The PAR and PECC Projects at the UNC-Chapel Hill Department of Emergency Medicine

The Performance Adherence Reports (PAR) Project

The research community of Emergency Medicine has spent considerable time, effort, and money to develop performance measures, educational materials, and guidelines to improve the outcomes of cases concerning ill and critically injured children. However, there is little evidence that these innovations reach the providers and emergency medicine systems in a timely and effective manner. Therefore, the individual patient does not benefit from this effort.

The PAR project sought to resolve this issue by developing an effective and low-cost method for disseminating new pediatric care education to EMS personnel and to build a system for real-time feedback on their resulting performance in the field. The PAR project is a combination of online educational tools, individualized performance feedback reports, and a comprehensive social media platform to encourage the use of both. PAR stands for Performance Adherence Reports, which are the online feedback tools that allow comparisons of performance benchmarks between individual providers, local emergency systems, and statewide standards. For this project, the PARs focused on three main areas of pediatric prehospital care: trauma, sepsis, and respiratory distress.

The PAR project involved eight North Carolina EMS systems, five rural and three urban. Although all of the systems were eager to participate and excited about the idea of accessing pediatric resources and performance feedback, they have reported challenges in keeping EMS personnel motivated to utilize the online courses and continually review their own performance feedback.

These challenges inspired a continuation of this project, titled Pediatric Emergency Care Coordinators (PECC).

The Pediatric Emergency Care Coordinators (PECC) Project

Pediatric Emergency Care Coordinator is an existing but undefined role in North Carolina EMS. This new project seeks to define the PECC role as a combination of pediatric expertise and leadership that is achieved through expanded training and education opportunities, as well as responsibility for the pediatric competence and performance within that PECC’s system. This project will recruit EMS personnel from ten rural North Carolina EMS systems who will serve as PECCs. They will receive comprehensive pediatric education in both in-person and online formats and be trained on how to utilize PARs and improve the pediatric knowledge and performance of personnel in their system. The PECC project seeks to establish sustainable methods of pediatric education, training, and data use within resource-scare EMS systems through a well-defined PECC role. This project will also expand the PAR topic areas beyond the original three, including diabetes, burns, and hypothermia, and expand the educational course offerings to more than twenty total resources.