Innovations in Precepting: Electronic Tracking

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Innovations in PreceptingElectronic Tracking

• Kent Brown ACP Program Coordinator
• City of Winnipeg
• Fire Paramedic Service

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Todays Path

• Evolution
• The Program
• Evaluation Relevance
• The Platform
• Costing
• Strengths
• Weaknesses
• Opportunities

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Evolution

• The Past
• Slow and time consuming
• Subjective
• Searchability
• Storage

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The Present

• Portable
• Interface friendly
• User friendly
• Multi-functional

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Impetus

• National Occupational Competency Profile
• Internal technology advances.
• Internal database advances.
• Wired network throughout City of Winnipeg Fire
  Paramedic Service.

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Impetus cont.

• The accreditation process expects programs to
  design evaluation tools that ensure that the
  student's performance of each C and P Specific
  Competency is evaluated against clear competency
  criteria .
• that the evaluation is recorded and signed.
• that there will be documented evidence that
  the student has demonstrated these competencies
  in the required setting

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The Path

• Phase I Internal - vision
• Introduce
• Analyze
• Phase II outsourced - reality
• Alter
• Analyze
• Phase III looking forward
• Build upon

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Phase I

• iPAQ purchases
• Internally developed program
• Initial trial
• Feedback
• Lengthy
• Collation
• Intuitiveness
• Analysis

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The Tyranny of the OR
Good
Fast
Cheap
Please Pick Two
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Stuff

• Hardware
• iPAQ
• Desktop PC
• Database Server
• Software
• Mobile VB Add ons
• DB2

• Internally Developed - contracted
• Precepting program (collection)
• Syncing program
• Analysis program

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Costing

• Hardware
• Database on site
• Desktops on site
• iPAQs 1000 including software
• Software
• 10000 contract with Lynx Software

• Old process
• Manuals 6.35/student

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Current Costing

• iPAQs now 500
• Cost recovery at 6.35 per manual
• 500/6.35 79 students
• Storage savings
• Search time

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Phase II - The Program

• Please excuse our spelling.
• Several courses
• 20 students per course

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Process

• The student is observed at the call.
• Data is entered into the handheld as soon as
  possible after the call.
• The preceptor goes over the data with the student
  citing any insufficiencies that is being entered.
• Both sign off on comments.

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Recording
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Competence involves the demonstration of skills,
knowledge and abilities in accordance with the
following principles

• consistency (the ability to repeat practice
  techniques and outcomes)
• independence (the ability to practice without
  assistance from others)
• timeliness (the ability to practice in a time
  frame that enhances patient safety)
• accuracy (the ability to practice utilizing
  correct techniques and to achieve the intended
  outcomes)
• appropriateness (the ability to practice in
  accordance with clinical standards and protocols
  outlined within the practice jurisdiction)

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• 1 Student had the opportunity, but did not
  demonstrate any of the critical behaviours of the
  specific competency.
• 2 Student demonstrates some or all of the
  critical behaviours with prompting or assistance
  from the instructor
• 3 The student performs safe, medically
  appropriate patient care, demonstrating all
  critical behaviours of the relevant patient care
  protocol or procedure. The provision of care by
  the student is organized, accurate and timely
  without prompting or assistance of the
  instructor.

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• End of the shift the data is downloaded
  electronically at the station and is stored in an
  electronic database

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Process

• Consistency Internally Defined.
• Program analyzes database to ensure consecutive
  3s
• Automatically updates student profile.
• Shares with all iPAQs in system

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Collection and Analysis
iPAQ 1
Desktop PC Site 1
Database
iPAQ 2
Desktop PC Site 2
iPAQ 3
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Data Analysis Student Perspective

• iPAQ recognizes display of consistency of
  competence deletes competency from student
  record.
• Desktop updates at database to collate data
  from all iPAQs

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Data Analysis Program Perspective

• Link to other databases (runsheet)
• Searchability for
• Exposures/likelihoods
• Preceptor participation
• Themes/trends
• Site specifics
• Results have lead to core preceptorship program
  changes.

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Storage

• CD To student Record
• Program Files Master Student Disc
• Backed up on WFPS City Server

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Expansion

• Initial development for Phase 2 approximately
  2-4 months.
• Adding additional educational programs, with
  different competencies, would now require one
  month as platform is in place.

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Strengths

• Perception of increased objectivity.
• Standardization for sign off
• Trackability
• Searchability.
• Immediacy
• Intuitiveness
• Storage

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Weaknesses

• Inservicing/IT/Resistance
• Glitches/IT dependence
• Power supply
• Upload timing
• Outliers
• Firewalls
• Queries not intuitive

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Opportunities

• Other clinical sites
• Database linkages
• Field Quality Assurance
• Operational Documents
• Extension Programs Central Database

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Threats

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Acknowledgements

• Nathan Wiebe
• Software Solution Developer, Lynx Graphics Ltd.
• Deputy Chief Jim Brennan WFPS
• Doug Major QI Officer (ret) - WFPS
• Ross Bale LIIA Paramedic WFPS

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