Electronic field protocols for prehospital care quality improvement in Lithuania: a randomized simulation-based study

Area of Science:

• Prehospital emergency medicine
• Medical simulation
• Cognitive aids in healthcare

Background:

• Prehospital emergency care is complex, necessitating effective decision-support tools.
• Cognitive aids are known to improve provider performance in clinical emergencies.
• Electronic cognitive aids have been under-investigated in prehospital settings.

Purpose of the Study:

• To evaluate the impact of an electronic field protocol (eFP) module on prehospital care providers.
• To assess the eFP module's effect on performance, adherence to the standard of care, and provider satisfaction.
• To investigate the utility of electronic cognitive aids in simulated prehospital environments.

Main Methods:

• A randomized simulation-based study involving 16 prehospital practitioners with over 3 years of experience.
• Twelve simulated scenarios were developed to test various critical prehospital conditions using the eFP module.
• Participants were randomly assigned to use the eFP module or perform without it, with performance and adherence measured against standardized checklists.

Main Results:

• The eFP module significantly improved performance in 10 out of 12 simulated scenarios compared to memory recall alone.
• Adherence to standardized checklists increased substantially from 60% to 85% (p < 0.001) with eFP use.
• Participants reported the eFP module as easy to use and relevant to prehospital clinical practice.

Conclusions:

• The electronic field protocol (eFP) module functions as an effective cognitive aid, enhancing prehospital practitioner performance and adherence to the standard of care.
• Standardized eFPs demonstrate significant potential as a quality improvement strategy in prehospital care.
• The findings support the integration of electronic cognitive aids into prehospital emergency medical services.