medical history (59%), age (56%), and weight (20%). Communicated vital signs included: respiratory rate (53%), heart rate (43%), oxygen saturation (39%), and blood pressure (31%). Inefficient communication occurred in 87%, including ED staff interruptions (51%), ED attending questions on previously reported information (40%), and ED staff questions on information not communicated (65%).

Conclusion: We described the quality of EMS to ED handoff communication during pediatric resuscitations in a single pediatric ED. We have identified multiple opportunities to improve the content and efficiency of this process.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Poster to be presented at GW Annual Research Days 2017.

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A Videographic Assessment of the Quality of EMS to ED Handoff Communication during Pediatric Resuscitations

Background: The National Association of EMS Physicians emphasizes the importance of high quality communication between emergency medical services (EMS) providers and emergency department (ED) staff for providing safe, effective care. The quality of handoff communication from EMS to ED teams for critically ill pediatric patients needs further exploration.

Objective: This study assessed the quality of handoff communication during pediatric resuscitations.

Methods/Design: This study was conducted at a level 1 pediatric trauma center. We retrospectively reviewed video recordings of pediatric patients who required critical care (“resuscitations”) in the ED between 1/1/2014 and 2/2/2016. All events that had video recordings with EMS to ED provider handoff communication were included. Handoff quality parameters included critical patient information (chief complaint, age, medical history, vital signs, weight, exam findings, pre-hospital interventions) and inefficient communication patterns (ED staff interruptions, ED attending questions to repeat previously communicated information, and ED staff questions on information not communicated by EMS). Times involving the handoff process were also collected [handoff time= arrival to ED bed; report time=complete EMS report]. Our institutional review board approved this study.

Results/Discussion: 68 resuscitations were reviewed; 25% were cardiac arrests. 78% arrived by ground transport; 22% by helicopter. The median handoff and report times were 50 seconds [IQR 30,74] and 108 seconds [IQR 62,252] respectively. EMS handoff included: chief complaint (88%), interventions (81%), exam (63%), medical history (59%), age (56%), and weight (20%). Communicated vital signs included: respiratory rate (53%), heart rate (43%), oxygen saturation (39%), and blood pressure (31%). Inefficient communication occurred in 87%, including ED staff interruptions (51%), ED attending questions on previously reported information (40%), and ED staff questions on information not communicated (65%).

Conclusion: We described the quality of EMS to ED handoff communication during pediatric resuscitations in a single pediatric ED. We have identified multiple opportunities to improve the content and efficiency of this process.