The urgent need for patients' diagnoses and outcome feedback in Germany's emergency medical services - insights from a web-based survey.

Abstract

Background: German Emergency Medical Services (EMS) face growing scrutiny due to regional disparities in quality of care. It is unclear if and how feedback in general is currently provided to EMS staff in Germany, and whether EMS staff receives feedback on patients' diagnoses and outcomes.

Methods: A web-based survey was conducted from June to August 2024 among physician and non-physician EMS staff, focusing on current feedback reception and the perceived need for feedback systems.

Results: A total of N = 428 EMS professionals participated in the survey. One-third of the participants reported receiving no feedback (n = 136, 31.8%), while over half of those who did, received feedback infrequently (n = 157, 55.5%). Informal feedback was the main source, with 95.4% of respondents desiring official feedback on the confirmed in-hospital diagnosis, e.g., to learn from previous cases. While 57.5% of emergency physicians occasionally or frequently receive information about the further course of treatment for patients after transport to the hospital, this was reported by only 14.3% (advanced emergency medical technicians) to 29.2% (emergency medical technicians) of non-physician EMS staff. More than 85% of the respondents stated that diagnosis feedback would improve the quality of EMS.

Conclusion: Structured feedback mechanisms, essential for quality assurance and improvement, are largely absent for EMS staff in Germany, especially for non-physicians. A strong desire among EMS staff for structured feedback on patients' diagnoses and outcomes was found, which could improve quality of care and staff competence development. However, significant infrastructural and legal barriers persist, hindering the implementation of standardized digital feedback systems within Germany's federalized EMS structure.