Qualitative development and content validation of the “SPART” model; a focused ethnography study of observable diagnostic and therapeutic activities in the emergency medical services care process

BMC Emergency Medicine

Fokie Cnossen¹  Wolter Paans²  Michel M. R. F. Struys³  Bert Dercksen⁴ 

[1] Faculty of Science and Engineering Artificial Intelligence, Bernoulli Institute, University of Groningen, Nijenborgh 9, 9747AG, Groningen, The Netherlands;Hanze University of Applied Sciences-Nursing Diagnostics and Centre of Expertise Healthy Ageing, Zernikelaan 6, 9747AA, Groningen, the Netherlands;University Medical Centre Groningen-department of anesthesiology/HEMS, Hanzeplein 1, 9713GZ, Groningen, Gn, The Netherlands;Faculty of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, 9713AV, Groningen, The Netherlands;University Medical Centre Groningen-department of anesthesiology/HEMS, Hanzeplein 1, 9713GZ, Groningen, Gn, The Netherlands;UMCG Ambulance Care, Vriezerweg 10, 9482TB, Tynaarlo, Dr, The Netherlands;Faculty of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, 9713AV, Groningen, The Netherlands;

关键词: SPART;    Emergency medical services;    EMS care process;    Paramedic process;    Ambulances;   

DOI  :  10.1186/s12873-021-00526-z

来源: Springer

【 摘 要 】

BackgroundClinical reasoning is a crucial task within the Emergency Medical Services (EMS) care process. Both contextual and cognitive factors make the task susceptible to errors. Understanding the EMS care process’ structure could help identify and address issues that interfere with clinical reasoning. The EMS care process is complex and only basically described.In this research, we aimed to define the different phases of the process and develop an overarching model that can help detect and correct potential error sources, improve clinical reasoning and optimize patient care.MethodsWe conducted a focused ethnography study utilizing non-participant video observations of real-life EMS deployments combined with thematic analysis of peer interviews.After an initial qualitative analysis of 7 video observations, we formulated a tentative conceptual model of the EMS care process. To test and refine this model, we carried out a qualitative, thematic analysis of 28 video-recorded cases. We validated the resulting model by evaluating its recognizability with a peer content analysis utilizing semi-structured interviews.ResultsBased on real-life observations, we were able to define and validate a model covering the distinct phases of an EMS deployment. We have introduced the acronym “SPART” to describe ten different phases: Start, Situation, Prologue, Presentation, Anamnesis, Assessment, Reasoning, Resolution, Treatment, and Transfer.ConclusionsThe “SPART” model describes the EMS care process and helps to understand it. We expect it to facilitate identifying and addressing factors that influence both the care process and the clinical reasoning task embedded in this process.

【 授权许可】

CC BY