The use of information and communication technology between emergency medical teams in emergency situations: A systematic review (original) (raw)
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Information Technology and Emergency Medical Care during Disasters
Academic Emergency Medicine, 2004
Disaster response to mass-casualty incidents represents one of the greatest challenges to a community's emergency response system. Rescuers, field medical personnel, and regional emergency departments and hospitals must often provide care to large numbers of casualties in a setting of limited resources, inadequate communication, misinformation, damaged infrastructure, and great personal risk. Emergency care providers and incident managers attempt to procure and coordinate resources and personnel, often with inaccurate data regarding the true nature of the incident, needs, and ongoing response. In this chaotic environment, new technologies in communications, the Internet, computer miniaturization, and advanced ''smart devices'' have the potential to vastly improve the emergency medical response to such mass-casualty incident disasters. In particular, next-generation wireless Internet and geopositioning technologies may have the greatest impact on improving communications, information management, and overall disaster response and emergency medical care. These technologies have applications in terms of enhancing mass-casualty field care, provider safety, field incident command, resource management, informatics support, and regional emergency department and hospital care of disaster victims.
Communication technology in trauma centers: A national survey
The Journal of Emergency Medicine, 2006
e Abstract-The relationship between information and communication technology (ICT) and trauma work coordination has long been recognized. The purpose of the study was to investigate the type and frequency of use of various ICTs to activate and organize trauma teams in level I/II trauma centers. In a cross-sectional survey, questionnaires were mailed to trauma directors and clinicians in 457 trauma centers in the United States. Responses were received from 254 directors and 767 clinicians. Communication with pre-hospital care providers was conducted predominantly via shortwave radio (67.3%). The primary communication methods used to reach trauma surgeons were manual (56.7%) and computerized group page (36.6%). Computerized group page (53.7%) and regular telephone (49.8%) were cited as the most advantageous devices; e-mail (52.3%) and dry erase whiteboard (52.1%) were selected as the least advantageous. Attending surgeons preferred less overhead paging and more cellular phone communication than did emergency medicine physicians and nurses. Cellular phones have become an important part of hospital-field communication. In high-volume trauma centers, there is a need for more accurate methods of communicating with field personnel and among hospital care providers.
The usefulness of information and communication technologies in crisis response
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2008
Information and communication technologies (ICTs) play a vital role in coordinating crisis response between pre-hospital services and emergency departments of hospitals. In spite of the advances in these technologies, there remain a variety of challenges to their usage during a crisis. To identify these challenges, we conducted focus group interviews with emergency department (ED) and emergency medical services (EMS) personnel. We found that ED and EMS personnel have widely varying perceptions about the usefulness and ease-of-use of information tools and communication tools used in crisis management. We discuss the importance of bringing together communication and information tools into integrated networks of ICTs for effective crisis response. We also highlight design features of ICTs which can support seamless and effective communication and coordination between ED and EMS teams.
Research Square (Research Square), 2022
There is a lack of knowledge regarding communication and information exchange between the emergency medical teams (EMTs) during emergencies, particularly in the Riyadh region of the Kingdom of Saudi Arabia (KSA). The aim of this study is to explore EMTs' experiences of communication and information exchange during di cult emergency situations in the city of Riyadh. A qualitative exploratory study was undertaken to explore the experiences of 62 respondents from the Saudi Red Crescent Authority (SRCA) and emergency departments (EDs): a total of 18 were SRCA staff (three call takers, four dispatchers, three eld supervisors and eight paramedics), and a total of 44 from hospital EDs, comprising 19 ED nurse managers, 12 ED physician consultants and 13 ED paramedics. Semi-structured interviews were held with the participants, who all had the experience of responding to emergencies and had the authority to communicate with one another. The interviews were tape-recorded and transcribed verbatim and the transcripts were analysed using Braun and Clarke's thematic analysis [1]. NVIVO 11 was used to aid data management. Three themes were identi ed comprising central factors that in uence coordination and communication between the participants. These themes were (1) the emotional impact on SRCA staff performance, (2) the effectiveness of the emergency response, and (3) perceptions of emergencies preparation. The rst theme highlighted important factors related to emotional and well-being, which impact the performance of the SRCA operation centre staff and have an impact on the information shared with other relevant staff. In the second theme, issues that emerged that related to the effectiveness of the emergency response, coordination and communication between the EMTs were highlighted to be limited in effectiveness. Although several communication systems were used, some of them were not formally sanctioned and some were technical issues related to the systems used. The third theme explored participants' perceptions of emergencies preparation, and again the ndings demonstrated limited evidence of disaster management training or preparation particularly between EMTs. The training in communication among EMTs staff in preparing for disasters was similarly found to have de cits and could be improved. Finally, the ndings from this study demonstrated that the level of debrie ng that was put in place following an incident could be substantially improved. Communication between EMTs not only involves the use of advanced technology but also requires improvements in coordinated communication within and between EMTs in relation to an effective response to emergencies and disasters. This could be achieved if the directors, managers and policymakers appreciated more fully the importance of the factors to be considered in relation to the effective use of ICT, the adverse impact of the ineffective use of communications systems, and how the