Prioritizing novel and existing ambulance performance measures through expert and lay consensus: A three-stage...

Area of Science:

• Pre-hospital care research
• Healthcare quality improvement
• Ambulance service metrics

Background:

• Current ambulance quality and performance measures, like response times, are insufficient for the evolving scope of pre-hospital care.
• There is a need for updated measures that incorporate both service provider and public perspectives on ambulance service quality.

Purpose of the Study:

• To identify and prioritize new measures for assessing ambulance service quality and performance.
• To ensure these measures reflect the perspectives of various stakeholders, including patients, the public, and healthcare professionals.

Main Methods:

• A three-stage consensus process was employed, including a multistakeholder consensus event, a modified Delphi study, and a patient and public consensus workshop.
• Participants included representatives from ambulance services, patient and public involvement groups, emergency care academics, commissioners, and policymakers.

Main Results:

• Nine key measures/principles were prioritized, focusing on aspects like pain management, patient experience, dispatch accuracy, and patient safety.
• A Delphi study refined measures, with 20 achieving high consensus across three domains, including call prioritization and time to definitive care.
• Patient and public representatives identified six important measures, such as pain reduction and survival rates for treatable conditions.

Conclusions:

• Consensus methods successfully identified a shortlist of ambulance outcome and performance measures valued by clinicians, providers, users, and academics.
• These measures reflect current pre-hospital care and can be used to evaluate pre-hospital quality and performance over time.
• Most identified measures can be calculated using routinely available data, facilitating practical implementation.