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Ruebsam ML, Orsson D, Metelmann B, Orsson J, Hahnenkamp K, Metelmann C. Cross-border simulation training for German and Polish emergency medical teams is feasible: conception and evaluation of a bilingual simulation training. BMC MEDICAL EDUCATION 2023; 23:863. [PMID: 37957612 PMCID: PMC10644418 DOI: 10.1186/s12909-023-04823-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Cross-border cooperation of emergency medical services, institutions and hospitals helps to reduce negative impact of national borders and consecutive discrimination of persons living and working in border regions. This study aims to explore the feasibility and effectiveness of a cross-border bilingual simulation training for emergency medical services within an INTERREG-VA-funded project. METHODS Five days of simulation training for German and Polish paramedics in mixed groups were planned. Effectiveness of training and main learning objectives were evaluated as pre-post-comparisons and self-assessment by participants. RESULTS Due to COVID-19 pandemic, only three of nine training modules with n = 16 participants could be realised. Cross-border-simulation training was ranked more positively and was perceived as more useful after the training compared to pretraining. Primary survey has been performed using ABCDE scheme in 18 of 21 scenarios, whereas schemes to obtain medical history have been applied incompletely. However, participants stated to be able to communicate with patients and relatives in 10 of 21 scenarios. CONCLUSION This study demonstrates feasibility of a bilingual cross-border simulation training for German and Polish rescue teams. Further research is highly needed to evaluate communication processes and intra-team interaction during bilingual simulation training and in cross-border emergency medical services rescue operations.
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Affiliation(s)
- Marie-Luise Ruebsam
- Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, University Medicine of Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
| | - Dorota Orsson
- Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, University Medicine of Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Bibiana Metelmann
- Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, University Medicine of Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Jakub Orsson
- Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, University Medicine of Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Klaus Hahnenkamp
- Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, University Medicine of Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Camilla Metelmann
- Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, University Medicine of Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
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Ruebsam ML, Metelmann B, Hofmann C, Orsson D, Hahnenkamp K, Metelmann C. Bilingual resuscitation training does not affect adherence to resuscitation guidelines but reduces leadership skills and overall team performance. An observational study with cross-border German-Polish training. Resusc Plus 2023; 15:100436. [PMID: 37601413 PMCID: PMC10436166 DOI: 10.1016/j.resplu.2023.100436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Aim of study This study aims to investigate feasibility and quality of a bilingual cardiopulmonary resuscitation training with interprofessional emergency teams from Germany and Poland. Methods As part of a cross-border European Territorial Cooperation (Interreg-VA) funded project a combined communication and simulation training was organised. Teams of German and Polish emergency medicine personnel jointly practised resuscitation. The course was held in both languages with consecutive translation.Quality of chest compression was assessed using a simulator with feedback application. Learning objectives (quality of cardiopulmonary resuscitation, adherence to guidelines, closed loop communication), and team performance were assessed by an external observer. Coopeŕs Team Emergency Assessment Measure questionnaire was used. Results Twenty-one scenarios with 17 participants were analysed. In all scenarios, defibrillation and medication were delivered with correct dosage and at the right time. Mean fraction of correct hand position was 85.7% ± 25.7 [95%-CI 74.0; 97.4], mean fraction of compression depth 75.1% ± 21.0 [95%-CI 65.6; 84.7], compression rate 117.7 min-1 ± 7.1 [95%-CI 114.4; 120.9], and chest compression fraction 83.3% ± 3.8 [95%-CI 81.6; 85.0].Quality of cardiopulmonary resuscitation was rated as "fair" to "good", adherence to guidelines as "good", and closed loop communication as "fair". Bilingual teams demonstrated good situational awareness, but lack of leadership and suboptimal overall team performance. Conclusion Bilingual and interprofessional cross-border resuscitation training in German and Polish tandem teams is feasible. It does not affect quality of technical skills such as high-quality chest compression but does affect performance of non-technical skills (e.g. closed loop communication and leadership).
