MEDEST

Clinical Quality

If someone asks why a medical professional deserve to work in a public emergency medical system, despite a degree (as many others in different fields), experience (subjective) and a fist of courses (mostly individually chosen and not institutionally validated) there is nothing objective that demonstrates that this professional was, and still is, eligible for this kind of job in terms of competence.

Certification of clinical quality is something missed in action in the jungle of Health Systems in general and in Emergency Medical Services in particular. 

We have generic admission criteria but no instruments to monitor on a regular basis the adequacy of clinical competence for medical professionals who work in emergency field.

Education

We spread education, giving competences equally distributed to all medical professionals, despite any specific  need.

Cultural needing are not a question of democracy.

They are specific for each person who works in a certain field and are conditioned by different personal attitudes and everyday clinical practice. 

We waste time, money and human resources giving, in large part of cases, unuseful informations to the wrong persons at the wrong time of their working careers. 

Competence

The fact is that we do not have a clear idea of who and which competences are needed to be a good medical emergency professional.

None stated which skills and which clinical practices, in quality and quantity, are needed to achieve a minimum level of competence.

The future?

1. Personal record of clinical competences for every emergency medicine professional.
   • Self-constructed (self-certified) on the base of daily clinical practice  and individually acquired education. Externally and institutionally validated.
2. Specific targeted education based on personal needing.
   • Targeted to complete the personal competence record when both, clinical practice and self-acquired education, are not sufficient or when new clinical instances come into the system
3. Quality assessment.
   • All the professionals who work in the emergency medical system respond to minimum required clinical competency standard. 

A  Rescue Helicopter suffered a fatal crash in L’Aquila, Abruzzo, Italy. Six person died in the crash. Doctor, Nurse, Pilot, HHO, Mountain rescue expert, patient. 

The helicopter crashed during a routine HEMS mission.

The five people of the crew and the patient all died.

When something like that happens the first thought for an HEMS professional is:

IT COULD BE ME!

Then you start to rationalise the situation, mostly in a technical and non emotional way, and arrive at the conclusion:

NEVER WOULD HAPPEN TO ME. 

There are many reason, in my opinion, why we arrive at that. 

We all have family and friends to care about and who take care of us. And we can’t even imagine them devastated by grief.

Our major concern is about patients health and not about our safety. 

And finally, we are humans and human being self-protect their inner fragility, avoiding to hurt themselves thinking about death, especially their own .

But I know, and always will. that IT COULD HAVE BE ME despite any protection and self-lie.

Cause even the 6 persons  who died in the crash had family and friends that now live in a devastating grief.

Even them were taking care of patients over they own safety.

And also them were humans, like me. 

So WAS ME! 

Today a part of me ideally died in that crash.

Tomorrow a new day will begin, but from now on things will look different.