Using field hospital simulation to demonstrate changes in completion rates of a UK emergency medical team (EMT) medical record

Objectives
The UK EMT is committed to driving forward the World Health Organisation's (WHO) standards for emergency medical team (EMT) response to sudden onset disasters. Specifically UK EMT have worked on the documentation standards and have designated exercises to focus on this aspect of emergency response.

Methods
Following previous testing and redevelopment, the UK EMT used a medical record during a 2-hour simulation exercise of phase one of a Type II field hospital. One of the main aims of the simulation was to identify any blocks and gaps in medical record use and to review user-friendliness of a single sheet record. Following from this a larger scale 3-day simulation was undertaken, one of the objectives was again to identify both improvements and remaining challenges in documentation practice following some further record redevelopment.

Results
Rate of data capture on the initial single sheet record (which covers the WHO EMT minimum data set) was mostly improved using the redeveloped form when compared to an original static simulation. Screening for safeguarding and disability was definitely improved however remained low which may in part reflect the simulation environment and the way the form passes through the field hospital. For some parameters the first simulation rate of completion was less than 5% and increased more than 10-fold. Therefore either/both the redesign of the form and the emphasis on medical record training may be considered contributory factors.

Conclusion
Emphasis on medical records prior to deployment has permitted the UK EMT to redesign their basic single sheet in response to practitioner input. Subsequently ongoing improvement has been seen in the quality of documentation within the initial single sheet record and remaining deficits are known which permits training to specifically focus on them.