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The Effect of a Quality Improvement Program on Paramedic On‐scene Times for Patients with Penetrating Trauma
Author(s) -
Eckstein Marc,
Alo Kathy
Publication year - 1999
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.1999.tb00154.x
Subject(s) - medicine , penetrating trauma , medical emergency , quality management , emergency medicine , surgery , operations management , blunt , management system , economics
Objective: To decrease paramedic onscene times (OSTs) for major trauma patients through a focused quality improvement (QI) program. Methods: A prospective study was conducted from 1993 through 1997 to determine the impact of a QI program on paramedic OSTs. All penetrating trauma patients transported by paramedics to Los Angeles County/USC Medical Center, a Level‐1 trauma center, were included, and all cases with OSTs > 20 minutes were reviewed in detail for extenuating circumstances. Cases including multiple victims or unsecured scenes were considered “acceptable deviations.” All others were considered “fallouts,” which prompted extensive review with the paramedics and their field supervisors. Results: Prior to the inception of the QI project there was a 4.1% fallout rate of penetrating trauma patients with OSTs > 20 minutes. This fallout rate fell to 1.5% in 1997 (p < 0.01). Mortality rates among these fallouts decreased from 5.1% to 0.8% during the study period (p < 0.01). Conclusions: An intensive QI program can have a significant, positive impact on paramedic OSTs among patients with penetrating trauma.