A prospective evaluation of the availability and utility of the Ambulance Call Record in the emergency department.
OBJECTIVE
To determine how often the Ambulance Call Record (ACR) was available to emergency department (ED) physicians and whether it contained information that changed the ED management of patients.


METHODS
This was a prospective cohort study of adult patients transported to one of two tertiary care centre EDs. Physicians completed a data collection form for each patient regarding ACR availability and the perceived value of the ACR. This study began shortly after the implementation of a new electronic ACR (eACR) handover process (Round 1). To control for any confounding factors related to this new eACR handover process, the study was repeated 6 months after its implementation (Round 2).


RESULTS
Total of 869 forms were collected: 545 in Round 1, and 324 in Round 2. The ACR was available at first physician assessment for 82 (15.7%) patients in Round 1, and 76 (24.4%) patients in Round 2 (Δ8.7%, 95% CI: 3.1%, 14.5%). The ACR was available at some point during patients' ED stay for 154 (28.9%) patients in Round 1, compared to 111 (34.5%) patients in Round 2 (Δ5.6%, 95% CI: 0.0%, 12.1%). When the ACR was available for a patient (n=265), physicians believed that information in the ACR changed their treatment plan in 76 (28.8%) cases.


CONCLUSIONS
Physicians who review the ACR believe that the ACR contains relevant information that may influence patient management; however, physicians commonly manage patients without reviewing the ACR.
*Southwest Ontario Regional Base Hospital Program,Western University,London,ON.
Natalie
N
Cram
Department of Family and Community Medicine,University of Toronto,Toronto, ON.
Shelley
S
McLeod
*Southwest Ontario Regional Base Hospital Program,Western University,London,ON.
Michael
M
Lewell
*Southwest Ontario Regional Base Hospital Program,Western University,London,ON.
Matthew
M
Davis
D000328:Adult; D000552:Ambulances; D057286:Electronic Health Records; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D009864:Ontario; D062209:Patient Handoff; D011446:Prospective Studies
Ambulance Call Record; Emergency Medical Services; paramedic handover; patient care record