Collecting core data in physician-staffed pre-hospital helicopter emergency medical services using a consensus-based template: international multicentre feasibility study in Finland and Norway

Abstract

Background Comparison of services and identification of factors important for favourable patient outcomes in emergency medical services (EMS) is challenging due to different organization and quality of data. The purpose of the present study was to evaluate the feasibility of physician-staffed EMS (p-EMS) to collect patient and system level data by using a consensus-based template. Methods The study was an international multicentre observational study. Data were collected according to a template for uniform reporting of data from p-EMS using two different data collection methods; a standard and a focused data collection method. For the standard data collection, data were extracted retrospectively for one year from all FinnHEMS bases and for the focused data collection, data were collected prospectively for six weeks from four selected Norwegian p-EMS bases. Completeness rates for the two data collection methods were then compared and factors affecting completeness rates and template feasibility were evaluated. Standard Chi-Square, Fisher’s Exact Test and Mann-Whitney U Test were used for group comparison of categorical and continuous data, respectively, and Kolomogorov-Smirnov test for comparison of distributional properties. Results All missions with patient encounters were included, leaving 4437 Finnish and 128 Norwegian missions eligible for analysis. Variable completeness rates indicated that physiological variables were least documented. Information on pain and respiratory rate were the most frequently missing variables with a standard data collection method and systolic blood pressure was the most missing variable with a focused data collection method. Completeness rates were similar or higher when patients were considered severely ill or injured but were lower for missions with short patient encounter. When a focused data collection method was used, completeness rates were higher compared to a standard data collection method. Conclusions We found that a focused data collection method increased data capture compared to a standard data collection method. The concept of using a template for documentation of p-EMS data is feasible in physician-staffed services in Finland and Norway. The greatest deficiencies in completeness rates were evident for physiological parameters. Short missions were associated with lower completeness rates whereas severe illness or injury did not result in reduced data capture. Electronic supplementary material The online version of this article (10.1186/s12913-019-3976-6) contains supplementary material, which is available to authorized users.

Template for documenting and reporting data in physician-staffed pre-hospital services: a consensus-based update

“…Physiological variables are often reported to be the most often missing variables [38,39]. In the original template we found the feasibility of collecting physiological data to be good [16], and these variables were not substantially changed in the updated template. Thus, we expect feasibility to be good for physiological variables in the updated template as well.…”

“…Several consensus-based templates for reporting in EMS and p-EMS have been created (e.g., trauma, airway handling and cardiac arrest) [14,15,26,36], and studies have proven that data collection according to such templates are feasible [12,16,37]. However, to increase the relevance of templates, variables should be coordinated.…”

“…The p-EMS template has been incorporated for daily use in Finland, but it has not yet been implemented in other European countries. A recent study concluded that the published template is feasible for use in p-EMS and that a large amount of data may be captured, facilitating collaborative research [16]. However, the feasibility study revealed areas for improvement of the template.…”

Association between case volume and mortality in pre-hospital anaesthesia management: a retrospective observational cohort

“…Data are recorded according to international guidelines regarding physician-staffed EMS, HEMS, and pre-hospital advanced airway management. 18 , 19 , 20 The database contains additional variables not required by the guidelines, including timestamps, patient details, medications administered, and vital signs at various points. 16 The database contains unique patient identifiers, which can be used to acquire additional data from other national registries.…”

Bringing CT Scanners to the Skies: Design of a CT Scanner for an Air Mobile Stroke Unit

“…Helicopter emergency medical services (HEMS) were traditionally used for trauma transfers and have increased popularity for use in providing triage and transportation for stroke patients to the nearest medical facilities or interfacility transportations since the approval of perfusion treatment for stroke by the FDA [17,18].…”