Do paramedics find it beneficial to learn the diagnosis given to their patients in the emergency department?

BACKGROUND: Traditionally, paramedics do not learn the diagnosis of a patient once handed over at the Emergency Department (ED). In this pilot study, a system of feedback from the ED was provided to a group of paramedics using secure email. The diagnosis given in ED and discharge destination of their patients was provided in an anonymised format.

METHODS: After receiving the feedback for eight weeks a questionnaire was distributed electronically to participating paramedics. The survey aimed to establish the perceived usefulness of the feedback by asking a series of questions with dichotomous response options. The facility to elaborate on some responses was also provided.

RESULTS: A 76% response rate was achieved with 19 of the 25 clinicians who received the feedback report returning the survey. Of those who responded 90% (n=17) indicated that it prompted them to reflect clinically, with 65% (n=11) noting that this included further reading. Some said the reading included key texts and guidelines to refresh knowledge, while others read around a specific subject to broaden their knowledge. 68% (n=13) indicated that the feedback had prompted clinical discussion with colleagues. A key question asked respondents if the ED diagnosis differed from their pre-hospital clinical impression, 63% (n=12) noted that there was a difference. Unanimously respondents thought receiving the feedback reports would help improve their skill in diagnosis and wanted to continue receiving them.

LIMITING FACTORS: This was a convenience sample of small size. Receiving feedback on the diagnosis given in ED is a novel experience for paramedics.

CONCLUSIONS: Receiving this feedback enables paramedics to audit the quality of their work. They find this beneficial and there is the potential to improve skill in diagnosis. Further studies in this area are suggested.