. 2017 Feb 15;25(1):14.

doi: 10.1186/s13049-017-0362-4.

Developing quality indicators for physician-staffed emergency medical services: a consensus process

Helge Haugland^{1

2

3}, Marius Rehn^{4

5

6}, Pål Klepstad^{7

8}, Andreas Krüger^{4

9

7}; EQUIPE-collaboration group

Collaborators, Affiliations

Collaborators

EQUIPE-collaboration group:
Gry Elise Albrektsen, Peter Anthony Berlac, Geir Sverre Braut, Per Bredmose, Robert Burman, Brian Burns, Alasdair Corfield, Marta Ebbing, Magnus Hjortdahl, Freddy Lippert, Pål Madsen, Per Oretorp, Leif Rognås, Julian Thompson, Oddvar Uleberg, Janne Virta, Wolfgang G Voelckel, Ryan Wubben

Affiliations

¹ Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway. helge.haugland@norskluftambulanse.no.
² Department of Emergency Medicine and Pre-Hospital Services, St. Olavs Hospital, Trondheim, Norway. helge.haugland@norskluftambulanse.no.
³ Department of Circulation and Medical Imaging, Medical Faculty, NTNU, Norwegian University of Science and Technology, Trondheim, Norway. helge.haugland@norskluftambulanse.no.
⁴ Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway.
⁵ Department of Health Studies, University of Stavanger, Stavanger, Norway.
⁶ Division of Emergencies and Critical Care. Department of Anaesthesia, Oslo University Hospital, Oslo, Norway.
⁷ Department of Circulation and Medical Imaging, Medical Faculty, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
⁸ Department of Anaesthesiology and Intensive Care, St. Olav University Hospital, Trondheim, Norway.
⁹ Department of Emergency Medicine and Pre-Hospital Services, St. Olavs Hospital, Trondheim, Norway.

PMID: 28202076
PMCID: PMC5311851
DOI: 10.1186/s13049-017-0362-4

Developing quality indicators for physician-staffed emergency medical services: a consensus process

Helge Haugland et al. Scand J Trauma Resusc Emerg Med. 2017.

. 2017 Feb 15;25(1):14.

doi: 10.1186/s13049-017-0362-4.

Authors

Helge Haugland^{1

2

3}, Marius Rehn^{4

5

6}, Pål Klepstad^{7

8}, Andreas Krüger^{4

9

7}; EQUIPE-collaboration group

Collaborators

EQUIPE-collaboration group:
Gry Elise Albrektsen, Peter Anthony Berlac, Geir Sverre Braut, Per Bredmose, Robert Burman, Brian Burns, Alasdair Corfield, Marta Ebbing, Magnus Hjortdahl, Freddy Lippert, Pål Madsen, Per Oretorp, Leif Rognås, Julian Thompson, Oddvar Uleberg, Janne Virta, Wolfgang G Voelckel, Ryan Wubben

Affiliations

¹ Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway. helge.haugland@norskluftambulanse.no.
² Department of Emergency Medicine and Pre-Hospital Services, St. Olavs Hospital, Trondheim, Norway. helge.haugland@norskluftambulanse.no.
³ Department of Circulation and Medical Imaging, Medical Faculty, NTNU, Norwegian University of Science and Technology, Trondheim, Norway. helge.haugland@norskluftambulanse.no.
⁴ Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway.
⁵ Department of Health Studies, University of Stavanger, Stavanger, Norway.
⁶ Division of Emergencies and Critical Care. Department of Anaesthesia, Oslo University Hospital, Oslo, Norway.
⁷ Department of Circulation and Medical Imaging, Medical Faculty, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
⁸ Department of Anaesthesiology and Intensive Care, St. Olav University Hospital, Trondheim, Norway.
⁹ Department of Emergency Medicine and Pre-Hospital Services, St. Olavs Hospital, Trondheim, Norway.

PMID: 28202076
PMCID: PMC5311851
DOI: 10.1186/s13049-017-0362-4

Abstract

Background: There is increasing interest for quality measurement in health care services; pre-hospital emergency medical services (EMS) included. However, attempts of measuring the quality of physician-staffed EMS (P-EMS) are scarce. The aim of this study was to develop a set of quality indicators for international P-EMS to allow quality improvement initiatives.

Methods: A four-step modified nominal group technique process (expert panel method) was used.

Results: The expert panel reached consensus on 26 quality indicators for P-EMS. Fifteen quality indicators measure quality of P-EMS responses (response-specific quality indicators), whereas eleven quality indicators measure quality of P-EMS system structures (system-specific quality indicators).

Discussion: When measuring quality, the six quality dimensions defined by The Institute of Medicine should be appraised. We argue that this multidimensional approach to quality measurement seems particularly reasonable for services with a highly heterogenic patient population and complex operational contexts, like P-EMS. The quality indicators in this study were developed to represent a broad and comprehensive approach to quality measurement of P-EMS.

Conclusions: The expert panel successfully developed a set of quality indicators for international P-EMS. The quality indicators should be prospectively tested for feasibility, validity and reliability in clinical datasets. The quality indicators should then allow for adjusted quality measurement across different P-EMS systems.

Keywords: Modified nominal group technique; Physician-staffed emergency medical services; Quality indicators.

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Figures

**Fig. 1**
Conceptual framework for multidimensional quality measurement in P-EMS

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Developing quality indicators for physician-staffed emergency medical services: a consensus process

Collaborators

Affiliations

Developing quality indicators for physician-staffed emergency medical services: a consensus process

Authors

Collaborators

Affiliations

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