Objective: Clinical handover between pre-hospital ambulance service and the ED is important for patient safety and quality care. This study assessed the availability and utility of the paramedic record to ED clinicians in their patient assessment.
Methods: The document transfer in 110 handovers between ambulance service and a tertiary metropolitan hospital ED was observed. Timestamps were recorded when the electronic paramedic record was printed, when it was placed in the hospital's paper-based patient medical record, when ED patient assessment occurred and it was noted if there was a verbal handover from paramedic to ED clinician. ED clinicians were surveyed about the availability and usefulness of the paramedic record.
Results: The paramedic record was printed prior to the patient being seen in only 49% of encounters and was available in the medical record at the time of initial clinical assessment in 32% of encounters. When available it was reviewed in over 90% of encounters. 87% of these reviews were reported as 'significantly' or 'somewhat useful'. The paramedic record could not be located at all in 21% of encounters. In 98% of encounters the treating ED clinician would have preferred the paramedic record to have been electronic. The ED system data was corrupt in 4% of encounters.
Conclusions: The information in the paramedic record was found to be useful to ED clinicians when it was available. Increasing the availability of the paramedic record for ED clinical assessment may be an opportunity to improve patient safety and flow.
Keywords: ambulance; electronic medical record; emergency department; handover; system integration.
© 2020 Australasian College for Emergency Medicine.