Effectiveness of Indirect Medical Oversight on the Quality of Prehospital Emergency Care by Emergency Medical Technicians

Lee, Ju Taek; Park, Sang Hyun; Lee, Chan Hee; Kim, Yung Kap; Lee, Chang Jae; Je, Dong Wook; Ko, Taei; Choe, Michael Sung Pil; Kim, Ok Jun

Abstract

PURPOSE
This study examined the effect of indirect medical oversight on the quality of prehospital emergency care by emergency medical technicians.
METHODS
Indirect medical oversight was applied for a year and 119 rescue run sheets were retrospectively analyzed before and after the program to study the effect of an indirect medical oversight program in one city. The general characteristics of patients who visited hospitals before and after the program were analyzed, along with patient evaluation records, personal data, outbreak patterns, transfer information, direct medical oversight, and emergency medical services (EMS) mobilization reports. In addition, by comparing medical records and the 119 rescue run sheets, changes in the accuracy of 119 rescue run reports, the adequacy of patient classification, and the adequacy of medical direction were analyzed. After gathering these data, statistical analysis was performed and the level of significance was defined as p<0.05.
RESULTS
After executing the indirect medical oversight, there was significant improvement in the accuracy of 119 rescue run sheets (p<0.001) and in the consistency of severity classification in 119 rescue run sheets compared with medical records (p=0.016). The adequacy of direct medical oversight request also showed improvement after the indirect medical oversight took effect (p<0.001). However, there was no statistical significance in prehospital procedures.
CONCLUSION
Indirect medical oversight significantly improved the quality of emergency medical service by emergency medical technicians. However, the further application and improvement of indirect medical oversight programs are required for the development of prehospital emergency medical care.