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.
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
UR - http://www.scopus.com/inward/record.url?scp=0027686956&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027686956&partnerID=8YFLogxK
U2 - 10.1017/S1049023X00040541
DO - 10.1017/S1049023X00040541
M3 - Article
C2 - 10155471
AN - SCOPUS:0027686956
VL - 8
SP - 299
EP - 302
JO - Prehospital and Disaster Medicine
JF - Prehospital and Disaster Medicine
SN - 1049-023X
IS - 4
ER -