Title: 122 The Utility of Out-of-Hospital Patient Care Records for Emergency Physicians
Abstract: BackgroundOut-of-hospital care plays an essential role in the health care system. Through the emergency department (ED), the transfer of information from the out-of-hospital setting to the hospital environment is critical to the integration of care between these 2 distinct, yet crucially linked areas of the health care system. The out-of-hospital patient care record is the primary method of conveying vital information between these 2 settings. However, few studies have examined the frequency in which physicians utilize this important document.Study ObjectiveWe sought to determine the information that emergency physicians desire from the out-of-hospital scene, the frequency in which physicians look at the patient care report, and the reasons for the frequency at which they review the records.MethodsFifty emergency medicine attending physicians and ten senior emergency medicine residents were asked via electronic mail to voluntarily complete a 5-question survey using SurveyMonkey. Participants were members of the emergency department at a tertiary care teaching facility in a major metropolitan city. Participants were assured that their responses would be kept anonymous. This survey was exempt from institutional review board approval.ResultsA total of 42 individuals (70%) responded to the survey (37 attending physicians and 5 resident physicians). Vital signs (95.2%), out-of-hospital course (90.5%), chief complaint (85.7%), and history of present illness (73.8%) were selected as the top 4 categories of information sought from the out-of-hospital scene. The bottom 3 categories were medical/surgical history and medications (tied at 54.8%) and allergies (45.2%). None of the physicians reviewed the patient care report all of the time. Only 7.1% of respondents reviewed the patient care report most of the time. A vast majority of the physicians examined the patient care report some of the time (45.2%), rarely (42.9%), or never (4.8%) (Figure 1). The most common reasons selected for not reviewing the patient care report on a regular basis was because the patient care report is not usually available in a timely manner (94.6%) followed by physicians usually hearing a verbal report of the patient's out-of-hospital course before the patient care report is available (48.6%). Other reasons for not regularly reviewing the patient care report is that it is disorganized (13.5%), that it does not contain any information that the physician cannot obtain from the patient (10.8%), and that the information contained in the patient care report would not alter the physician's clinical management of the patient (8.1%).ConclusionThis study revealed that the physicians surveyed do not regularly examine the patient care report because it is not readily available. A more focused patient care report could increase the likelihood that physicians would review it. Further research is necessary to determine the specific barriers to the immediate availability of the patient care report, which could lead to improved efficiency in the ED and the entire health care system. BackgroundOut-of-hospital care plays an essential role in the health care system. Through the emergency department (ED), the transfer of information from the out-of-hospital setting to the hospital environment is critical to the integration of care between these 2 distinct, yet crucially linked areas of the health care system. The out-of-hospital patient care record is the primary method of conveying vital information between these 2 settings. However, few studies have examined the frequency in which physicians utilize this important document. Out-of-hospital care plays an essential role in the health care system. Through the emergency department (ED), the transfer of information from the out-of-hospital setting to the hospital environment is critical to the integration of care between these 2 distinct, yet crucially linked areas of the health care system. The out-of-hospital patient care record is the primary method of conveying vital information between these 2 settings. However, few studies have examined the frequency in which physicians utilize this important document. Study ObjectiveWe sought to determine the information that emergency physicians desire from the out-of-hospital scene, the frequency in which physicians look at the patient care report, and the reasons for the frequency at which they review the records. We sought to determine the information that emergency physicians desire from the out-of-hospital scene, the frequency in which physicians look at the patient care report, and the reasons for the frequency at which they review the records. MethodsFifty emergency medicine attending physicians and ten senior emergency medicine residents were asked via electronic mail to voluntarily complete a 5-question survey using SurveyMonkey. Participants were members of the emergency department at a tertiary care teaching facility in a major metropolitan city. Participants were assured that their responses would be kept anonymous. This survey was exempt from institutional review board approval. Fifty emergency medicine attending physicians and ten senior emergency medicine residents were asked via electronic mail to voluntarily complete a 5-question survey using SurveyMonkey. Participants were members of the emergency department at a tertiary care teaching facility in a major metropolitan city. Participants were assured that their responses would be kept anonymous. This survey was exempt from institutional review board approval. ResultsA total of 42 individuals (70%) responded to the survey (37 attending physicians and 5 resident physicians). Vital signs (95.2%), out-of-hospital course (90.5%), chief complaint (85.7%), and history of present illness (73.8%) were selected as the top 4 categories of information sought from the out-of-hospital scene. The bottom 3 categories were medical/surgical history and medications (tied at 54.8%) and allergies (45.2%). None of the physicians reviewed the patient care report all of the time. Only 7.1% of respondents reviewed the patient care report most of the time. A vast majority of the physicians examined the patient care report some of the time (45.2%), rarely (42.9%), or never (4.8%) (Figure 1). The most common reasons selected for not reviewing the patient care report on a regular basis was because the patient care report is not usually available in a timely manner (94.6%) followed by physicians usually hearing a verbal report of the patient's out-of-hospital course before the patient care report is available (48.6%). Other reasons for not regularly reviewing the patient care report is that it is disorganized (13.5%), that it does not contain any information that the physician cannot obtain from the patient (10.8%), and that the information contained in the patient care report would not alter the physician's clinical management of the patient (8.1%). A total of 42 individuals (70%) responded to the survey (37 attending physicians and 5 resident physicians). Vital signs (95.2%), out-of-hospital course (90.5%), chief complaint (85.7%), and history of present illness (73.8%) were selected as the top 4 categories of information sought from the out-of-hospital scene. The bottom 3 categories were medical/surgical history and medications (tied at 54.8%) and allergies (45.2%). None of the physicians reviewed the patient care report all of the time. Only 7.1% of respondents reviewed the patient care report most of the time. A vast majority of the physicians examined the patient care report some of the time (45.2%), rarely (42.9%), or never (4.8%) (Figure 1). The most common reasons selected for not reviewing the patient care report on a regular basis was because the patient care report is not usually available in a timely manner (94.6%) followed by physicians usually hearing a verbal report of the patient's out-of-hospital course before the patient care report is available (48.6%). Other reasons for not regularly reviewing the patient care report is that it is disorganized (13.5%), that it does not contain any information that the physician cannot obtain from the patient (10.8%), and that the information contained in the patient care report would not alter the physician's clinical management of the patient (8.1%). ConclusionThis study revealed that the physicians surveyed do not regularly examine the patient care report because it is not readily available. A more focused patient care report could increase the likelihood that physicians would review it. Further research is necessary to determine the specific barriers to the immediate availability of the patient care report, which could lead to improved efficiency in the ED and the entire health care system. This study revealed that the physicians surveyed do not regularly examine the patient care report because it is not readily available. A more focused patient care report could increase the likelihood that physicians would review it. Further research is necessary to determine the specific barriers to the immediate availability of the patient care report, which could lead to improved efficiency in the ED and the entire health care system.