Quality of work of locum tenens prehospital emergency physicians

Background Since 1 March 2016, the employment of locum tenens physicians became necessary due to the increasing shortage of on-staff prehospital emergency physicians at the emergency medical services in Bad Belzig, Germany. Objective The aim of this retrospective study was to compare the quality of work of on-staff prehospital emergency physicians and locum tenens prehospital emergency physicians by checking the drug and diagnostic matching and the documentation quality. Materials and methods In all, 90 documented treatments of on-staff prehospital emergency physicians and 98 documented treatments of locum tenens prehospital emergency physicians were included. By systematically comparing the drug administration or the preclinical suspected diagnosis to the discharge diagnosis, the drug matching and the diagnostic matching, respectively, were determined after careful examination of the entire course of each patient's case. In addition, the documentation quality was checked in the patient care reports. The results were tested for statistical significance using the chi(2) test. Results The drug matching did not show statistically significant differences between on-staff prehospital emergency physicians and locum tenens prehospital emergency physicians. Overall, there was an incorrect drug application in 28% of cases. The diagnostic matching was not present in 24.5% of cases by on-staff prehospital emergency physicians and in 36% of cases by locum tenens physicians. The NACA score and the GCS were documented more often by on-staff physicians than by locum tenens. Discussion The key quality indicator, namely the correct drug application in the prehospital emergency mission, did not show any difference in the quality of work between on-staff prehospital emergency physicians and locum tenens prehospital emergency physicians. With a share of 28% incorrect drug applications, the question arises as to whether the necessary standards and guidelines were complied with by the emergency physicians.