title: Informing clinical policy decision-making practices in ambulance services.
abstract: OBJECTIVE
  This study aims to identify the processes and frameworks that support an evidence-based approach to clinical policy decision-making practices in ambulance services.
  
  
  METHODS
  This literature review focused on: (i) the setting (pre-hospital); and (ii) the process of evidence translation, for studies published after the year 2000. Searches of Medline, CINAHL and Google were undertaken. Reference lists of eligible publications were searched for relevant articles.
  
  
  RESULTS
  A total of 954 articles were identified. Of these, 20 full text articles were assessed for eligibility and seven full text articles met the inclusion criteria. Three provided detailed descriptions of the evidence-based practice processes used to inform ambulance service protocol or guideline development or review.
  
  
  CONCLUSIONS
  There is little published literature that describes the processes involved, and frameworks required, to inform clinical policy decision making within ambulance services. This review found that processes were iterative and involved collaborations across many internal and external stakeholders. In several jurisdictions, these were coordinated by a dedicated team. Success appears dependent on committed leadership and purposive human and structural resources. Although time consuming, structured processes have been developed in some jurisdictions to assist decision-making processes. Further insight is likely to be obtained from literature published by those from other disciplines.
authors.affiliation: Research, Ambulance Service of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Sandy
authors.initials: S
authors.lastname: Muecke
authors.forename: Nada
authors.initials: N
authors.lastname: Curac
authors.forename: Darryn
authors.initials: D
authors.lastname: Binks
mesh_terms: D000552:Ambulances / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D055416:Evidence-Based Emergency Medicine; D006291:Health Policy; D006801:Humans; D011050:Policy Making
keywords: clinical protocols; emergency medical services; evidence-based practice; guideline; health policy