Moore L
Department of Emergency Medical Services, International Association of Fire Fighters, Washington, DC, USA.
Prehosp Emerg Care. 1999 Oct-Dec;3(4):325-31. doi: 10.1080/10903129908958963.
In today's health care environment, the demand for objective comparative information about the performance of health care organizations and providers has created a need for data-driven evaluation processes. In response, national organizations and federal agencies have established quality indicators, created tools to measure performance according to those indicators, and issued report cards for individual providers, as well as health care organizations.
Emergency medical services (EMS) systems are no different from other health care systems in the need for objective comparative system information to assist government officials at all levels in establishing relevant policy, selecting appropriate system design, and monitoring system quality and effectiveness. Governmental decision makers, payers, and consumers are demanding objective evidence that they are receiving value and quality for the cost of EMS. EMS systems administrators also require objective feedback about performance that can be used internally to support improvement efforts and externally to demonstrate accountability to the public and other stakeholders. To date, there are few validated indicators of effectiveness and quality in EMS systems. Moreover, most potential indicators have not been studied for use in systemwide evaluation. As a result, there are no universally accepted methods of measurement. The following paper examines traditional efforts to assure quality in EMS systems, while assessing the need to go beyond the traditional to establish measurable indicators of system quality. Valid and measurable indicators will provide a basis for establishing benchmarks of performance. In the future, these benchmarks will facilitate comparisons of a system with itself, as well as with other systems.
在当今的医疗保健环境中，对医疗保健组织和提供者绩效的客观比较信息的需求催生了对数据驱动评估流程的需求。作为回应，国家组织和联邦机构制定了质量指标，创建了根据这些指标衡量绩效的工具，并为个体提供者以及医疗保健组织发布了成绩单。
紧急医疗服务（EMS）系统与其他医疗保健系统并无不同，同样需要客观的比较系统信息，以协助各级政府官员制定相关政策、选择合适的系统设计以及监测系统质量和有效性。政府决策者、付款人和消费者都要求获得客观证据，证明他们在为EMS投入成本后获得了价值和质量。EMS系统管理人员也需要有关绩效的客观反馈，这些反馈可在内部用于支持改进工作，在外部用于向公众和其他利益相关者证明其问责制。迄今为止，EMS系统中几乎没有经过验证的有效性和质量指标。此外，大多数潜在指标尚未针对全系统评估进行研究。因此，不存在普遍接受的测量方法。以下论文审视了确保EMS系统质量的传统努力，同时评估超越传统以建立可衡量的系统质量指标的必要性。有效且可衡量的指标将为建立绩效基准提供基础。未来，这些基准将便于一个系统自身以及与其他系统进行比较。
