National Assessment of Quality Programs in Emergency Medical Services

Area of Science:

• Public Health
• Emergency Medicine
• Healthcare Quality Improvement

Background:

• Clinical quality measurement is crucial for improving Emergency Medical Services (EMS) agency performance.
• Understanding the current landscape of quality improvement (QI) adoption and physician involvement is essential.
• Significant variability exists in QI resources and practices among EMS agencies nationwide.

Purpose of the Study:

• To assess the adoption of clinical quality measurement at the EMS agency level across the United States.
• To identify characteristics of agencies participating in quality measurement and the extent of physician involvement.
• To determine barriers to implementing quality improvement initiatives within EMS.

Main Methods:

• A 46-question national survey was distributed to EMS agencies to collect data on QI practices.
• Data were collected from August to November 2015, with 1,060 complete or near-complete responses.
• Statistical analyses included univariate, bivariate, and multiple logistic regression using SAS 9.3.

Main Results:

• 70.5% of agencies reported dedicated QI personnel, and 62.5% followed clinical metrics.
• Medical director involvement (<5 hours/month for 61.5%) correlated with tracking QI measures.
• Air medical and hospital-based EMS were more likely to track quality measures; rural agencies were less likely.

Conclusions:

• Substantial variation exists in EMS agency QI resources, medical direction, and clinical quality measure adherence.
• Agency type and geographic environment influence the adoption of quality metrics.
• Further research is necessary to understand how this variability impacts patient care outcomes.