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About EMS Performance Measures

Resources | History of EMS Performance Measures | FAQs

The ultimate goal of EMS is to provide effective, high-quality healthcare to patients. But without performance measures, EMS providers, executives, and regulators have no way of knowing if they’re achieving those goals.

A consistent set of measures will allow EMS caregivers, managers, and government agencies to monitor performance and improve performance to ensure the best care for patients and the best service to the community.

Performance measures are critical for individuals, organizations, and the community—without them it is difficult to recognize:

  • Whether performance is improving or deteriorating
  • If an implemented change has had the intended impact
  • Whether the cost of a program or piece of equipment is worth the expense

In healthcare, the use of performance measures is not new, but their use has expanded tremendously in the last two decades: by hospitals to improve systems of care, by payers to determine reimbursement rates, and by communities to hold healthcare providers accountable. Having validated, patient-centered performance measures created for the EMS community, by the EMS community, is vital to ensuring that EMS is ready for the future healthcare environment.

Using Available EMS Data

The ability to collect and manage data has spurred the increase in performance measurement. Never before have prehospital providers collected so much information in such a usable way, with electronic patient care reports and computer-aided dispatch systems creating vast databases of clinical and operational information.

The success of the National EMS Information System (NEMSIS) has led to standardized data collection in EMS systems throughout the country. But the next step is to use that data in a standardized way—and that’s what EMS Compass will make possible.

Members of the EMS community, from an individual ambulance service to local, state, and federal agencies, struggle with how to use these enormous quantities of data in a meaningful way. This is where performance measures play a role. For example:

  • an EMS quality improvement officer in a small city in Ohio can track how well his agency compares to the national average with a clinical measure on the treatment of patients with signs and symptoms of a heart attack;
  • an EMS director in rural Montana, knows whether a recent quality improvement and training initiative to reduce the number of medication errors has been successful, and how her agency compares to other rural systems;
  • and an EMS chief in a large city in Texas, who wants to compare billing rates to previous years, can use a standard performance measure to ensure the numbers are calculated the same way every year, and it stays consistent even after she retires.

How a Performance Measure is Created

EMS Compass established a system for creating performance measures based on the principles established by the National Quality Forum (NQF). The NQF is a highly regarded non-profit organization that works to improve healthcare by endorsing performance measures through a consensus-building, evidence-based process.

Through an initial month-long “Call for Measures,” members of the public submitted more than 400 measures to EMS Compass. With input from stakeholders, the EMS Compass leadership prioritized the measures for development. The EMS Compass Measurement Design Group worked to ensure the measures were designed in a way that was feasible to use and consistent with the best science and evidence available.

In order to design measures that were consistent with data being collected by EMS systems today, the Technology Developer Group reviewed the measures and the measures were tested in the field using actual data from EMS agencies. After testing and validation, the measures were approved by the EMS Compass Steering Committee.

The goal of EMS Compass is to establish an ongoing system of measure design, evaluation, implementation, and re-evaluation that lasts well beyond the initial two-year timeline of the initiative.