Improving Patient Care and Demonstrating Value to our Communities

Two decades ago, the EMS community came together and created a vision for the future of the profession. At the center of the 1996 EMS Agenda for the Future was a system that harnessed the power of technology and information to make decisions based on evidence.

That vision is now being realized thanks to the widespread use of electronic patient care records, the success of the National EMS Information System (NEMSIS) and the shared goal of EMS personnel everywhere to provide high-quality patient care and service to their communities.

EMS Compass represents another critical step on the path toward achieving the goals of the Agenda for the Future. An EMS system’s ability and willingness to measure its performance-and take steps to improve based on those measures-is a sign of the EMS profession’s maturity and growth. We’ve come a long way since the days of “ambulance drivers” and “scoop and run.” There’s no longer any doubt that EMS is an integral member of the healthcare team.

But EMS Compass represents a beginning, not an end. For too long, our profession has relied on theory and assumptions to steer our training and care. The last few decades have brought striking change as EMS embraced evidence-based care, challenging some concepts we’ve held dear since our beginnings but leading to more effective care and better outcomes.

The next step in this evolution is a learning healthcare system, one that measures performance based on the best possible evidence. It’s one thing to develop an evidence base, and another to collect and analyze data. The power of each of those activities, though, is exponentially greater when they are combined.

Without measurement, an EMS system has no way of knowing whether changes, even those based on evidence and best practices, are being implemented correctly or having the intended impact on outcomes.

At the same time, measurement and improvement efforts can be ineffective or even dangerous without supporting evidence. Our history has plenty of examples of how measurement can lead us astray if we focus on the wrong aspects of care.

More than 60 volunteers have put their expertise to work on behalf of EMS Compass. For their work and continuing effort we are grateful. (For a list of the steering committee and working groups, see p. 24.)

What’s Inside

EMS Compass builds upon previous efforts to develop performance measures, but in many ways breaks new ground. The science of improvement, especially within the healthcare community, continues to evolve every day, thanks to behavioral research and the efforts of healthcare organizations across the country and around the world.

Another unique aspect of EMS Compass is its focus not just on the content of the measures, but on the process to design and build consensus around them. The measures development process ensures incorporation of the latest science and the participation of the EMS community. In this supplement, EMS Compass project manager Nick Nudell, a veteran paramedic and technology expert, takes you through the process step by step.

Of course, performance measures are only as good as the data they use. Alisa Williams and Jules Scadden provide us with a great overview of why it’s so critical for information to be entered correctly in patient care reports and other records. Electronic data open up a world of possibilities, but only if we enter the data in a consistent and accurate manner and then share information with EMS practitioners, patients and the communities we serve.

How do you take the idea of performance measurement and apply it to any size and type of EMS agency? Matt McQuisten, Gary Wingrove and Michael Gerber team up to show how performance measures have been used in EMS systems. What’s clear is that data-driven decision-making is possible, but we still have a long way to go.

We all know that EMS Compass isn’t happening within a vacuum. The focus of the initiative is helping EMS systems improve, but data and measures can also help EMS systems demonstrate value to the communities that support them and the patients who use their services. Alex Garza puts EMS Compass into context and talks about why designing measures that improve the effectiveness of EMS systems is so important in a healthcare system that emphasizes value. And we talk to the experts from outside the EMS community who are part of the EMS Compass team on how the initiative fits into the broader picture of healthcare and performance improvement.

Finally, Keith Griffiths discusses the potential that new technologies will bring to data collection and performance measurement. From real-time feedback to integrated patient records, the future of performance improvement looks bright.

Since day one, EMS Compass has strived to be an inclusive, transparent and collaborative effort. We’re grateful for the input and feedback we’ve received from the EMS community and other stakeholders, and we ask for your involvement to ensure that EMS Compass remains true to its vision: a future where the EMS profession embraces a data-driven approach to patient-centered and evidence-based care.

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