Evidence-Based Performance Measures for Emergency Medical Services Systems: A Model for Expanded EMS Benchmarking

Myers, Joseph B.; Slovis, Corey M.; Eckstein, Marc; Goodloe, Jeffrey M.; Isaacs, S. Marshal; Loflin, James Randall; Mechem, C. Crawford; Richmond, Neal; Pepe, Paul E.

doi:10.1080/10903120801903793

Cited by 105 publications

(61 citation statements)

References 73 publications

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“…The 15 min time frame was chosen with consideration for average EMS response times and published data regarding survival associations. [9][10][11] Number of EMS personnel on-scene was classified by categories: 0 personnel, 1 or 2 personnel, 3 or 4 personnel, 5 or 6 personnel, 7 or 8 personnel, and >8 personnel.…”

Section: Measurementsmentioning

confidence: 99%

Volume versus outcome: More emergency medical services personnel on-scene and increased survival after out-of-hospital cardiac arrest

et al. 2015

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a b s t r a c tBackground and aim: : The large regional variation in survival after treatment of out-of-hospital cardiac arrest (OHCA) is incompletely explained. Communities respond to OHCA with differing number of emergency medical services (EMS) personnel who respond to the scene. The effect of different numbers of EMS personnel on-scene upon outcomes is unclear. We sought to evaluate the association between number of EMS personnel on-scene and survival after OHCA. Methods: We performed a retrospective review of prospectively collected data on 16,122 EMS-treated OHCA events from December 1, 2005 to May 31, 2007 from a combined population over 21 million people residing in an area of over 33,000 square miles in Canada and the United States. Number of EMS personnel on-scene was defined as the number of EMS personnel who responded to the scene of OHCA within 15 min after 9-1-1 call receipt and prior to patient death or transport away from the scene. Associations with survival to hospital discharge were assessed by using generalized estimating equations to construct multivariable logistic regression models. Results: Compared to a reference number of EMS personnel on-scene of 5 or 6, 7 or 8 EMS personnel onscene was associated with a higher rate of survival to hospital discharge, adjusted odds ratio [OR], 1.35 (95% CI: 1.05, 1.73). There was no significant difference in survival between 5 or 6 personnel on-scene versus fewer. Conclusion: More EMS personnel on-scene within 15 min of 9-1-1 call was associated with improved survival of out-of-hospital cardiac arrest. It is unlikely that this finding was mediated solely by earlier CPR or earlier defibrillation.

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Section: Measurementsmentioning

confidence: 99%

Volume versus outcome: More emergency medical services personnel on-scene and increased survival after out-of-hospital cardiac arrest

et al. 2015

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“…29 A single CPG for respiratory distress could recommend oxygen titrated to relieve hypoxia. It should be at the lower end of the recommended range for patients suspected of COPD, i.e.…”

Section: Discussionmentioning

confidence: 99%

Paramedic Differentiation of Asthma and COPD in the Prehospital Setting Is Difficult

Williams¹,

Finn²,

Fatovich³

et al. 2015

Prehospital Emergency Care

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“…Some research has not been effectively translated into practice, [3][4][5][6][7] whereas in any other areas of EMS, there continues to be few empirical data available. 8 In response, EMS organizations across Canada, including a national association, have identified the development of research as a priority. 9 Several countries have undertaken development of a national research agenda with the goal of advancing EMS research.…”

Section: Ré Sumémentioning

confidence: 99%

The Canadian National EMS Research Agenda: a mixed methods consensus study

Jensen

Bigham

Blanchard

et al. 2013

CJEM

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Introduction: Research is essential for the development of evidence-based emergency medical services (EMS) systems of care. When resources are scarce and gaps in evidence are large, a national agenda may inform the growth of EMS research in Canada. This mixed methods consensus study explores current barriers and existing strengths within Canadian EMS research, provides recommendations, and suggests EMS topics for future study. Methods: Purposeful sampling was employed to invite EMS research stakeholders from various roles across the country. Study phases consisted of 1) baseline interviews of a subsample, 2) roundtable discussion, and 3) an online Delphi survey, in which participants scored each statement for importance. Consensus was defined a priori and met if 80% scored a statement as “important” or “very important.” Results: Fifty-three stakeholders participated, representing researchers (37.7%), EMS administrators (24.6%), clinicians/ providers (20.7%), and educators (17.0%). Participation rates were as follows: interviews, 13 of 13 (100%); roundtable, 47 of 53 (89%); survey round 1, 50 of 53 (94%); survey round 2, 47 of 53 (89%); and survey round 3, 40 of 53 (75%). A total of 141 statements were identified as important: 20 barriers, 54 strengths/opportunities, 31 recommendations, and 36 suggested topics for future research. Like statements were synthesized, resulting in barriers (n 5 10), strengths/opportunities (n 5 24), and recommendations (n 5 19), which were categorized as time, opportunities, and funding; education and mentorship; culture of research and collaboration; structure, process, and outcome of research; EMS and paramedic practice; and the future of the EMS Research Agenda. Conclusions: Consensus-based key messages from this agenda should be considered when designing, funding, and publishing EMS research and will advance EMS research locally, regionally, and nationally.

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Evidence-Based Performance Measures for Emergency Medical Services Systems: A Model for Expanded EMS Benchmarking

Cited by 105 publications

References 73 publications

Volume versus outcome: More emergency medical services personnel on-scene and increased survival after out-of-hospital cardiac arrest

Volume versus outcome: More emergency medical services personnel on-scene and increased survival after out-of-hospital cardiac arrest

Paramedic Differentiation of Asthma and COPD in the Prehospital Setting Is Difficult

The Canadian National EMS Research Agenda: a mixed methods consensus study

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