Performance indicators
Different indicators can be defined to measure the quality of the Emergency Medical System system. Different indices can be used to measure the quality of treatment provided by permanent medical facilities, or to characterize the whole trauma care system.
An unpublished review of evaluation parameters in use by Gitelman et al, included:
- At the EMS Level [34][40]
Type of training that EMS teams receive: BLS (Basic Life Support) versus ALS (Advanced Life Support)
- Type of evacuation to trauma centre: self, regular ambulance, MICU, helicopter
- Time values [52]: arrival at scene, treatment in the field, arrival for definitive treatment in hospital (are they within "the golden hour" rule?)
- Type of field treatment
- Treatment implementation according to protocols, to the extent that protocols exist.
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Performance Measurement of Ambulance Emergency Services - Victoria
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Timeliness
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2003-04
Expected
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2004-05
Outcome
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Emergency response time (code 1)in 50 per cent of cases -metro minutes
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9
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8
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Emergency response time (code 1)in 90 per cent of cases -metro minutes
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14
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13
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Emergency response time (code 1)in 50 per cent of cases -statewide minutes
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9
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9
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Emergency response time (code 1)in 90 per cent of cases -statewide minutes
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15
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15
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At the Hospital Level
- Level of coverage: to what extent do critical patients arrive at trauma centres and not at hospitals of other levels?
- Outcome according to Severity of injuries (ISS) and according to part of body injured and nature of injury (Barel Matrix), with emphasis on head, chest and abdomen injuries
- Performance of specific surgical procedures and evaluation of outcome, comparisons of treatment in specific procedures
- Speed of treatment in the hospital, speed of arrival to Emergency Rooms, extent of work according to protocols.
For outcomes
- Death rate,
- Hospitalisation in Intensive Care Unit
- Total length of hospitalisation.
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