Background ‘Closing the feedback loop’ is an important part of clinical reflective practice, but case feedback can be difficult for EMS staff to access. Our ‘Paramedic Postbox’ opened in July 2017, enabling paramedics to request case feedback directly from Emergency Department doctors.

Aims

1. To review utilisation of our Postbox

2. To assess user satisfaction and user–reported educational benefits of the feedback

Method

1. The first 12 months of feedback requests were analysed.

2. User satisfaction data was obtained by inviting participation in an online survey (consent was obtained at the time of the feedback requests(s)).

Results There were 148 feedback requests from 60 individuals in the first year. 76% used the Postbox more than once, with 15% using it more than five times. 33/60 Postbox users responded to the user survey, of which 32 had received their requested feedback and completed the questionnaire. All respondents were satisfied with the service (75% excellent, 25% good), would use it again, and recommend it to colleagues. User-reported goals when requesting feedback were to check their pre-hospital diagnosis (67%) or treatment given (39%), ascertain patient outcome (64%), as a specific question (15%) and all of these in 36%.

Two-thirds of users agreed the Postbox had allowed them to reflect on a case or clarify something they were unsure about, and half said they’d learned something new. 42% agreed their ‘practice had changed’ as a result. Free-text comments confirmed the Postbox is encouraging learning and changing behaviour.

Discussion This feedback system is now well established in our ED and has been adopted by multiple other UK Emergency Departments. We are encouraged by the positive reception our Postbox has received, and especially the high rate of repeat use. In time, we hope to identify topics where paramedics feel under-confident, and explore the characteristics of the 15% ‘super-reflectors’.