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Affiliation(s)
- Marie-Luise Ruebsam
- University Medicine of Greifswald, Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Bibiana Metelmann
- University Medicine of Greifswald, Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Christian Hofmann
- University Medicine of Greifswald, Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Dorota Orsson
- University Medicine of Greifswald, Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Klaus Hahnenkamp
- University Medicine of Greifswald, Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Camilla Metelmann
- University Medicine of Greifswald, Department of Anaesthesia, Intensive Care, Emergency and Pain Medicine, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
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Hayden EM, Davis C, Clark S, Joshi AU, Krupinski EA, Naik N, Ward MJ, Zachrison KS, Olsen E, Chang BP, Burner E, Yadav K, Greenwald PW, Chandra S. Telehealth in emergency medicine: A consensus conference to map the intersection of telehealth and emergency medicine. Acad Emerg Med 2021; 28:1452-1474. [PMID: 34245649 PMCID: PMC11150898 DOI: 10.1111/acem.14330] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/18/2021] [Accepted: 06/23/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Telehealth has the potential to significantly change the specialty of emergency medicine (EM) and has rapidly expanded in EM during the COVID pandemic; however, it is unclear how EM should intersect with telehealth. The field lacks a unified research agenda with priorities for scientific questions on telehealth in EM. METHODS Through the 2020 Society for Academic Emergency Medicine's annual consensus conference, experts in EM and telehealth created a research agenda for the topic. The multiyear process used a modified Delphi technique to develop research questions related to telehealth in EM. Research questions were excluded from the final research agenda if they did not meet a threshold of at least 80% of votes indicating "important" or "very important." RESULTS Round 1 of voting included 94 research questions, expanded to 103 questions in round 2 and refined to 36 questions for the final vote. Consensus occurred with a final set of 24 important research questions spanning five breakout group topics. Each breakout group domain was represented in the final set of questions. Examples of the questions include: "Among underserved populations, what are mechanisms by which disparities in emergency care delivery may be exacerbated or ameliorated by telehealth" (health care access) and "In what situations should the quality and safety of telehealth be compared to in-person care and in what situations should it be compared to no care" (quality and safety). CONCLUSION The primary finding from the process was the breadth of gaps in the evidence for telehealth in EM and telehealth in general. Our consensus process identified priority research questions for the use of and evaluation of telehealth in EM to fill the current knowledge gaps. Support should be provided to answer the research questions to guide the evidenced-based development of telehealth in EM.
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Affiliation(s)
- Emily M Hayden
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Christopher Davis
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Sunday Clark
- Department of Emergency Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Aditi U Joshi
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Neel Naik
- Department of Emergency Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Michael J Ward
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kori S Zachrison
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Erica Olsen
- Department of Emergency Medicine, Columbia University, College of Physicians and Surgeons, New York, NY, USA
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University, College of Physicians and Surgeons, New York, NY, USA
| | - Elizabeth Burner
- Department of Emergency Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Kabir Yadav
- Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Peter W Greenwald
- Department of Emergency Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Shruti Chandra
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA, USA
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Conway RBN, Armistead MG, Denney MJ, Smith GS. Validating the Matching of Patients in the Linkage of a Large Hospital System's EHR with State and National Death Databases. Appl Clin Inform 2021; 12:82-89. [PMID: 33567463 PMCID: PMC7875675 DOI: 10.1055/s-0040-1722220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background
Though electronic health record (EHR) data have been linked to national and state death registries, such linkages have rarely been validated for an entire hospital system's EHR.
Objectives
The aim of the study is to validate West Virginia University Medicine's (WVU Medicine) linkage of its EHR to three external death registries: the Social Security Death Masterfile (SSDMF), the national death index (NDI), the West Virginia Department of Health and Human Resources (DHHR).
Methods
Probabilistic matching was used to link patients to NDI and deterministic matching for the SSDMF and DHHR vital statistics records (WVDMF). In subanalysis, we used deaths recorded in Epic (
n
= 30,217) to further validate a subset of deaths captured by the SSDMF, NDI, and WVDMF.
Results
Of the deaths captured by the SSDMF, 59.8 and 68.5% were captured by NDI and WVDMF, respectively; for deaths captured by NDI this co-capture rate was 80 and 78%, respectively, for the SSDMF and WVDMF. Kappa statistics were strongest for NDI and WVDMF (61.2%) and NDI and SSDMF (60.6%) and weakest for SSDMF and WVDMF (27.9%). Of deaths recorded in Epic, 84.3, 85.5, and 84.4% were captured by SSDMF, NDI, and WVDMF, respectively. Less than 2% of patients' deaths recorded in Epic were not found in any of the death registries. Finally, approximately 0.2% of “decedents” in any death registry re-emerged in Epic at least 6 months after their death date, a very small percentage and thus further validating the linkages.
Conclusion
NDI had greatest validity in capturing deaths in our EHR. As a similar, though slightly less capture and agreement rate in identifying deaths is observed for SSDMF and state vital statistics records, these registries may be reasonable alternatives to NDI for research and quality assurance studies utilizing entire EHRs from large hospital systems. Investigators should also be aware that there will be a very tiny fraction of “dead” patients re-emerging in the EHR.
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Affiliation(s)
- Rebecca B N Conway
- Department of Community Health, University of Texas Health Science Center at Tyler, Tyler, Texas, United States
| | - Matthew G Armistead
- Department of Biomedical Informatics, West Virginia Clinical and Translational Science Institute, Morgantown, West Virginia, United States
| | - Michael J Denney
- Department of Biomedical Informatics, West Virginia Clinical and Translational Science Institute, Morgantown, West Virginia, United States
| | - Gordon S Smith
- Department of Epidemiology, West Virginia University, Morgantown, West Virginia, United States
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