Rural Emergency Medical Services Clinicians’ Perceptions and Preferences in Receiving Clinical Feedback From Hospitals: A Qualitative Needs Assessment

Abstract

Objective

Emergency medical services (EMS) clinicians experience dissatisfaction with the quality and quantity of clinical feedback from hospitals. Satisfaction is further diminished by the lack of a standardized systems approach. The purpose of this study was to identify rural clinicians’ perceptions and preferences regarding clinical feedback received from hospitals, the delivery mechanisms, and its impact on their relationships with health care organizations.

Methods

This was a qualitative study focused on EMS clinicians involved in rural prehospital care at a single Midwestern academic medical center. Using a phenomenological framework, semi-structured interviews were conducted with medical directors, service directors, fire captains, air medical personnel, emergency medical responders, emergency medical technicians, advanced emergency medical technicians, and paramedics, all of whom were selected through purposive sampling. Interviews were recorded, transcribed, and independently coded by two trained reviewers.

Results

Twenty participants (11 frontline clinicians and 9 administrative staff members) with a wide range of clinical experience from 14 air and ground EMS agencies were interviewed. Emerging themes included: (1) the value or usefulness of feedback; (2) desired feedback system characteristics; (3) barriers to receiving feedback; (4) utilization and application of feedback; and (5) the feedback’s impact on the relationship with health care organizations. Participants felt that clinical feedback from hospitals was especially important as a method of improving quality of care, though was rarely provided. Professional development was seen as a major benefit of receiving clinical feedback from hospitals.

Conclusion

Our results suggest that consistent clinical feedback provided by hospitals was valued. Establishing a culture of providing organized feedback to practicing rural EMS clinicians is important for professional development and can strengthen the relationships between EMS clinicians and hospitals. These study findings can assist in the development and implementation of a standardized feedback instrument to benefit rural EMS clinicians, patients, and the health care system as a whole.

Acknowledgments

We thank the following individual for their expertise and assistance throughout writing the manuscript: Sydney Krispin, MPH, MA. This manuscript is not being considered for publication elsewhere. Each of the authors meet the criteria for authorship, claims responsibility for the manuscript, and none have conflicts of interest to report. All authors participated in the concept and design, analysis, and interpretation, drafting and revising the manuscript, and approving the submitted manuscript.

Presentation

Abstract presentation at the National Association of EMS Physicians Meeting in January 2023, Tampa, FL.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The University of Iowa Department of Emergency Medicine provided financial support for this study.