The Role of Direct Physician Engagement in EMS Transport Refusal Rates: A Prospective Study
Wake Forest University Health Sciences
Summary
The primary goal of this study is to find out if patients who speak with an EMS physician over the phone are less likely to refuse care compare to patients who do not speak with an EMS physician.
Description
This study aims to assess the impact of direct physician communication on patients' decisions to refuse EMS transport. The research approach is designed to measure the influence of physician interaction on patient transport decisions in a prospective model. By conducting this research, the study team hopes to provide evidence-based recommendations for EMS protocols regarding patient engagement and refusal management.
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: • Adult patients ≥18 years old in care of Mecklenburg EMS (MEDIC) on an emergency basis (911 call) who wish to refuse transportation to the hospital in whom MEDIC has, via existing processes and decision-making, engaged online medical control EMS Physicians for further guidance Exclusion Criteria: * Patients \<18 years old. * Patient refuses to speak with online medical control EMS Physicians. MEDIC or patient requests to have primary care physician. * Lack of clinical capacity. * Incarcerated population.
Interventions
- BehavioralPhysician Consultation
Every other month will be randomized to either Physician Consultation or Standard of Care. During the months designated for Physician Consultation, direct communication between the patient and a designated physician by phone will be implemented when a patient refuses transport in cases where the EMS clinician feels that physician consultation is warranted for further guidance. The physician will attempt to address patient concerns and provide additional medical advice.
- BehavioralStandard of Care
Every other month will be randomized to either Physician Consultation or Standard of Care. During the months designated for Standard of Care, physician intervention will not be provided. For safety reasons, if physicians or EMS MEDIC clinicians feel that speaking with the patient is important to provide additional clinical benefit, they may do so without hesitation and can override the designated intervention month.
Location
- Atrium Health Carolinas Medical CenterCharlotte, North Carolina