Developing EMS Quality Assessment Indicators

Dagher, Michel; Lloyd, Robert J.

doi:10.1017/s1049023x00039248

Cited by 8 publications

(4 citation statements)

References 5 publications

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“…Three types of indicators are used to measure quality in patient care: Structure, process and outcome indicators (Table 1) [16–19]. EMS system performance indicators follow the same classification.…”

Section: Ems System Performance Indicators: Structure-process-outcmentioning

confidence: 99%

“…Performance indicators are measurement tools that should be “specific, measurable, action oriented, relevant and timely” [ 15 ]. Three types of indicators are used to measure quality in patient care: Structure, process and outcome indicators ( Table 1 ) [ 16 – 19 ]. EMS system performance indicators follow the same classification.…”

Section: Ems System Performance Indicators: Structure-process-outcmentioning

confidence: 99%

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Measuring Quality in Emergency Medical Services: A Review of Clinical Performance Indicators

Sayed

2012

Emergency Medicine International

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Measuring quality in Emergency Medical Services (EMSs) systems is challenging. This paper reviews the current approaches to measuring quality in health care and EMS with a focus on currently used clinical performance indicators in EMS systems (US and international systems). The different types of performance indicators, the advantages and limitations of each type, and the evidence-based prehospital clinical bundles are discussed. This paper aims at introducing emergency physicians and health care providers to quality initiatives in EMS and serves as a reference for tools that EMS medical directors can use to launch new or modify existing quality control programs in their systems.

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Section: Ems System Performance Indicators: Structure-process-outcmentioning

confidence: 99%

Section: Ems System Performance Indicators: Structure-process-outcmentioning

confidence: 99%

Measuring Quality in Emergency Medical Services: A Review of Clinical Performance Indicators

Sayed

2012

Emergency Medicine International

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“…It is well documented that the timeliness and the quality of care provided by the EMS system has a significant influence on patient outcome. 3 For example, differences in survival after out-of-hospital cardiac arrest across Europe 4 may be explained by medical performance or system design. The provision of care ranges from Basic Life Support by volunteers to full Advanced Life Support by emergency physicians.…”

Section: Comparing Ems Systemsmentioning

confidence: 99%

European Emergency Data Project (EED Project): EMS data-based Health Surveillance System

Krafft¹,

Castrillo-Riesgo

Edwards

et al. 2003

The European Journal of Public Health

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Emergency Medical Services (EMS) constitute a unique component of health care at the interface between primary and hospital care. EMS data within the pre-hospital setting represents an unparalleled source of epidemiological and health care information that have so far been neglected for public health monitoring. The European Emergency Data Project (EED Project) thus intends to identify common indicators for European EMS systems and to evaluate their suitability for integration into a comprehensive public health monitoring strategy. The article provides a brief overview on objectives and methodology in the form of a progress report.

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“…5 Various methods have been developed to better assess EMS including personal computers, 3 5 optically scanned trip sheets, 6 establishment of detailed protocols, 7 peer review, 8 and physician supervision." More comprehensive proposals have involved adapting the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) 10-step model indicators for EMS, 10 and creating an EMS quality assurance (QA) loop. 11 A retrospective review of prehospital care records with a focus on difficult or substandard areas, 1 has been the mainstay of EMS quality assessment.…”

Section: Introductionmentioning

confidence: 99%

The Effect of a Quality Improvement Feedback Loop on Paramedic Skills, Charting, and Behavior

O’Connor

Megargel²

1994

Prehosp. Disaster med.

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Objective:A mechanism was initiated for conveying quality improvement (QI) results to paramedics as a means of improving chart documentation in difficult-to-correct areas. This study examines the impact of this QI feedback loop on charting, resuscitation rates from cardiac arrest, endotracheal intubation (ETI) success rates, and trauma scene times.Design:Paramedic trip sheets were reviewed before and after the institution of the QI feedback hop in this interrupted time series design.Setting:The New Castle County, Delaware, Paramedic Program.Participants:All New Castle County paramedics participated in the study.Interventions:In January 1990, the medical director began to circulate a QI summary among the paramedics in an effort to improve performance and chart documentation. The summary focused on the management of respiratory distress or arrest, cardiac arrest, and major trauma. The success rate for ETI was compared with the rate of field resuscitation from cardiac arrest, the percentage of unjustified prolonged trauma scene times (longer than 10 minutes), and the percent compliance with minimum endotracheal intubation documetation (ETID) requirements from a six-month period before institution of the QI feedback mechanism with data obtained from a six-month period after the program had been operational for one year.Results:Comparing results from before with after the initiation of the QI program, the ETI success rate was 273 of 295 (92.5%) before and 300 of 340 (88.2%) after (X2 = 3.04, p <.1, ns); field resuscitations totaled 26 of 187 (13.9%) before and 44 of 237 (18.6) after (X2 = 1.40, p <.25, ns); ETID rate was 249 of 295 (84.4%) before and 336 of 340 (98.8%) after (X2 = 44.24, p <.001), and unjustified prolonged trauma scene times were 69 of 278 (24.8%) before and seven of 501 (1.4%) after (X2 = 320.5, p <.001).Conclusion:The use of QI feedback had little effect on psychomotor skills such as the ETI success rate or resuscitation rate, but had a dramatic effect on chart documentation, as evidenced by ETID rate, and behavior, as evidenced by the reduction in prolonged trauma scene times. The use of QI feedback is recommended as a means of correcting charting deficiencies or modifying behavior.

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Developing EMS Quality Assessment Indicators

Cited by 8 publications

References 5 publications

Measuring Quality in Emergency Medical Services: A Review of Clinical Performance Indicators

Measuring Quality in Emergency Medical Services: A Review of Clinical Performance Indicators

European Emergency Data Project (EED Project): EMS data-based Health Surveillance System

The Effect of a Quality Improvement Feedback Loop on Paramedic Skills, Charting, and Behavior

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