Davis E A, Billitier A J
Allegheny General Hospital, Pittsburgh, Pa.
Prehosp Disaster Med. 1993 Apr-Jun;8(2):127-32. doi: 10.1017/s1049023x0004019x.
The concept of the necessity of a good quality assurance (QA) plan for emergency medical services (EMS) is well-accepted; guidelines as how best to achieve this and how current systems operate have have not been defined. The purpose of this study was to survey EMS systems to discover current methods used to perform medical control and QA and to examine whether the existence of an emergency medicine residency affected these components.
A survey was mailed in 1989 to the major teaching hospitals associated with all of the emergency medicine residency programs (n = 79) and all other hospitals with greater than 350 beds within the 50 largest United States metropolitan areas (n = 172). If no response was received, a second request was sent in 1990. The survey consisted of questions concerning four general EMS-QA categories: 1) general information; 2) prospective; 3) immediate; and 4) retrospective medical control.
Completed surveys were received from 78.5% of residency and 50% of non-residency programs. The majority had an emergency medicine physician as medical director (80.1% vs 61.5%, p = .03). While both residency and non-residency hospitals participated in initial public and prehospital personnel education, academic programs were more likely to be involved in continuing medical education (98.2% vs 82.3%, p = .009). On-line (direct) supervision was more likely to be provided by residency institutions (96.4% vs 81.0%, p = .017) which was provided by a physician in 88.3%.(ABSTRACT TRUNCATED AT 250 WORDS)
急诊医疗服务（EMS）需要高质量质量保证（QA）计划这一概念已被广泛接受；但关于如何最好地实现这一目标以及当前系统如何运作的指南尚未明确。本研究的目的是调查EMS系统，以发现当前用于实施医疗控制和QA的方法，并检查急诊医学住院医师培训项目的存在是否会影响这些组成部分。
1989年向与所有急诊医学住院医师培训项目相关的主要教学医院（n = 79）以及美国50个最大都市地区内所有床位超过350张的其他医院（n = 172）邮寄了调查问卷。如果未收到回复，则在1990年再次发出请求。该调查包括有关四个一般EMS-QA类别的问题：1）一般信息；2）前瞻性；3）即时性；4）回顾性医疗控制。
收到了78.5%的住院医师培训项目和50%的非住院医师培训项目的完整调查问卷。大多数项目有急诊医学医生担任医疗主任（80.1%对61.5%，p = 0.03）。虽然住院医师培训医院和非住院医师培训医院都参与了初始公众和院前人员教育，但学术项目更有可能参与继续医学教育（98.2%对82.3%，p = 0.009）。住院医师培训机构更有可能提供在线（直接）监督（96.4%对81.0%，p = 0.017），其中88.3%由医生提供。（摘要截断于250字）
