A recent EMSWorld.com article, Man vs. Machine: who won the CIRC trial reminded me of my participation in the trial (not as a patient!) as a paramedic at one of the clinical sites.
1. Research trial gives a group focus. I really enjoyed being part of the research trial. We received quarterly education programs and hands-on practice on the study protocol. We were tested and had to meet specific clinical benchmarks.
2. Focus on improvement after every encounter. After every cardiac arrest the machine data and run report were carefully analyzed by the site coordinator. Then we had a face to face meeting to discuss areas for improvement and what went well. I learned something every time.
3. Machines are really good at repetitive actions that require precision. People are not as good. The Auto Pulse does the same thing every time. It doesn’t get tired. It doesn’t get distracted. It doesn’t complain.
4. Paramedics are better than a machine at seeing the big picture, trouble shooting variation, and applying judgement. When paramedics are asked to perform a repetitive action that requires precision it distracts them from decision making and anticipating the next steps.
5. All change leads to more change. Adding a piece of equipment in the ambulance changes how equipment is stored, checked, deployed, and maintained. Processes need to change with change.
6. New change might be counter to other new change. Mechanical CPR devices have partly been promoted to be used during transport so EMS professionals can stay seated. That is a good change. But there is another good change it counters – not transporting patients in cardiac arrest.
7. Pit crews work. The pit crew process of assigning specific roles under the supervision of a crew leader works. Coupled with checklists and regular practice the pit crew should be able to improve patient encounters.