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

      review-article
      Author(s): *
      Publication date (Electronic):
      Journal: Emergency Medicine International
      Publisher: Hindawi Publishing Corporation

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          Abstract

          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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          Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. A statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council.

          R Cummins, D Chamberlain, N Abramson … (1991)
          Article 0 comments Cited 270 times – based on 0 reviews     Review now
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            Advanced cardiac life support in out-of-hospital cardiac arrest.

            T Campeau, Christopher Field, Brian Field … (2004)
            The Ontario Prehospital Advanced Life Support (OPALS) Study tested the incremental effect on the rate of survival after out-of-hospital cardiac arrest of adding a program of advanced life support to a program of rapid defibrillation. This multicenter, controlled clinical trial was conducted in 17 cities before and after advanced-life-support programs were instituted and enrolled 5638 patients who had had cardiac arrest outside the hospital. Of those patients, 1391 were enrolled during the rapid-defibrillation phase and 4247 during the subsequent advanced-life-support phase. Paramedics were trained in standard advanced life support, which includes endotracheal intubation and the administration of intravenous drugs. From the rapid-defibrillation phase to the advanced-life-support phase, the rate of admission to a hospital increased significantly (10.9 percent vs. 14.6 percent, P<0.001), but the rate of survival to hospital discharge did not (5.0 percent vs. 5.1 percent, P=0.83). The multivariate odds ratio for survival after advanced life support was 1.1 (95 percent confidence interval, 0.8 to 1.5); after an arrest witnessed by a bystander, 4.4 (95 percent confidence interval, 3.1 to 6.4); after cardiopulmonary resuscitation administered by a bystander, 3.7 (95 percent confidence interval, 2.5 to 5.4); and after rapid defibrillation, 3.4 (95 percent confidence interval, 1.4 to 8.4). There was no improvement in the rate of survival with the use of advanced life support in any subgroup. The addition of advanced-life-support interventions did not improve the rate of survival after out-of-hospital cardiac arrest in a previously optimized emergency-medical-services system of rapid defibrillation. In order to save lives, health care planners should make cardiopulmonary resuscitation by citizens and rapid-defibrillation responses a priority for the resources of emergency-medical-services systems. Copyright 2004 Massachusetts Medical Society
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              Quality of health care. Part 2: measuring quality of care.

              R H Brook, E A McGlynn, P D Cleary (1996)
              Article 0 comments Cited 83 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Med Int
                Journal ID (publisher-id): EMI
                Title: Emergency Medicine International
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-2840
                ISSN (Electronic): 2090-2859
                Publication date (Print): 2012
                Publication date (Electronic): 15 October 2011
                Volume: 2012
                Electronic Location Identifier: 161630
                Affiliations
                EMS and Prehospital Care Program, Department of Emergency Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 110 72020, Lebanon
                Author notes
                *Mazen J. El Sayed: mj_sayed@ 123456hotmail.com

                Academic Editor: Stephen H. Thomas

                Article
                DOI: 10.1155/2012/161630
                PMC ID: 3196253
                PubMed ID: 22046554
                SO-VID: 7bcc7d45-c1c8-4a90-8a1f-715d0cecc0b5
                Copyright © Copyright © 2012 Mazen J. El Sayed.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 8 August 2011
                Date accepted : 15 August 2011
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Emergency medicine & Trauma
                Data availability:
                ScienceOpen disciplines: Emergency medicine & Trauma

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