Professional Development in Emergency Medical Services

KU Leuven

Overview

The ProDEms-trial focuses on nurses and ambulance drivers working in prehospital care, taking care on the one hand of patients suffering from time-sensitive critical conditions like STEMI, acute stroke or severe traumatic brain injury, and on the other hand of patients whose lives are not in immediate danger but suffer from acute exacerbation of chronic conditions or suffer from acute pain. In the current study the investigators will use a multistage approach to test the hypothesis whether the use of a CDSS in prehospital emergency care will: 1. Improve protocol adherence, 2. Reduce emergency department length of stay, 3. Improves diagnostic accuracy; without impeding the workflow of the prehospital team or impairing patient safety.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Conditions

Clinical Decision Support Clinical Practice Guidelines Emergency Medical Services

Interventions

Clinical Decision Support Tool for Prehospital CarePROCEDURE

A clinical decision support system (CDSS) is a health information technology system that is designed to assist physicians and other health professionals with clinical decision-making tasks. A working definition of the Centre for Health Evidence: "Clinical Decision Support systems link health observations with health knowledge to influence health choices by clinicians for improved health care".

Eligibility

Sex: ALLMin age: 1 YearMax age: 112 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients who receive treatment from the Paramedic Intervention Team (PIT) in the prehospital Emergency Medical Services (EMS) area of the University Hospitals, Leuven. Exclusion Criteria: * Patient-related interventions not dispatched by the Emergency Medical Dispatch center (EMD) * Patient related interventions during transport between two healthcare facilities or in mass casualty situations.

Locations (1)

Academic Center for General Practice

Leuven, Vlaams-Brabant, Belgium

Outcomes

Primary Outcomes

Treatment protocol adherence

Measured by comparing the prescribed actions to be taken following the selected standing order (-s) or procedures, with the actual action (-s) taken.

Time frame: Up to 12 months

Secondary Outcomes

Length of Stay in the ED

Measured as the duration between the times the patient is assigned with a unique EAD number in the emergency department and the disposition decision is marked in the Electronic Patient Record (EPR), indicating that the patient is ready to be discharged from the ED.

Time frame: Up to 12 months

Prehospital Patient Time Interval

Measured as the duration between the arrival time at the scene and and arrival time at the ED.

Time frame: Up to 12 months

Consistency in reported diagnose and the choice of PIT standing order (-s) or procedure (-s)

Measured by comparing the selected standing order (-s) or protocol (-s) and the reported diagnose (-s).

Time frame: Up to 12 months

Alignment between diagnostic accuracy and interventions taken.

Measures by comparing the use of available scales and the corresponding prescribed action (-s) to be taken following the standing orders.

Time frame: Up to 12 months

Data from ClinicalTrials.gov

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