coordination of services could be improved during emergency situations. Road tra c incidents (RTIs) account for 4.7 per cent of all fatalities in the KSA [5]. According to Al-Wathinani et al., (2021) the KSA has one of the highest rates of RTI mortality and morbidity in the world. Riyadh has witnessed terrorist incidents and riots in past years which have resulted in large-scale deaths and injuries. According to Alamri, (2010), in 2003, three residential compounds in Riyadh were targeted by terrorists, killing 40 people and seriously injuring over 160. In the following year, another residential compound was targeted, causing 17 deaths and 122 injuries [6] and in 2003 the Ministry of the Interior was subject to an attack that left ve dead and 145 injured including a number of police o cers [7]. Other forms of human activity have caused unintentional death and injury. In 2012, a fuel-truck accident caused 23 deaths and 139 injuries (Reuters, 2012). In 2013, riots by illegal immigrants from Ethiopia resulted in a number of deaths and injuries [9]. Riyadh experiences severe annual climate events such as oods and sandstorms which affect patients who suffer from acute reactive lung diseases such as asthma (Alangari et al., 2015). As a result, the number of patients seeking care in the ED increases during these adverse weather events and can sometimes lead to death [11]. In the event of an emergency, victims are treated by EMTs, which includes two organizations: EMS and ED personnel [12]. A growing body of literature has recognized the importance of patient information being up-todate, accurate and communicated e ciently between EMTs following emergency situations and during the transportation of the injured to hospital [13]. Ineffective communication between EMS and hospital staff during emergencies, according to numerous studies (Rowlands, 2003; Pun et al., 2015; Meisel et al., 2015), could result in extra di culties such as the risk of medical errors, which can result in more injuries or deaths. If communication between EMS and ED workers fails during an incident, critical information may be altered, lost or otherwise unavailable to emergency physicians or advanced practice providers (Martin et al.,2018) Studies have been already conducted to assess the effectiveness of information sharing in busy environments such as an ED, particularly during the handover between EMS and EDs, and have concluded that challenges exist [18-20]. Evans et al.,(2010) found that some information, such as patient demographics, allergy status and mechanism of injury, was not documented by trauma team members or paramedics, and that information was frequently lost during handovers. A quantitative study conducted by Kalyani et al., (2017) discovered that communication and information sharing between EMS and ED staff was regarded as a problem. That study showed that factors such as overcrowding in the ED, distractions and a lack of effective listening during face-toface handovers all have an effect on the quality of clinical handover and can result in the loss of critical patient information [20]. According to Bost et al., (2010), communication and information loss during patient handover can cause paramedics to have to remain in the ED longer than necessary, impacting upon them being able to conduct their primary role of protecting patients. Effective communication between EMS and ED personnel during and after emergency situations can signi cantly reduce fatalities in the rst 24 hours [21]. Martin et al., (2018) indicated that ICTs could help to improve communication and collaboration and facilitate the transition between EMS and ED personnel, as well as help to assess their needs and ensure that adequate resources are available. The use of advanced communication systems, according to Beul, et al., (2010), can facilitate the transmission of patient data to receiving hospitals. As a result, it is necessary to consider the use of ICTs by various emergency organizations in terms of how systems can most effectively support information exchange and coordination between EMTs under time constraints (Abbas, Norris, Parry, 2018). ICT used in healthcare systems during emergency situations Page 4/50 There are numerous examples of information-sharing systems used by EMTs during emergencies and disasters. The use of mobile phones and landlines enables medical staff to access updated data and disseminate information in life-threatening situations [24], as does the use of a two-way transmitter and receiver such as the Terrestrial Trunked Radio (TETRA) (Protogerakis et al., 2011;Kunavut, 2014). TETRA enables effective and safe wireless communication for all authorities involved in emergency communications, such as ambulance, police, re and rescue services [27]. The use of computer-based systems has brought about signi cant change and plays a critical role in the operation of healthcare systems because of the ability to transfer and store considerable amounts of data and monitor transactions in real-time through software systems (Ferreira, 2011; Fragkiadakis et al., 2011). Electronic health records accessible by hospital staff provide an example of communication-based systems. Vos et al., (2020), stated that electronic health records facilitate coordination, cooperation and joint decision-making. These resources have enabled real-time sharing of integrated patient information between HCPs, enabling the provision of high-value care [31]. In the EMS, Staff in the emergency communication centre use software called computer-aided dispatch (CAD) to determine the location of an incident through a global positioning system (GPS), record the status of a patient or injured person, and triage casualties effectively ([32, 33]. The role of EMTs and the emergency noti cation process in the KSA Emergencies responses are not limited just to the use of ICT; each medical team has a role to play to respond more effectively. Effective emergency management, from a healthcare perspective, requires collaboration between EMS and ED with the primary goal of saving lives during and following an emergency [34, 35]. In addition, EMS responders are the rst HCPs on the scene following an event [36]. When EMS workers transfer patients to receiving hospitals, the EMS is responsible for patient care until the patients arrive at the hospital's ED. Thus, the EMS is an essential component of health care since it is instrumental in saving lives and reducing mortality and morbidity rates (Aringhieri et al., 2017). In healthcare systems, noti cation processes begin with emergency control room staff such as call-takers and medical dispatchers, whose job is to receive and distribute information to the appropriate personnel (Clawson, and Dernocoeur, 2014).Call-takers are tasked with the responsibility for gathering critical information about patients' condition and location from callers and then entering it into a CAD system, and then emergency medical dispatchers classify the reported...
