Needs for Appraisal of the Quality of Prehospital Patient's Care and for Reeducation

ABSTRACT

BACKGROUND: The prehospital emergency medical system(EMS) for 119 rescue has progressed considerably, but leaves much to be desired. To improve prehospital EMS, we need to evaluate prehospital patient care, and reeducation. METHODS: The records of 1,882 patients, who visited Sanggye Paik Hospital Emergency Department via 119 rescue from April 1 to July 30, 1999, were analyzed according to the quality of patient care as documented by the 119 rescue protocol and database. Patients are grouped into 5 classes based on the quality of the care received. Class 1A received adequate care, class 1B received inadequate care, class 1C did not receive the necessary care, and class 2A received unnecessary care, class 2B did not receive unnecessary care. The results of such analyses are presented to the fireman at monthly meetings, thus reeducating them. RESULT:S The overall RESULT:s were 1027 cases in Class 1A(55%), 83 in 1B(4%), 149 in 1C(8%), 21 in 2A(1%), and 602 in 2B(32%). Well performed care(1A+2B) occured in 1629 cases(87%) and badly performed care(1B+1C+2A) occured in 253 cases(13%). Well performed care gradually increased from April to July (April 83%, May 85%, June 87%, and July 89%). CONCLUSION: Meticulous appraisal of the quality of prehospital patient care and reeducation through the regular meetings of EMS physicians and firemen in each community is needed for developing a model protocol for indirect retrospective medical control of the prehospital EMS.