TY - JOUR
T1 - Physician in-field observation of prehospital advanced life support personnel
T2 - A statewide evaluation
AU - Spaite, Daniel W.
AU - Valenzuela, Terence D.
AU - Meislin, Harvey W.
N1 - Funding Information:
Arizona Emergency Medicine Research Center, College of Medicine, University of Arizona, Tucson, Ariz. Presented to the Eighth Annual Meeting of the National Association of EMS Physicians, 20June 1992, Pittsburgh, Pennsylvania Supported by a Grant from the Arizona Department of Health Services Correspondence: Daniel W. Spaite, MD, 1501 N. Campbell Ave., Tucson, AZ 85724 USA
PY - 1993/12
Y1 - 1993/12
N2 - Study Hypothesis: Direct physician observation of advanced life support (ALS) personnel is rare in a demographically diverse state. Study Population: Twenty ALS agencies from throughout Arizona. Methods: A board-certified emergency physician performed on-site interviews with the emergency medical services (EMS) supervisor of each agency to approximate the number of days per year that physicians observe ALS personnel in the field. Results: Only 11 agencies (55%) reported that physicians ever observed ALS personnel. Among all agencies, an estimated total of 84 observer-days occurred per year. The agencies staffed a total of 86 ALS units, resulting in an estimated 0.98 observer-days/unit/year (84/86). On the average, it took 3.4 ALS personnel to staff a given unit over time and the probability that an ALS provider would be on a unit on any given day was 0.29 (1/3.4). The probability of a given provider being observed during one year was approximately 0.29 (0.98 x 0.29). Thus, on the average, an ALS provider would be observed by a physician approximately once every 3.5 years (1/0.29). Among urban agencies, the “average” ALS provider would be observed once every 2.9 years. This compared to a likelihood of in-field observation of only once every 6.7 years for non-urban providers (p =.036). Conclusions: The skills of ALS providers in Arizona are observed by a physician in the field very infrequently. Although an uncommon occurrence in urban agencies, observation of non-urban ALS personnel occurs even less frequently. In addition, nearly one-half of the agencies surveyed never had a physician-observer. Although a variety of skills evaluation methods exist, it remains unclear whether any method is as useful as direct observation. Future investigations are needed to evaluate whether in-field physician observation impacts skills, patient care, or outcome in EMS systems. Prehospital and Disaster Medicine, 1993:8(4):299-302.
AB - Study Hypothesis: Direct physician observation of advanced life support (ALS) personnel is rare in a demographically diverse state. Study Population: Twenty ALS agencies from throughout Arizona. Methods: A board-certified emergency physician performed on-site interviews with the emergency medical services (EMS) supervisor of each agency to approximate the number of days per year that physicians observe ALS personnel in the field. Results: Only 11 agencies (55%) reported that physicians ever observed ALS personnel. Among all agencies, an estimated total of 84 observer-days occurred per year. The agencies staffed a total of 86 ALS units, resulting in an estimated 0.98 observer-days/unit/year (84/86). On the average, it took 3.4 ALS personnel to staff a given unit over time and the probability that an ALS provider would be on a unit on any given day was 0.29 (1/3.4). The probability of a given provider being observed during one year was approximately 0.29 (0.98 x 0.29). Thus, on the average, an ALS provider would be observed by a physician approximately once every 3.5 years (1/0.29). Among urban agencies, the “average” ALS provider would be observed once every 2.9 years. This compared to a likelihood of in-field observation of only once every 6.7 years for non-urban providers (p =.036). Conclusions: The skills of ALS providers in Arizona are observed by a physician in the field very infrequently. Although an uncommon occurrence in urban agencies, observation of non-urban ALS personnel occurs even less frequently. In addition, nearly one-half of the agencies surveyed never had a physician-observer. Although a variety of skills evaluation methods exist, it remains unclear whether any method is as useful as direct observation. Future investigations are needed to evaluate whether in-field physician observation impacts skills, patient care, or outcome in EMS systems. Prehospital and Disaster Medicine, 1993:8(4):299-302.
KW - EMS
KW - EMS systems
KW - advanced life support
KW - non-urban
KW - performance evaluation
KW - physician
KW - physician-observer
KW - urban
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U2 - 10.1017/S1049023X00040541
DO - 10.1017/S1049023X00040541
M3 - Article
C2 - 10155471
AN - SCOPUS:0027686956
SN - 1049-023X
VL - 8
SP - 299
EP - 302
JO - Prehospital and Disaster Medicine
JF - Prehospital and Disaster Medicine
IS - 4
ER -