Quality Indicators for Evaluating Prehospital Emergency Care: A Scoping Review. 2018

Ian Howard, and Peter Cameron, and Lee Wallis, and Maaret Castren, and Veronica Lindstrom
1Department of Clinical Science and Education,Södersjukhuset,Karolinska Institutet,Stockholm,Sweden.

Introduction Historically, the quality and performance of prehospital emergency care (PEC) has been assessed largely based on surrogate, non-clinical endpoints such as response time intervals or other crude measures of care (eg, stakeholder satisfaction). However, advances in Emergency Medical Services (EMS) systems and services world-wide have seen their scope and reach continue to expand. This has dictated that novel measures of performance be implemented to compliment this growth. Significant progress has been made in this area, largely in the form of the development of evidence-informed quality indicators (QIs) of PEC. Problem Quality indicators represent an increasingly popular component of health care quality and performance measurement. However, little is known about the development of QIs in the PEC environment. The purpose of this study was to assess the development and characteristics of PEC-specific QIs in the literature. METHODS A scoping review was conducted through a search of PubMed (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA); EMBase (Elsevier; Amsterdam, Netherlands); CINAHL (EBSCO Information Services; Ipswich, Massachusetts USA); Web of Science (Thomson Reuters; New York, New York USA); and the Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom). To increase the sensitivity of the literature, a search of the grey literature and review of select websites was additionally conducted. Articles were selected that proposed at least one PEC QI and whose aim was to discuss, analyze, or promote quality measurement in the PEC environment. RESULTS The majority of research (n=25 articles) was published within the last decade (68.0%) and largely originated within the USA (68.0%). Delphi and observational methodologies were the most commonly employed for QI development (28.0%). A total of 331 QIs were identified via the article review, with an additional 15 QIs identified via the website review. Of all, 42.8% were categorized as primarily Clinical, with Out-of-Hospital Cardiac Arrest contributing the highest number within this domain (30.4%). Of the QIs categorized as Non-Clinical (57.2%), Time-Based Intervals contributed the greatest number (28.8%). Population on Whom the Data Collection was Constructed made up the most commonly reported QI component (79.8%), followed by a Descriptive Statement (63.6%). Least reported were Timing of Data Collection (12.1%) and Timing of Reporting (12.1%). Pilot testing of the QIs was reported on 34.7% of QIs identified in the review. CONCLUSIONS Overall, there is considerable interest in the understanding and development of PEC quality measurement. However, closer attention to the details and reporting of QIs is required for research of this type to be more easily extrapolated and generalized. Howard I , Cameron P , Wallis L , Castren M , Lindstrom V . Quality indicators for evaluating prehospital emergency care: a scoping review. Prehosp Disaster Med. 2018;33(1):43-52.

UI MeSH Term Description Entries
D008297 Male Males
D011787 Quality of Health Care The levels of excellence which characterize the health service or health care provided based on accepted standards of quality. Pharmacy Audit,Quality of Care,Quality of Healthcare,Audit, Pharmacy,Care Quality,Health Care Quality,Healthcare Quality,Pharmacy Audits
D004632 Emergency Medical Services Services specifically designed, staffed, and equipped for the emergency care of patients. Emergency Care,Emergency Health Services,Emergicenters,Prehospital Emergency Care,Emergency Care, Prehospital,Emergency Services, Medical,Medical Services, Emergency,Services, Emergency Medical,Emergency Health Service,Emergency Medical Service,Emergency Service, Medical,Emergicenter,Health Service, Emergency,Health Services, Emergency,Medical Emergency Service,Medical Emergency Services,Medical Service, Emergency,Service, Emergency Health,Service, Emergency Medical,Service, Medical Emergency,Services, Emergency Health,Services, Medical Emergency
D005260 Female Females
D006302 Health Services Research The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed) Health Care Research,Medical Care Research,Research, Health Services,Action Research,Health Services Evaluation,Healthcare Research,Research, Medical Care,Evaluation, Health Services,Evaluations, Health Services,Health Services Evaluations,Research, Action,Research, Health Care,Research, Healthcare
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D019984 Quality Indicators, Health Care Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care. Global Trigger Tool, Healthcare,Health Metrics,Healthcare Global Trigger Tool,Quality Indicators, Healthcare,Health Metric,Healthcare Quality Indicator,Healthcare Quality Indicators,Indicator, Healthcare Quality,Indicators, Healthcare Quality,Metrics, Health,Quality Indicator, Healthcare
D038622 Internationality The quality or state of relating to or affecting two or more nations. (After Merriam-Webster Collegiate Dictionary, 10th ed) Globalization,International Aspects,International Perspectives,International Relations,Multinational Aspects,Multinational Perspectives,Aspect, International,Aspect, Multinational,Aspects, International,Aspects, Multinational,International Aspect,International Perspective,Multinational Aspect,Multinational Perspective,Perspective, International,Perspective, Multinational,Perspectives, International,Perspectives, Multinational,Relations, International

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