Quality indicators for out-of-hospital emergency medical services: the paramedics' perspective.
OBJECTIVE
Out-of-hospital emergency medical services (EMS) need relevant and measurable indicators of quality. Those front-line workers who provide service directly to the customer are integral to the process of defining quality. The authors' objective was to obtain from paramedics, the front-line workers in the EMS system, their perspective on quality of care.


METHODS
During regularly scheduled education sessions, 102 of the 140 field paramedics from a large municipal EMS system attended a presentation on total quality management. The paramedics were then assigned to focus groups and asked to identify quality indicators and provide recommendations for how they should be measured.


RESULTS
Eighteen different quality indicators were identified. In addition, the paramedics suggested 17 ways to measure these proposed quality indicators.


CONCLUSIONS
From the perspective of the study participants, indicators of the quality of out-of-hospital care differ from many used in traditional EMS quality assurance programs. Future studies should investigate the applicability of these indicators to the total quality management of EMS systems.
Greenberg
M D
MD
Department of Emergency Medicine, University of Pittsburgh, PA, USA.
Garrison
H G
HG
Delbridge
T R
TR
Miller
W R
WR
Mosesso
V N
VN
Roth
R N
RN
Paris
P M
PM
D001291:Attitude of Health Personnel; D004632:Emergency Medical Services / Q000592:standards*; D004634:Emergency Medical Technicians / Q000193:education / Q000523:psychology*; D017144:Focus Groups; D006801:Humans; D010414:Pennsylvania; D019984:Quality Indicators, Health Care / Q000592:standards*; D017749:Total Quality Management; D014504:Urban Health