Communication in emergency medical teams
2009
The focus of most clinical communication research and training has for many years been on the clinician-patient relationship (1). Only recently has the focus begun to shift to recognize the crucial role of communication within and between clinical teams and organizations for effective organizational performance and safe clinical practice.
Information and Communication Technology (ICT) for Emergency Services
International Journal of E-Politics, 2013
While most would suggest that more effective use of ICT bodes well for emergency services, there are issues associated with the introduction of such use. To explore these issues in Texas, the authors administered a survey of Texas Emergency Services Districts (ESDs). These districts are charged with delivery of emergency and medical services throughout the state and receive modest tax revenue to fund operations. The results show that in Texas ESDs political and organizational factors are important. Budgets are closely related to the political process in the ESDs, so politics plays a central role. Organizational culture and prevailing sentiments in Texas ESDs are generally supportive of ICT adoption and use. While ICT is seen as essential to service delivery, survey results show that problems of interoperability of communication systems is an issue. The most commonly used ICTs include email, GPS, Google Maps, standard web pages, Wi-Fi networks, smart phones, reverse 911, emergency al...
2012
Study objective: We identify and describe emergency physicians' and nurses' perceptions of the effect of an integrated emergency department (ED) information system on the quality of care delivered in the ED. Methods: A qualitative study was conducted in 4 urban EDs, with each site using the same ED information system. Participants (nϭ97) were physicians and nurses with data collected by 69 detailed interviews, 5 focus groups (28 participants), and 26 hours of structured observations. Results: Results revealed new perspectives on how an integrated ED information system was perceived to affect incentives for use, awareness of colleagues' activities, and workflow. A key incentive was related to the positive effect of the ED information system on clinical decisionmaking because of improved and quicker access to patient-specific and knowledge-base information compared with the previous stand-alone ED information system. Synchronous access to patient data was perceived to lead to enhanced awareness by individual physicians and nurses of what others were doing within and outside the ED, which participants claimed contributed to improved care coordination, communication, clinical documentation, and the consultation process. There was difficulty incorporating the use of the ED information system with clinicians' work, particularly in relation to increased task complexity; duplicate documentation, and computer issues related to system usability, hardware, and individuals' computer skills and knowledge. Conclusion: Physicians and nurses perceived that the integrated ED information system contributed to improvements in the delivery of patient care, enabling faster and better-informed decisionmaking and specialty consultations. The challenge of electronic clinical documentation and balancing data entry demands with system benefits necessitates that new methods of data capture, suited to busy clinical environments, be developed.
Trauma, Teams, and Telemedicine: Evaluating Telemedicine and Teamwork in a Mass Casualty Simulation
Military Medicine, 2021
Introduction Mass casualty events (MASCAL) are on the rise globally. Although natural disasters are often unavoidable, the preparation to respond to unique patient demands in MASCAL can be improved. Utilizing telemedicine can allow for a better response to such disasters by providing access to a virtual team member with necessary specialized expertise. The purpose of this study was to examine the positive and/or negative impacts of telemedicine on teamwork in teams responding to MASCAL events. Methods We introduced a telemedical device (DiMobile Care) to Forward Surgical Teams during a MASCAL simulated training event. We assessed teamwork-related attitudes, behaviors, and cognitions during the MASCAL scenario through pre-post surveys and observations of use. Analyses compare users and nonusers of telemedicine and pre-post training differences in teamwork. Results We received 50 complete responses to our surveys. Overall, clinicians have positive reactions toward the potential benefi...