The last year of work has gone into what we will measure. Dr. Remle Crowe and Dr. Tony completed a systematic review of the literature and returned 317 clinical performance measures. The 317 clinical performance measures were reduced to 168 measures after removing duplicates. The third round of surveys is almost complete, and we will have a list of measures that received consensus (or 80% agreement) that the measure is important and rural relevant. From there, 12 new people will look at the list for feasibility and priority. Finally, our 12 subject matter experts will decide on the 5 that we are going to move forward with.
Now this process has been long, but measuring the right things is as important as starting to measure. And the process will not be over then. We will need feedback on how the measures work and if the definition needs to be refined by all of you.
At the Southwest EMS conference, one of the comments was tell us what kinds of things we could be measuring. I would direct people to the NEMSQA measures and ESO EMS Index as a starting point. If you are using ESO EHR, those measures are built into the analytics portion of your EHR. If you are using another software, ask them if they have the NEMSQA measures built in.
But I will not leave you without a little teaser from our North Dakota project. In the first round of survey results, 100% of the participants agreed that these measures are important.
1) Aspirin for patients with suspected cardiac chest pain or STEMI
2) 12-Lead ECG acquisition for patients with suspected cardiac chest pain or STEMI
3) Advance hospital notification (pre-arrival alert) for patients with suspected STEMI
4) Appropriate administration of oxygen for patients with asthma/bronchoconstriction
5) Blood glucose measurement for patients with seizure
6) Stroke assessment recorded for patients with suspected stroke/TIA
7) Blood glucose recorded for patients with suspected stroke/TIA
We are still in the process of deciding which 5 performance measures the Rural EMS Counts project will focus on, but it is never too early to start looking at your agency's data.
As always, thanks for all you do.
Because Rural EMS Counts!
Lindsey B. Narloch
Project Manager
Join us at our monthly townhalls which can be found here.
Email lnarloch@ndemsa.org if you want to be part of an ESO EHR or Stryker HealthEMS user group.
Interested in the national EMS performance measures (NEMSQA)? There is an event happening next week. The invite is below.
Evidence Based Quality Measures - The key to making meaningful improvement
Friday, November 6, 2020
Ask a room full of 20 EMS leaders how they measure response time and you’ll get 25 different answers. Knowing what to measure, how to measure, and why to measure something in EMS is quite a challenge. Several national attempts to build standardized EMS quality measures in the past failed to gain significant momentum or lead to meaningful improvement, but a new effort hopes to succeed where others have struggled.
Join us for the next installment of Conversations that Matter, when facilitator Mike Taigman discusses the next generation of performance measures with Michael Redlener, MD, president of the National EMS Quality Alliance, and Sylvia Verdugo, MD, MPH, FirstWatch’s medical director.
Mike Taigman uses more than four decades of experience to help EMS leaders and field personnel improve the care and service they provide to patients and their communities. Mike is the improvement guide for FirstWatch and a nationally recognized author and speaker. He was the facilitator for the national EMS Agenda 2050 project and teaches improvement science in the Master’s in Healthcare Administration and Interprofessional Leadership program at the University of California San Francisco. He will serve as host and facilitator for Conversations that Matter.
Michael Redlener, MD, FAEMS
Michael Redlener, MD, FAEMS, is an associate professor of emergency medicine at the Icahn School of Medicine at Mount Sinai in New York. Dr. Redlener serves as the associate medical director of the Mount Sinai West Emergency Department and the medical director for EMS quality in the Mount Sinai Health System. He has devoted his professional career to EMS quality improvement, safety and systems of care development and has championed these ideas at a local, regional and national level. In addition to serving as president of the National EMS Quality Alliance (NEMSQA), Dr. Redlener co-founded and co-directs the National Association of EMS Physicians Quality and Safety Course, a year-long course designed to introduce EMS physicians and professionals to the tenets of healthcare improvement science.
Silvia Verdugo, MD, MPH
Before becoming FirstWatch’s medical director, Silvia was chief of HIV and STD Prevention for the State Health Department of Baja California, Mexico. She earned her MD and MPH degrees through a joint program at the Universidad Autónoma de Baja California, Mexico, and the University of California, San Diego. As a volunteer paramedic with the Mexican Red Cross, she experienced the different challenges of care in the field. In her role as full-time medical director, Silvia provides guidance on all clinical issues and during COVID19 has been an invaluable resource to public safety and public health agencies.
Conversations That Matter is a virtual roundtable series hosted by FirstWatch. Held monthly, its goal is to provide compelling, relevant, conversations intended to improve people-centered care using data and the science of quality improvement—it’s not your father’s webinar!
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